2015 survey results: Speaking out about EHRs
When we set out to survey Healthcare IT News readers about their electronic health record platforms, we expected they'd have a lot to say. And boy, did they ever.
Our survey was limited to readers who were actively engaged in the management or use of an EHR. After asking them to rate the systems numerically, we posed two open-ended questions: "What do you like best?" and "What would you change?" (EHR vendors with a limited number of user reviews – 12 or fewer – were excluded from our list.)
Most of the nearly 400 people who completed our survey shared their thoughts freely. Many of their replies were detailed, documenting specific problem areas and suggesting lots of ideas for improvement.
Overall, their responses demonstrated a sense of passion about the importance EHRs continue to play in delivering clinical care – and a sincere desire for the systems' continued improvement.
The following offers a flavor of what they had to say about the nine ranking vendors.
Survey respondents liked the fact that their Allscripts EHR "seems pretty stable" and comes "pre-built with many things that other software requires a separate load to accomplish." Others were pleased that "the areas that can be customized are very detailed." In fact, "the customizability of the EHR is outstanding" said one. Another said the technology is "intuitive (and) patient-oriented," while another said, simply, "docs love using it."
But product support drew complaints. "Technical support has improved, but response times are still slow," wrote one user. "Do not like the support model," wrote another. "Both implementation and support services could be much better," wrote a third, complaining about a support structure that had "narrow silos of product knowledge" and lacked a central support function that could help providers tie the applications together.
Cerner got high marks for being "very customizable," with respondents noting the wide variety of solutions available. "I like being able to run my own reports out of Cerner," said one respondent. "Ease of use and interoperability" were appreciated by another. "They have kept up very well with all the new regulations that we have had to comply with," reported a third. The support team also drew praise for their "responsiveness" to questions.
"We are a critical access hospital and rural health clinic," reported one end-user. "One of the biggest selling points, when we chose Cerner, was OneChart. Our patient records from the clinic environment to the hospital environment look and act as one chart. Providers can easily see all the information from both environments. Records can be pulled and provided to care givers at time of transfer from both environments."
Others, however, complained that the EHR is "not very intuitive," and tasks in general require "too many clicks." One suggested "more automation for rote things, especially outbound CCDs for summary of care." Others wrote that the software encourages "over-customization," leading to "unnecessary complexity."
Some respondents liked the "speed at which staff can get trained and start using the product," and there was a general sense of satisfaction with the platform's ease of use and workflow tools. But eClinicalWorks received a number of complaints about its tech support. One wrote that "we are an enterprise client and we consistently find major bugs in their products that go unresolved for months." Not everyone agreed, however, with one respondent referring to "good support."
The wish list from survey respondents' included "ancillary functionality such as behavioral health" and "the ability to open multiple screens without having to close a screen while viewing one patient record." Others would like to see the ability to "customize on the fly… within limits."
Epic enjoyed nearly unanimous praise for access to support. The EHR has "lots of capability" and "fairly good" customer service. But one reader wished for more "modern interface" – in addition to "the ability to have at least minimal interoperability with other applications." The "look and feel is outdated compared to many modern applications that are Web-based and responsive," wrote another.
Data exchange was a common theme. "More interoperability" was a common request.
"It is reliable," wrote one respondent, adding that "documentation alerts have gotten better or more sophisticated." Another liked the "data repository where no information is lost (and) all users have access. Yet another thought the EHR was "user friendly."
Suggestions for improvement? "Decrease the amount of flowsheets," for one. Epic "needs to do a better job" telling "the patient's story," wrote another user, pulling in data "from all disciplines."
Feedback from customers seems not to fall on deaf ears. "They are always making it better," wrote one. Added another: "There are multiple tweaks that we recommend to Epic, but for the most part I find it more flexible than any other EHR I've ever worked with."
Survey takers said GE Healthcare's Centricity Enterprise still had some selling points, particularly with regard to "ease of use" and "interface issues." The technology is "VERY user friendly," wrote one caps lock enthusiast. "Visually, it is fine for users," wrote another respondent.
But as GE starts phasing out its hospital EHR, some are complaining that "vendor support has rapidly withdrawn in the last year." Another customer reports that GE "has not been able to keep up" with functionality for meaningful use." Meanwhile, its CPOE and e-prescribing "are hard to use for all providers" and workflows are "cumbersome." Another user wished for "better support so we don't need to hire third-party clinical consultants."
McKesson got positive comments for reliability and ease of use – "basics are not complicated for staff." Another wrote, "I like the look, the ease of use, the multiple ways to access chart, functionality of the software."
Some wrote that they liked the integration with financial systems, and one noted "ICD-10 conversion was well planned."
Several noted problems with interoperability: it's "difficult to integrate with other systems" and "workflows are complex and difficult to manage interdepartmentally."
The "ability to change things on the fly" was much appreciated by one MEDITECH user. "I can easily change screens and build templates." The system's "ability to bar code blood products and scan labs," was another top feature cited by a respondent. Others pointed to good "customer service and training" and the fact that the EHR was "easy to use, intuitive, easy to troubleshoot."
Others were not happy with the user interface: "Nurses document in one area, physicians in another," wrote one. "There is not a way in the current system to print the 'complete' medical record," wrote another. "We have to go into the modules to print all sections." A third complained that there's "no physician logic available in document," citing "product-based order entry," and the fact that one "can only send and receive CCD in CDA format (no other document types)."
Customers like NextGen's "flexibility," and the way it enables users to "build their own templates and workflows." Its ambulatory is "very intuitive," writes one, and support staff are "good about instruction on what is necessary" for users to meet Stage 2 meaningful use. "They are aggressively in front of regulatory requirements," writes another.
Meanwhile, "access to data within the database is good" and "the content that is delivered by specialty is much better than I have seen with other systems."
But while NextGen "has much of the community health functionality that we need," according to one provider, another wishes the interface with hospital systems – "not good for certain surgical specialties" – was better. Other wishes: "reduce clicks," "less SQL bloat," and " more support for single sign-on."
A year after its acquisition by Cerner, Siemens systems are still in use. Positive comments were related to the cost, which one provider thought was reasonable. Another said "financials are the best aspect." But many survey respondents expressed frustrations in day-to-day use. "Our facility has had to hire outside consultants to try to get the systems to work," one reported.
Another wrote: "Its modules make optimizing all the functionality difficult because organizations don't prioritize efficiencies" such as "automated upload of bedside data pumps" and vitals tracking. "The costs associated with these modules are perceived as nice to have rather than prioritizing efficiency."
See all vendor rankings here: