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Is Ambulatory EMR Usability Improving?
Ambulatory EMR Usability 2013

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Ambulatory EMR Usability 2017 Ambulatory EMR Usability 2017
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Ambulatory EMR Usability 2017
Leadership Perceptions of Vendor Performance

author - Aaron Gleave
Aaron Gleave
author - Alex McIntosh
Alex McIntosh
December 21, 2017 | Read Time: 4  minutes

In ambulatory settings, EMR usability as well as the efficiencies of a well-built EMR are hugely important for physicians. All vendors claim they are focused on improving physician usability, yet in KLAS’ previous usability reports, no vendors excelled at meeting usability expectations. What has changed over the past two years and how are these changes helping or hurting physicians’ abilities to deliver care? To find out, KLAS interviewed ambulatory organizations with 11 or more physicians, speaking mainly to physician leaders and end-user physicians.

What Does EMR Usability Mean to a Clinician?

The answer depends on who you ask.

Physician leadership vs. end users

emr usability satisfaction is a function of

This report is a measurement, as reported by physician leadership, of vendor performance in delivering highly usable solutions. It does not focus on the experiences of end users.

In 2017, KLAS started the Arch Collaborative, which enables highly committed provider organizations to gather and benchmark end-user feedback and learn from each other’s best practices. It should be noted that end-user ratings of the holistic EMR experience are often different from the physician-leadership ratings of their vendors.

A key finding from the Arch Collaborative research is that organization culture and choices are the number-one drivers of EMR success and that these factors impact end-user ratings even more than which EMR is being used.

average impact of variable on respondent net experience

For more information about the findings of the Arch Collaborative, click here. If your organization is interested in joining the Arch Collaborative, please email

arch collaborative logo

1. No EMR Excels in Ideal Physician Workflow and Many Lag Considerably

On average, ratings for ambulatory EMR workflow for physicians are below average, and physician workflows do not meet most physician leaders’ expectations. Though the workflow leaders, athenahealth and Cerner, perform somewhat better, they still fall short of respondents’ ideal expectations. To their credit, athenahealth and Cerner deliver noticeable workflow-improvement efforts that customers have received positively and that have had a positive impact on the physician experience. Allscripts TouchWorks, Allscripts Sunrise Ambulatory, eClinicalWorks, and NextGen Healthcare customers are much less satisfied with their workflows and usability, often expressing a desire for improved customization options, user interfaces, vendor guidance and outreach, and all-around functionality.

overall performance vs intuitive workflow

2. athenahealth and Cerner Rated Highest in Physician Efficiency; Epic and eClinicalWorks Decline

athenahealth and Cerner lead in physician usability. Providers feel that the solutions from these vendors are more efficient and provide the tools and functionality needed to deliver better care. Those using athenahealth feel that the release of the “Streamlined” version has helped improve their experience and allows them to more quickly get to the information they need. Dynamic Documentation and MPages, though not new, have finally seen significant adoption among ambulatory organizations using Cerner, and providers using these modules report large efficiency gains and an ability to customize their EMR experience to their own likes and needs. Providers using Epic and eClinicalWorks have seen drops in efficiency satisfaction. Those using eClinicalWorks express __ frustration over seemingly superficial improvements that just serve to keep the product compliant. Epic customers report being overwhelmed by the user interface and amount of data presented.

physician efficiency 2015 vs 2017

3. Cerner Steadily _____ Improving Technology

Due to their forward-thinking technology designed for the ambulatory environment, Cerner has consistently led all other vendors in the degree to which ambulatory physician leaders feel the vendor’s product development efforts have led to improved usability. GE Healthcare, Epic, and athenahealth have shown the most improvement in this metric since 2016; users of these solutions highlight advancements to the user interface, a reduction in the steps needed to complete documentation, and consistent delivery of new technology that enhances the physician experience. Though the data is limited, Allscripts Sunrise Ambulatory customers report the steepest drop in new developments, and Sunrise’s product development score now sits firmly below average. eClinicalWorks customers feel that improvements to the system have not done much to enhance physician satisfaction.

product development improvement

4. Epic, Cerner, and athenahealth Assisting Physicians in the Quest for Usability; NextGen Takes ______ a Back Seat

More than half of Epic, Cerner, and athenahealth customers feel their vendor is significantly involved in shaping and improving physician usability. Although there is no universally correct answer to how involved a vendor should be in driving usability improvements, most providers feel there should be some shared responsibility. Unfortunately, those using NextGen Healthcare have seen their vendor pull out from meaningful partnerships, and along with Allscripts Sunrise Ambulatory users, NextGen Healthcare customers now feel that responsibility for improving usability rests on providers’ shoulders with --- little vendor help.

who do organizations feel is driving improvements in usability

5. Mobile Functionality ____ Gaining Traction but Not _____ Yet Widely Adopted

Mobile functionality that meets the needs and expectations of physicians has been on the horizon for several years. Providers are keen to share that although many of the mobile solutions offered by EMR vendors have promising bits and pieces of technology, no single solution has been presented that is interchangeable with the standard workstation EMR. Although the mobile solutions from athenahealth and Epic have seen the highest levels --- of adoption, limits to what can be done on a mobile -- device currently keep providers from seeing increases ----- in efficiency.

adoption of mobile functionality

author - Natalie Jamison
Natalie Jamison
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.

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