Focus on helping doctors use its ambulatory electronic health record software pays off for EHR upstart Athenahealth in KLAS Research survey.
As for why all of the hospital information system vendors except for Epic did poorly in the survey, she noted that they'd started out behind on the ambulatory side and are still trying to catch up. That's actually not quite true of Allscripts, which began as an ambulatory vendor and later bought in-patient EHR vendor Eclypsis.
Recently, she noted, Cerner and Meditech decided to ditch their old ambulatory-care EHRs, which weren't working well for most customers, and build entirely new systems. Cerner's new model is pretty good, she said, but isn't well known yet in the industry. Meditech's new entry won't be on the market for another year, she added.
Overall, she said, the usability of EHRs has been slow to improve. "One of the downsides of Meaningful Use has been the lack of progress across the board on usability. There's hasn't been progress anywhere, unless somebody is doing a new rebuild [of their EHR]," she noted.
EHRs from the major vendors tend to be poorly suited for specialists, she said, a point also made in the KLAS survey, which showed significant percentages of specialists were unhappy with the usability of their systems. The vendors need to overhaul their software entirely to fit the workflow of those specialties, she said, but they're not likely to do that soon. The "easy fix" is to integrate voice recognition with the EHRs and let specialists dictate into boxes for the subjective, objective, assessment and plan parts of the patient exam, she said.
Evan Steele, president of SRS Software, an EHR vendor that was not rated in the KLAS survey, agreed that specialists have received short shrift. As a result, primary care doctors are generally happier with their EHRs than specialists, and some specialists such as ob/gyns are happier than others, such as orthopods and ophthalmologists.
Asked whether the KLAS survey was representative, as it focused on large practices, Steele said that a recent SRS survey about physician satisfaction with EHRs found that practice size was not correlated with whether doctors would recommend their system to a friend. So he doesn't think it makes any difference.
However, he said, the small sample size of the KLAS survey might have led to some skewing of the results. "With 163 groups and nine vendors, there are 17 to 18 data points per vendor, so you can get a lot of variability. You might get three doctors that love the Athena interface, and that drives their score. With 150 to 200 practices [per vendor], you're not going to get that variability and volatility."