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EHR Usability, Functionality Top Concerns for Half of Hospitals

By Jennifer Bresnick

- Community hospitals continue to struggle to get their electronic health records to work and communicate the way they need them to, according to a new report from peer60, with EHR usability, limited functionality, and poor interoperability driving nearly 20 percent of survey respondents into a search for a replacement EHR. 

EHR usability and interoperability

In an era of healthcare that requires organizations to master the complex process of creating EHR documentation that is accurate, comprehensive, easy to exchange, and simple to integrate into a patient’s longitudinal health record, the fact that 54 percent of hospitals are unhappy with the usability of their EHRs is sadly telling of a difficult marketplace.

Demand for intuitive, productivity-boosting electronic health records continues to be high as hospitals push deeper into Stage 2 meaningful use and stare down the barrel at the high thresholds included in the proposed criteria for Stage 3.  While more than half of the 277 community hospitals participating in the poll said they had successfully attested to the second phase of the EHR Incentive Programs, and a further 36 percent are in the process of attesting, hospitals across the spectrum continue to face a number of fundamental problems with their EHRs.

At the top of that list are EHR usability and functionality, both of which are critical for hospitals that hope to develop robust health information exchange networks with their business partners and peers.  Without an EHR that makes sense from a clinical point of view, users will have difficulty integrating external patient data into their workflows, and may suffer from communication bottlenecks.

Nearly thirty percent of respondents said that their current EHRs do not support their strategic objectives.  With seven percent of community hospitals undergoing mergers and acquisitions, being unable to have faith in the strength and flexibility of health IT infrastructure can have immediate impacts on organizational goals, including the ability to conduct health information exchange with newly acquired entities.

Of the 20 percent of hospitals so frustrated with their EHRs that they are considering replacement, many may turn to more nimble and adaptable cloud-based products, predicts a recent unrelated poll conducted by Black Book Rankings.  Small practices are especially likely to take advantage of the benefits of the cloud, which include cheaper installation costs, quicker upgrades, and greater interoperability with other providers.

“The focus of healthcare technology vendors needs to be on mobile, cloud, and data integration to successfully meet the future demands of the changing healthcare landscape,” said Doug Brown, Managing Partner of Black Book in June. "The bigger issues of interoperability and population health outcomes, quality of care reporting and ICD-10 have framed the third generation EHR vendor, and the majority (69%) of small practices plan to increase their investment in the advancements made by their current cloud-based vendor.”

"The EHR/practice billing vendor's abilities to meet the evolving demands of interoperability, networking, mobile devices, accountable care, patient accessibility, customization for specialty workflow, and reimbursement are the main factors that the replacement mentality and late adoption remain volatile especially among solo and small practices," Brown added.

Despite an interest in cloud-based technologies among smaller providers, server-based EHR products still dominate in the hospital setting.  The peer60 report pins MEDITECH as the current leader, with 28 percent of the market share, followed by McKesson, Cerner, and Healthland Centriq.  Epic Systems, which only has 8 percent of the market share in the report, is firmly on top of the “mind share” among community hospitals.  More than 40 percent of participants think of Epic as a major leader in the space, with Cerner coming in second and MEDITECH taking third place.

The ongoing vibrancy of the EHR replacement market presents lucrative opportunities for these and other vendors.  As interoperability becomes more integral to the function and daily use of EHRs, the high level of dissatisfaction among providers might spur a greater focus on developing workflows that promote health information exchange and care coordination among the vendor community.  

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