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Nurse Satisfaction With EHRs Rises Dramatically, But Problems Remain

Posted on May 18, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

In the past, nurses despised EHRs as much as doctors did – perhaps even more. In fact, in mid-2014, 92% of nurses surveyed weren’t satisfied with the EHR they used, according to a study by Black Book Research. But things have changed a lot since then, Black Book says. The following data is focused largely on hospital-based nursing, but I think many of these data points are relevant to medical practices too.

Despite their previous antipathy to EHR’s, as of Q2 2018, 96% of nurses told Black Book that they wouldn’t want to go back to using paper records. That score is up 24% since 2016, the research firm reports.

Part of the reason the nurses are happier is that they feel they’re getting the technical support they need. Eighty-eight percent of responding nurses said that their IT departments and administrators were responding quickly when they asked for EHR changes, as compared with 30% in 2016.

On the other hand, the study also noted that when hospitals outsource the EHR helpdesk, nurses don’t always like the experience. Twenty-one percent said their experience with the EHR’s call center didn’t meet their expectations for communication skills and product knowledge. On the other hand, that’s a huge improvement from 88% in 2016.

Not only that, RNs are eager to improve their EHR skillsets. Most nurses are now glad that they are skilled at using at least one EHR, and 65% believe that persons who are skilled at working with multiple systems are seen as highly-desirable job candidates by health systems.

Providers’ choice of EHR can be an advantage for some in attracting top dressing talented. Apparently, RNs are beginning to choose job openings for the EHR product and vendor the provider uses as an indication of how the working environment may be than the provider itself. Eighty percent of job-seeking RNs reported that the reputation of the hospital’s EHR system is one of the top three considerations impacting where they choose to work.

That being said, there are still some IT issues that concern nurses. Eighty-two percent of nurses in inpatient facilities said they don’t have computers in each room or handheld/mobile devices they can use to access the EHR. That number is down from 93% in 2016, but still high.

These statistics should be of great interest to both hospitals and physicians. Obviously, hospitals have an institutional interest in knowing how nurses feel about their EHR platform and how they supported. Meanwhile, while most average size practices don’t address the same IT issues faced by hospitals, it benefits them to know what their nurses are looking for in a system. There’s much to think about here.

Cloud-Based EHRs With Analytics Options Popular With Larger Physician Groups

Posted on April 20, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Ever wonder what large medical practices want from the EHRs these days? According to one study, the answer is “cloud-based systems with all the bells and whistles.”

Black Book Research just completed a six-month client satisfaction poll questioning members of large practices about their EHR preferences. The survey collected data from roughly 19,000 EHR users.

According to the survey, 30% of practices with more than 11 clinicians expect to replace their current EHR by 2021, primarily because they want a more customizable system. It’s not clear whether they are sure yet which vendors offer the best customization options, though it’s likely we’ll hear more about this soon enough.

Among groups planning an EHR replacement, what appealed to them most (with 93% ranking it as their preferred option) was cloud-based mobile solutions offering an array of analytical options. They’re looking for on-demand data and actionable insights into financial performance, compliance tracking and tools to manage contractual quality goals. Other popular features included telehealth/virtual support (87%) and speech recognition solutions for hands-free data entry (82%).

Among those practices that weren’t prepared for an EHR replacement, it seems that some are waiting to see how internal changes within Practice Fusion and eClinicalWorks play out. That’s not surprising given that both vendors boasted an over 93% customer loyalty level for Q1 2018.

The picture for practices with less than six or fewer physicians is considerably different, which shouldn’t surprise anybody given their lack of capital and staff time.  In many cases, these smaller practices haven’t optimized the EHRs they have in place, with many failing to use secure messaging, decision support and electronic data sharing or leverage tools that increase patient engagement.

Large practices and smaller ones do have a few things in common. Ninety-three percent of all sized medical and surgical practices using an installed, functional EHR system are using three basic EHR tools either frequently or always, specifically data repositories, order entry and results review.

On the other hand, few small to midsize groups use advanced features such as electronic messaging, clinical decision support, data sharing, patient engagement tools or interoperability support. Again, this is a world apart from the higher-end IT options the larger practices crave.

For the time being, the smaller practices may be able to hold their own. That being said, other surveys by Black Book suggest that the less-digitalized practices won’t be able to stay that way for long, at least if they want to keep the practice thriving.

A related 2018 Black Book survey of healthcare consumers concluded that 91% of patients under 50 prefer to work with digitally-based practices, especially practices that offer conductivity with other providers and modern portals giving them easy access to the health data via both phones and other devices.

Specialty-Focused EHRs Re-Entering The Picture

Posted on June 6, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Over time, I’ve read a great deal on whether specialist clinicians should invest in EHRs designed for their area of practice or not. One school of thought seems to be that specialists can do just fine by buying broadly-based systems and implementing practice-specific templates, a move which also offers them a longer list of EHRs from which they can choose. Another, meanwhile, is that EHRs designed for use by all clinicians can undercut practice efficiency by forcing specialist workflow into a one-size-fits-all straightjacket.

But the arguments in favor of specialized EHRs seem to be taking hold of late. According to the latest data from Black Book, specialist surgical and medical practices have been switching over to specialty-driven EHRs in overwhelming numbers during the first half of this year. Its researchers found that during the first and second quarter of 2016, 86% of the 11,300 specialty practices it surveyed were in favor of switching from generalist to specialist EHRs.

According to the research firm, 93% of specialists surveyed felt that templates available in specialty EHRs offered a substantial benefit to patients who needed individualized documentation, especially in practices that see a high volume of predictable diagnoses.

If that’s the case, why did so many specialists start out with generalized EHRs?  Eighty-nine percent of respondents said that they bought the non-specialist EHR they had because they were focused on meeting Meaningful Use deadlines, which left them too little time to vet their original EHR vendor sufficiently.

Lately, however, specialist practices have decided that generic EHRs just aren’t workable, Black Book found. Nearly all respondents (92%) said that given their workflow needs, they could not afford to spend time need to shape all-purpose systems to their needs. When they switched over to purchasing a specialty-driven EHR, on the other hand, specialists found it much easier to support ultra-specific practice needs and generate revenue, Black Book reported.

That being said, specialists also switched from generalized EHRs to practice-specific systems for reasons other than clinical efficiency. Black Book found that 29% of specialists make the change because they felt their current, generic EHR was not achieving market success, raising the possibility that the vendor would not be able to support their growth and might not even be stable enough to trust.

Specialists may also be switching over because the systems serving their clinical niche have improved. Black Book researchers note that back in 2010, 80% of specialist physicians felt that specialized EHRs were not configurable or flexible enough to meet their needs. So it’s no surprise that they chose to go to with more robust multi-use and primary care systems, argues Black Book’s Doug Brown.

Now, however, specialized EHRs perform much better, it seems. In particular, improvements in implementations, updates, usability and customization have boosted satisfaction of specialist EHRs from 13% meeting or exceeding expectations in 2012 to 84% in the second quarter of 2016.

Still, practices that buy specialty EHRs do make some significant trade-offs, researchers said. Specifically, 88% of specialists said they were concerned about a lack of interoperability with other providers, particularly inpatient facilities. Respondents reported that specialty-specific EHRs aren’t fitting well within hospital network and regional health information exchanges, imposing a considerable disadvantage over large multispecialty EHRs.

And not surprisingly, investing in a replacement specialty EHR has proven to be a financial burden for specialist practices, Black Book concluded. Forty-eight percent of all specialty practices switching EHRs between June 2014 and April 2016 said that making such investment has put the practice in an unstable financial position, the research firm found.

My general sense from reading this research is that specialist practices have good reasons to replace their generalized EHR with a specialist EHR these days, as such products appear to have matured greatly in recent years. However, these practices had better be ready to deploy their new systems quickly and effectively, or the financial problems they’ll inherit will outweigh the benefits of the switchover.