Skip to main content

Switching EHRs Adds Functionality but Not Always Satisfaction

By Joyce Frieden, News Editor, MedPage Today  
   April 17, 2015

Providers who switch from one electronic health record to another do so to add more functionality, but often it doesn't make them more satisfied, according to a recently published survey. From MedPage Today.

CHICAGO -- Providers who switch from one electronic health record (EHR) to another do so to add more functionality, but often it doesn't make them more satisfied, according to a recently published survey.

"I love my EHR, but I work with a lot of physicians who don't," Kenneth Adler, MD, MMM, a family physician in Tucson, Ariz., said here Thursday at the annual meeting of the Healthcare Information and Management Systems Society. "I bought them an EHR and they still blame me for it."

Adler is medical director of Arizona Community Physicians, a 130-physician practice and also serves as medical editor of Family Practice Management, a journal published by the American Academy of Family Physicians. The magazine did a survey last year of readers who had switched from one EHR to another in 2010 or later; the survey was published in the journal's January/February 2015 issue.

The survey had 438 respondents, but the journal had to eliminate 133 of them because "they couldn't really tell us what EHR they were on," leaving 305 respondents, Adler said.

Of the remaining respondents, about half worked in practices owned by hospitals or health systems, while another 41% worked in physician-owned practices. Nearly one-fourth of respondents -- 24% -- worked in large practices with 100 or more doctors, while 21% were in solo practice, Adler said.

The 305 respondents had bought their previous EHR from one of 73 different EHR companies, but the EHRs they switched to came from one of 43 different firms, indicating consolidation in the marketplace, he noted. In all, 25 EHR systems accounted for 82% of respondents' prior EHRs, but among the new EHRs, 11 systems accounted for 82%.

Despite the consolidation, there was no consistent pattern of physicians changing from one particular system to another; instead, there were 198 different "from-to" pairs, according to Adler. "The most common switch was from Centricity to Epic, but that [combination] only accounted for 6% of switches," he said.

The most common systems physicians switched to were Epic, and Praxis, while the most common systems physicians switched away from were Centricity, and Allscripts, Adler said. One EHR system, eClinical Works, made both top lists: most commonly switched to and most commonly switched away from.

In terms of reasons for switching, 60% switched because they wanted to get added functionality, although the survey didn't ask what type of functionality the respondents hoped to gain. Other popular reasons for switching included helping to achieve meaningful use objectives, getting better usability, finding better support or training, and consolidating multiple EHRs due to practice consolidation.

"Saving money wasn't a big consideration, nor was going to a cloud-based system," which was surprising since cloud-based systems are all the rage now, Adler said.

Overall, the survey found that 59% of respondents said their new EHRs have added functionality, and 57% said their new systems were allowing them to meet meaningful use criteria. However, only 43% said they were glad they made the switch, 42% said they were now getting better support, and 39% said they were happy with their new EHR.

"People who were [more] involved with the switch were generally happy with the switch" -- these were mostly people in solo practices, said Adler. "It's the providers in the larger systems -- where an institution says, for whatever reason, 'We're going to change EHRs' -- who feel disempowered and are most unhappy."

All of the physicians who had switched to one of two particular systems -- Praxis or Amazing Charts -- said they were happy with their new system. On the other hand, the most unhappy respondents were those who had switched to either Allscripts or NextGen, Adler noted.

Overall, most of the questions produced an even split between satisfied and dissatisfied physicians -- for example, there were roughly equal numbers of respondents who felt they were and were not getting better support and training with their new system, he said.

Productivity continued to be an issue with the new systems; only 28% of respondents agreed with the statement, "Our new EHR has improved our productivity," while 49% disagreed, Adler said. Respondents also felt the switch often involved considerable expense, and usability also was still an issue -- not all respondents felt their new system was easier to use.

"Changing an EHR can be a step backwards in loss of ... productivity, [though it] does add useful functionality," Adler said.

He challenged EHR vendors to make their systems more usable. "What I constantly hear complaints about is how many clicks [people] have to make and how much data [they] have to enter; somehow there's got to be a better way."

But Adler also said that providers have a role to play. "A lot of times people aren't happy because they haven't spent a lot of time trying to make [their system] ... work well for them."

From our partners at MedPage Today.

Tagged Under:

Get the latest on healthcare leadership in your inbox.