New Spike in EHR Replacement Activity Jars Larger Physician Practice Market, 2018 Black Book Survey

Thirty percent of practices with over 11 clinicians expect to replace their current system by 2021 for customization issues

Highly functional, highly customizable integrated EHR, Practice Management, Revenue Cycle Management and ICD10/ Coding products are proving to be the sought after technology solution of choice for groups and clinics with 12 or more practitioners according to the nearly 19,000 total EHR users responding to the six month client satisfaction poll released recently.

Cloud-based mobile solutions for on-demand data with access to practice actionable insight into financial performance, compliance tracking and contractual quality goals received the top interest by groups in the replacement mode (93 percent), followed by Telehealth/Virtual Visit Support (87 percent) and Speech Recognition Solutions for hands-free data entry (82 percent).

Another notable finding is the “wait and see” before replacement posturing of some of the major suppliers of solo physician practice systems in states of change including Practice Fusion and eClinicalWorks, with both claiming over 93 percent customer loyalty positions in Q1 2018.

“Traditionally, its been the smaller and solo practices with the highest dissatisfaction ratings for electronic health record applications but we confirmed also that the smaller the practice, the less likely they are to use advanced IT tools and that is where EHR frustration among small practices is generally focused,” said Doug Brown, managing partner of Black Book.

Eighty-eight percent of small practices of six or less practitioners still aren’t optimizing advanced EHR tools such as patient engagement, secure messaging, decision support and electronic data sharing according to the latest Black Book survey of ambulatory EHR products.

Ninety-three percent of all sized medical and surgical practices with an installed, functional system are using the three basic EHR tools frequently or always: Data Repository, Order Entry and Results Review. “So when we look at apples-to-apples client satisfaction among small practices, it’s about basic functionality experience,” said Brown. “While in large practices, the rating of customer satisfaction is based on that plus a much wider breadth of vendor offerings and client execution from claims management to population health bundled in.”

When it comes to the use of advanced features, namely: Electronic Messaging, Clinical Decision Support, Interoperability, Data Sharing and Patient Engagement, most small to midsized groups, clinics and practices are failing to optimize and/or reap any benefits in 2018.

Q1 2018 Use of Advanced IT Functionalities By Practice Size

Single/Solo Practices
Use Always/Frequently 3%
Use Never/Infrequently 88%

Electronic Messaging
Use Always/Frequently 5%
Use Never/Infrequently 90%

Clinical Decision Support
Use Always/Frequently 6%
Use Never/Infrequently 86%

Interoperability/Record Share
Use Always/Frequently 13%
Use Never/Infrequently 80%

Patient Engagement
Use Always/Frequently 8%
Use Never/Infrequently 84%

Small/Midsize Practices 2-14

Electronic Messaging
Use Always/Frequently 28%
Use Never/Infrequently 62%

Clinical Decision Support
Use Always/Frequently 31%
Use Never/Infrequently 58%

Interoperability/Record Share
Use Always/Frequently 29%
Use Never/Infrequently 59%

Patient Engagement
Use Always/Frequently 36%
Use Never/Infrequently 38%

Large Practices 15+

Electronic Messaging
Use Always/Frequently 82%
Use Never/Infrequently 7%

Clinical Decision Support
Use Always/Frequently 84%
Use Never/Infrequently 6%

Interoperability/Record Share
Use Always/Frequently 64%
Use Never/Infrequently 22%

Patient Engagement
Use Always/Frequently 83%
Use Never/Infrequently 9%

In a related study, Black Book’s 2018 survey of healthcare consumers identified that 91 percent of patients under 50 years old are gravitated toward digitally based practices, particularly those with advanced features, connectivity with other providers and comprehensive portals which give them easy access to managing their health via phones and devices. “The technology expectations of upcoming generations will likely then contribute to the gradual demise of independent, solo physician practices if they do not invest and provide what healthcare consumers clearly want,” said Brown.

The results of the 2018 Black Book Integrated Ambulatory Systems including electronic health records, coding, revenue cycle management and practice management capabilities based on 18 key performance indicators of vendor performance and client experience are announced also:

  • Solo/Single Practice (Medical Specialties): AdvancedMD
  • Solo/Single Practice (Surgical Specialties): Modernizing Medicine
  • 2-5 Physician Practice (All Specialties): NextGen
  • 6-10 Physician Practice (All Specialties): NextGen
  • 11-25 Physician Practice (All Specialties): Epic Systems
  • 26-99 Physician Practices & Networks (All Specialties): Allscripts
  • 100+ Physician Practices & Networks (All Specialties): Epic Systems

Full results are available at Black Book Market Research.

About Black Book
Black Book™, its founders, management and staff do not own or hold any financial interest in any of the vendors covered and encompassed in the surveys it conducts. Black Book reports the results of the collected satisfaction and client experience rankings in publication and to media prior to vendor notification of rating results and does not solicit vendor participation fees, review fees, inclusion or briefing charges and/or vendor collaboration as Black Book polls vendors’ clients.

Since 2000, Black Book™ has polled the vendor satisfaction across over 30 industries in the software and services sectors around the globe. Black Book’s mission is to improve healthcare delivery by expanding the stakeholder’s voice from the front-line employee, IT and financial managers, clinical and nursing staff through the C-suite and board, as well as healthcare consumers.

For methodology, auditing, resources, comprehensive research and ranking data, see Black Book Market Research website.