Emergency departments feeling best-of-breed remorse

By Bernie Monegain
09:22 AM

Best-of-breed software systems may no longer be the way to go for emergency departments, KLAS reports.

An increasing number of hospitals are replacing stand-alone, best-of-breed emergency department software with enterprise solutions that foster better integration, the Orem, Utah-based research firm says in a new report. But, it warns, many of those solutions aren't satisfying ED clinicians.

"Emergency Department Information Systems: Is Best of Breed Still the Best Approach?" offers the opinions of more than 500 providers and includes performance ratings for 18 emergency department information system (EDIS) solutions.

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Among the findings, the report notes, 72 percent of those planning to buy or replace an EDIS are leaving a best-of-breed product in favor of an enterprise offering. At the same time, the report says, ED customers of enterprise vendors Cerner, Eclipsys, McKesson and MEDITECH are having some of the highest levels of buyer's remorse.

"With the exception of Epic, EDIS solutions from the large enterprise vendors consistently score well below the KLAS average for software satisfaction – while five of the top six rated offerings are best-of-breed products," said Steve VanWagenen, KLAS' clinical research director and author of the study. "That gap underscores the challenge many CIOs face in choosing between an ED solution that's an extension of the EMR versus a product more tailored to the needs of clinicians."

Much of the dissatisfaction with enterprise ED solutions comes from a perceived lack of functionality. Clinicians at provider organizations that have moved to Cerner, Eclipsys, McKesson or MEDITECH often report less intuitive and less efficient clinical functionality in those products.

Despite clinician concerns, the KLAS report finds that the percentage of providers planning to leave their best-of-breed vendor is two-and-a-half times higher than it was in 2005. In addition, thanks to the tighter integration between the ED and other modules made possible by enterprise solutions, IT professionals scored enterprise solutions significantly higher than did clinical users. The only exception was McKesson, which scored below average with both groups but actually higher with clinicians.

Of the vendor products included in the KLAS report, Wellsoft EDIS was the top-rated product – a position it has held in the last three KLAS ED performance studies – with a score of 89.9 out of 100. It was followed by Epic ASAP ED (86.5), and Allscripts ED and MEDHOST EDMS (both at 85.3). Other vendors rated in the report are Cerner, CMR, Eclipsys, EDIMS, Emergisoft, EmpowER, LOGICARE, McKesson, MEDITECH (two products), PCTS, Picis, Poseidon Group and T-System.

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