Half of EHRs Sold Are Replacements

August 13, 2012

August 13, 2012 — Use of electronic health records (EHRs) is snowballing, and so is the number of unhappy users.

Half of EHR systems sold to physician practices are now replacements, up from 30% last year, according to a recent study by research firm KLAS.

The leading reason for switching systems, cited by 44% of practices, is product issues. Service issues (15%) and group consolidation (14%) — such as when a hospital converts newly hired physicians to a new EHR — are a distant second and third.

Other reasons include unmet expectations, concerns about the ability of the product to qualify for federal "meaningful use" bonuses, and a desire to have a single vendor for all practice software, including that for billing and scheduling, according to the study, titled "Ambulatory EMR 2012: Market Splitting Under Adoption Pressure."

Among practices of 1 to 10 physicians that are buying EHRs, also called electronic medical records (EMRs), 60% are entering the market for the first time. In contrast, replacements account for roughly two thirds of EHR purchases among larger groups.

First-time buyers, particularly smaller practices, make cost a top priority, in contrast with replacement buyers, who worry more about finding "a proven vendor that has a solid reputation," writes study author Mark Wagner, the senior director of clinical and ambulatory research at KLAS.

Allscripts, GE Healthcare, and McKesson top the list of those whose EHR systems are most likely to be replaced for all practice sizes, according to the KLAS study, which was published in June. Wagner writes that these 3 vendors are struggling to keep up with product development and customer support while they attempt to sell to first-time buyers.

Although Allscripts accounts for 19% of all replaced systems, it still is a candidate in 31% of all purchases, winning 8% of the time among first-time buyers and 11% among replacement buyers.

EclinicalWorks, Epic Systems, and Greenway Medical Technologies are the EHR vendors receiving the most looks from replacement buyers.

Physicians Hired by Hospitals May Lose Beloved Software

The spike in replacement EHRs reported by KLAS seems to clash with a recent report on EHR use from the Centers for Disease Control and Prevention (CDC). The CDC found that 55% of physicians had an EHR system in 2011, and of these, 85% said they were either somewhat or very satisfied with the technology.

The 2 studies are not exactly comparing apples to apples, however. The CDC surveyed only physicians, whereas most of the people polled by KLAS were nonphysicians. This difference in methodology may explain why the CDC study paints a rosier picture of the EHR world.

In addition, physician satisfaction may have nothing to do with the third-leading reason for replacement purchases: group consolidation. When hospitals acquire a practice that already has an EHR, they tend to switch the practice to the hospital's system, Wagner told Medscape Medical News. "It doesn't matter if the physicians love their EHR."

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