Evaluating Enterprise EMR Vendors in the Patient Access Market - Cover

Evaluating Enterprise EMR Vendors in the Patient Access Market

For healthcare organizations, collecting accurate data at the front end of the patient journey is critical. Accurate data helps ensure a more efficient and effective patient experience and significantly increases the chances of healthcare organizations billing and collecting correctly. On the flip side, inaccurate data drives up healthcare costs, as finding correct data is both time consuming and redundant. One of the factors that greatly affects the accuracy of patient data is patient access functionality.

According to KLAS’ definition, patient access includes address verification, cost estimates, coverage discovery, eligibility verification, medical necessity, prior authorizations, propensity to pay, registration QA, and scheduling. (While patient access is closely related to other areas like patient experience improvement, patient financial engagement, and patient intake management, KLAS does not include these areas in our definition of patient access.)

Historically, provider organizations have supplemented their enterprise EMR vendor’s native patient access functionality with a third-party vendor’s functionality. To shine a light on how enterprise EMR vendors are doing in this space, we recently published our Patient Access 2021 report, which shares organizations’ perceptions of how well positioned their enterprise EMR vendors are to deliver patient access functionality traditionally offered by third parties.

Organizations Are Interested in Consolidating

While organizations have often turned to third-party vendors for patient access functionality, many want to save money and increase organization efficiency by consolidating. It can be frustrating for organizations to manage complex relationships with multiple RCM vendors. Additionally, organizations are always looking to reduce administrative costs and often focus on eliminating seemingly superfluous software solutions to reduce duplicative functionality.

As KLAS collected data, we compared third-party functionality to enterprise EMR functionality and determined the number of third-party solutions healthcare organizations use to supplement their enterprise EMR solution. This report seeks to help organizations determine whether consolidating to an EMR vendor’s solution is possible and worthwhile.

A Look at the Data

While the report contains deeper and more specific findings, the following summarizes respondents’ commentary:

  • Epic customers say the vendor is well positioned for further developing their patient access offerings and that Epic is good about communicating their road map.
  • Customers of Cerner commend them for the strong relationship and support they offer but report a lower overall performance score.
  • MEDITECH’s data, though limited, indicates customers are satisfied with the solution and its reliability. Though there are areas of improvement, respondents believe MEDITECH is well positioned for the future.

overall performance score

Looking forward, there is an opportunity for KLAS to measure which specific areas each of these vendors excels in and which areas need improvement. For example, provider organizations may wonder how enterprise EMR vendors fare in scheduling or patient estimation tools. Future KLAS reports may also include customer experiences around vendors’ patient experience or digital front door offerings.

Third Parties Are Here to Stay

As enterprise EMR vendors fine-tune their patient access offerings, provider organizations will continue to rely on those native solutions to meet patient access needs. However, third-party solutions likely won’t disappear altogether. Historically, they have pushed the envelope in the HIT world by providing advanced features provider organizations have come to rely on to meet their specific needs. While organizations are considering consolidation, many plan to stay with their third-party vendor because they often outpace the performance of enterprise EMR vendors.

When analyzing the data for this report, we found that Epic customers anticipate adopting more functionality as it becomes available. Cerner customers reported that they will continue to rely on third-party vendors to meet their patient access needs, since this aligns with Cerner’s strategy of utilizing offerings of third-party vendors instead of developing internally. MEDITECH customers are uncertain of their plans because MEDITECH is still developing their solution.

While both third-party and enterprise EMR vendors will continue to rapidly innovate around their patient access solutions, organizations report they will continue to use both sources. This means complete consolidation likely won’t be happening anytime soon for provider organizations.

Patients Will Determine the Future of Patient Access

The future of the patient access market all depends on refining the patient experience and accurately compensating providers for providing care. As provider organizations strive to become more patient-centric and increase collection rates, they will have to evaluate their patient access tools to ensure they have the necessary functionality.

Patient access solutions significantly impact a patient’s healthcare experience, both clinically and financially. Unsurprisingly, any enhancements that organizations and vendors can make to the patient access process can yield critical results. We expect that both parties will invest a lot of time and money into patient access to further enhance the patient experience and improve data quality.

For more insights on the current patient access market, check out the report.

Photo credit: WrightStudio, Adobe Stock