Large practices happier with EHRs than small ones

'A measureable shift in loyalty to vendors that offered a robust, core EHR'
By Mike Miliard
11:02 AM
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Contrary to a spate of recent surveys and studies that show rising physician aggravation with EHR systems, another new poll shows majorities of large practices commending "enhancements in functionality, service and innovation" of leading vendors.

More than two-thirds of physician practices with more than 25 clinicians surveyed by Black Book Rankings – multispecialty clinics, IPAs, large group practices – applauded the usability of their EHRs in the second quarter of  2015.  

Black Book surveyed the clients of EHR vendors with the highest scores in customer experience in the areas of document management, productivity, practice administration, reporting, interoperability, order entry and decision support.

[See also: Ambulatory IT shows 'adverse impacts on workflow']

It found an uptick in physician experience across the large practice and clinic sector, compared with results since it first began measuring EHR satisfaction.

Back in 2013, for instance, a whopping 92 percent of multispecialty groups using EHRs were "very dissatisfied" with the ability of their systems to improve clinical workload, documentation and user functionalities.

This year, however, 71 percent of large practice clinicians said their optimization expectations of "top ranked" vendors were being met or exceeded.

Those high-scoring vendors focused on the large group practices: Allscripts, Greenway, McKesson and athenahealth.

Black Book shows huge recent leaps in satisfaction among the more than 1,300 large practices surveyed.

Ratings for physician experience satisfaction jumped from 8 percent in 2013 to 31 percent in 2014 – and to 67 percent in 2015.


For the same time periods, appreciation for physician documentation improvements increased from from 10 percent to 28 percent to 63 percent. Scores for practice productivity enhancements leapt from 7 percent to 17 percent to 68 percent.

[See also: Doctors like EHRs even less than they did five years ago]

One reason might be that consumers have become much more discerning, and are making smarter choices about better products.

"Meaningful use deadlines, total integration and reliable delivery may have influenced large group practice buyers to purchase initial EHRs from 2010 through 2013, but replacement buyers sought better EHR tools in 2014 that include patient engagement, true interoperability, enhanced usability and productivity gains," said Doug Brown, managing partner of Black Book, in a press statement.

"There was also a measureable shift in loyalty to vendors that offered a robust, core EHR to accommodate evolving reforms," he added.

Based on the aggregate client experience and customer satisfaction scores on 18 key performance indicators, Allscripts was the top scorer across all surveyed EHRs for large practice categories of 26-99 physicians, and 100-plus physicians, according to Black Book.

This is the second consecutive year Allscripts has achieved the top ranking for 100-plus physician groups including independent practice associations, multispecialty clinics, academic practices, and large group clinics.

Allscripts also ranked in the top spot for 26-99 physician group satisfaction for the first time, according to Black Book – surpassing Epic, eClinicalworks and QSI NextGen, which have occupied the top spots in recent years.

Other findings from the survey:

  • Clinics and large practices implementing an original EHR prior to Q4 2012 were the most dissatisfied (71 percent) with their EHR vendor's performance in 2015.
  • 62 percent of primary care and medical specialists in large group practices report a return to normal levels of productivity after rolling out their EHR systems.
  • 53 percent of surgical specialists in large group practices reported productivity enhancements over 2014.
  • 18 percent of those large practices and clinics surveyed by Black Book are in the discussion or execution stages of replacing their original EHR by the end of 2016.

"EHR firms with a wide offering of products including health information exchange, population health tools, revenue cycle management services, patient portals, dashboards and analytics are emerging as the next wave of healthcare technology leaders," said Brown.

"These leading vendors are assisting their clients in assessing current practice operations to meet the demands of ICD-10, payment reform, connectivity beyond closed networks, revenue cycle management gaps, and population health tools, and recommending effective options within the same vendor suite," he said.