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SWITCHING EHRS:A National Survey of Physician UsersApril 15, 2015Kennneth Adler, MD & Robert EdsallDISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

Conflict of InterestKenneth Adler, MD and Robert EdsallHave no real or apparent conflicts of interest to report. HIMSS 2015

Learning ObjectivesWHY: Identify the factors that lead to an EHR switchHOW: Explain the challenges involved in an EHRswitchWHAT: Analyze the outcomes of making an EHRswitch

STEPSS: Satisfaction Provider satisfactionT: Treatment / Clinical Quality / Efficiency / SafetyS: Savings Efficiency savingshttp://www.himss.org/ValueSuite

A new survey of nearly 17,000 activeelectronic health records (EHR) systemusers found that about 23% of currentlyimplemented physician practices arefrustrated enough to consider switchingvendors.Medical Economics reporting on Black BookMarket Research - Feb 2013

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EHR Switch Survey Open only to members of the AAFP July-Sep 2014 Requirement: Practice changed from one EHR toanother after January 1, 2010 438 respondents 133 eliminated leaving 305 respondents– 13 changed from paper to EHR– 9 changed EHRs because they changedpractices– 111 didn’t name an identifiable EHR Survey published in Family Practice ManagementJanuary 2015

Respondents’ Practice Types Family Physicians 50% work in hospital or health system ownedpractices 41% work in physician owned practices 24% in practices with 100 physicians 21% in solo practice 50/50: 10 physician / 10 physician practices

Switched from What to What? 305 respondents 73 previous EHRs 41 current EHRs 25 systems accounted for 82% of prior EHRs 11 systems accounted for 82% of current EHRs 198 “from-to” pairs Most common switch – Centricity to EPIC(17/305 6% of switches)

Before Centricity EMR 30 eClinicalWorks 27 Allscripts Professsional 22 NextGen 22 Practice Partner 18 Misys 14 Allscripts Touchworks 13 athenaClinicals 11 EPIC 11 SOAPware 10 Proprietary systems 8 eMDs 8 Cerner PowerChart/Works 7 Practice Fusion 7 Allscripts MyWay 6 Amazing Charts 6 ChartConnect 6 Horizon Ambulatory Care 5 McKesson Practice Complete 4 Praxis 4 MPM / Meditech 3After EPIC 74Praxis 30eClinicalWorks 34athenaClinicals 17Practice Fusion 12Amazing Charts 11e-MDs 9Allscripts Touchworks 13Allscripts Professional 18NextGen 18Cerner PowerChart/Works 15(63)(26)(7)(6)(5)(5)(1)(0)(-4)(-4)(-8)

Why Did They Switch ?

Reasons for the Switch“Administration of the big system mandatedwe change from NextGen to Allscripts, and intwo months we will be moving to Athena,mandated by the giant mothership we areowned by now.”

How Hard Was the Switch ?

Outcome: Was the Switch Worthwhile ?

Outcome: Physician Satisfaction

Outcome: Physician Productivity“Our new EHR has improved our productivity.”Agreed 28%Disagreed 49%

Study Conclusions EHR market is consolidating Most common reason to change is toadd needed functionality Other important reasons to change:MU, vendor inadequacies, softwareusability System integrations are forcing changes

Study Conclusions Changing EHRs is a major undertaking:expensive and time-consuming Changing an EHR can be a stepbackwards in data retention and productivity Changing an EHR DOES add usefulfunctionality and helps with achieving MU Changing an EHR DOES NOT makephysicians happier or lead consistently tobetter overall EHR performance

Further Thoughts Is it a software problem or animplementation problem ? “The grass is always greener whereyou water it. “

References The FPM Survey of Family Physicians WhoHave Changed EHR Systems - Adler/Edsall– July-August 2014http://www.aafp.org/fpm/2014/0700/p18.html EHR Switch Survey: Responses from 305Family Physicians - Edsall/Adler– January-February 2015http://www.aafp.org/fpm/2015/0100/p13.html

Discussion Questions Why did you switch ? What were your largest challenges ? What have been the biggest pros ofthe switch ?

Discussion Questions What have been the biggest cons ofthe switch ? Do you expect continued EHR marketconsolidation ? What will be the future drivers of EHRswitches ?

Questions?Contact:Kenneth Adler, MDRobert EdsallFamily Practice [email protected]

Cerner PowerChart/Works 15 (-8) Centricity EMR 30 eClinicalWorks 27 Allscripts Professsional 22 NextGen 22 Practice Partner 18 Misys 14 Allscripts Touchworks 13 athenaClinicals 11 EPIC 11 SOAPware 10 Proprietary systems 8 8 Cerne