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2023 BEST IN KLAS
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2017
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Ambulatory Surgery Center EMR 2021
High Clinical Adoption Driving Value
Author
Aaron Gleave
Author
Alex McIntosh
Current Time Inside Cache Tag Helper: 9/23/2023 11:17:02 AM and Model.reportId = 1943
As more medical care moves to ambulatory settings, ambulatory surgery centers (ASCs) are gaining momentum in both general and specialty settings. Today, the vast majority of ASCs use paper for their clinical documentation, but the market is shifting. Some newer vendors have begun offering EMRs for ASCs alongside their specialty-specific EMRs. Organizations can choose from ASC-specific solutions or integrated ambulatory solutions. Across vendors, the value is clear—nearly all interviewed organizations have achieved high physician adoption of clinical documentation tools and can complete all documentation in the EMR. And nearly all feel their EMR has helped them deliver better patient care and drive clinical outcomes. This report examines how vendors in this market measure up in key areas.
HST Pathways and Surgical Information Systems (SIS) See Broadest Adoption, Very High Usability
The EMRs from HST Pathways and Surgical Information Systems (SIS) are used for a significantly higher number of surgical specialties than other measured vendors, and across this breadth, both vendors have a very high percentage of satisfied or very satisfied respondents (86% for HST, 89% for SIS). Organizations using HST report the EMR’s flexibility and customizability allow them to create specialty-specific workflows, leading to strong ease of use. SIS customers say the EMR is straightforward, and building templates is (as one customer put it) a “self-explanatory experience.” Both vendors’ customer bases say that new users quickly acclimate to the EMR and that the code/build quality is very high—resulting in few system frustrations. For ease of use, respondents give HST and SIS near-perfect scores, and customers are quick to attribute their success with the EMRs to their usability.
HST, SIS & Provation Customers Achieve Clear Clinical Outcomes with the EMR
HST Pathways customers feel the EMR’s ease of use enables them to get through encounters effectively and focus on patients. Providers also appreciate the built-in features that ensure documentation is complete and put patient safety at the forefront. SIS customers say the substantial amount of front-end work required to make the EMR usable is worthwhile on the back end. The solution enables providers to complete more cases in a day and presents all relevant information at the point of care in an easily accessible and digestible format. Provation customers like the EMR’s reporting capabilities and feel the solution helps drive outcomes by ensuring all clinicians working with a patient (surgeons, nurses, anesthesiologists, etc.) can see the complete patient record in one location.
Misses in Anesthesia Documentation Are the Biggest Opportunity for Improvement
HST and SIS customers mention issues with built-in anesthesia documentation as their biggest gap, and one respondent apiece for Modernizing Medicine and Provation also cite this miss. While SIS has released an anesthesia module, many customers have not yet adopted it and are still completing anesthesia documentation on paper. Several HST respondents also report challenges with the anesthesia integration when the equipment is not HL7 compliant. Two of the seven interviewed Provation clients lack the integration needed for EKG data to flow directly from the machines to the EMR; these respondents have to scan EKG printouts into the EMR and attach them to patient charts. Provation has recently acquired iProcedures with the intent to better address anesthesia gaps. Despite these functionality misses, nearly all interviewed organizations, regardless of vendor, feel their EMR provides almost all capabilities they need to effectively document.
Provation Excels in GI; Satisfaction with Modernizing Medicine EMR Hampered by Pricing Structure
Provation and Modernizing Medicine are heavily concentrated in the gastrointestinal (GI) space. Provation users who have deployed the EMR for GI find it very easy to use; they can customize the layout to see “medical content exactly as the physicians want to see it” (practice administrator). Respondents also say images and pathology results seamlessly integrate into the medical record, and the overall documentation experience is very clear. Organizations using the Modernizing Medicine EMR in GI have run into more issues; only 44% of these respondents rate their overall satisfaction 80 or above (out of 100). Two-thirds of Modernizing Medicine GI customers feel nickel-and-dimed, particularly since the purchase of gMed several years ago—they cite upgrade costs and extra charges for functionality they feel should be included. Additionally, some organizations have experienced functionality issues or glitches and slow problem resolution from support personnel.
Functionality the Leading Factor in ASC Solution Purchases
Half of interviewed organizations cite ASC-specific workflows and functionality as the main reason they chose their vendor. As detailed above, HST and SIS receive praise for flexible, easy-to-use EMR functionality. Customers on the latest Provation version are highly satisfied with the functionality; users on older versions report significantly more frustration. Customers of Modernizing Medicine or NextGen Healthcare feel their EMRs mostly meet functionality needs and expectations; both sets of clients express some frustration with the amount of manual IT work required to customize their EMR.
A Note on NextGen Healthcare in Ophthalmology: More IT Resources Needed to Optimize ASC Functionality
Most of the feedback on NextGen Healthcare comes from ophthalmology practices using the ASC module as an extension of their NextGen EMR. While prior research (conducted 12–24 months ago) showed more consistent satisfaction among NextGen’s ophthalmology customers, the data over the last 12 months has been more variable. Several smaller customer organizations are frustrated with the effort required to customize the module to fit their surgical needs. That said, these customers feel the module has much of the functionality they need to run the surgical portion of their practices. More-satisfied organizations (which tend to be larger practices with additional IT resources) feel the module is very customizable and functional.
Across Vendors, Clinical Documentation Is Robust and Well Adopted
About This Report
The data in this report comes from two sources: (1) KLAS’ standard quantitative evaluation for healthcare software, and (2) a supplemental evaluation tailored specifically for ambulatory surgery centers. Interviews were conducted over the last 12 months.
KLAS’ standard quantitative evaluation is composed of 16 numeric ratings questions and 4 yes/no questions, all weighted equally. Combined, the ratings for these questions make up the overall performance score, which is measured on a 100-point scale. The questions are organized into six customer experience pillars—culture, loyalty, operations, product, relationship, and value.
To supplement the customer satisfaction data gathered with the standard evaluation, KLAS also created a supplemental evaluation to delve deeper into several questions specific to ambulatory surgery centers. This evaluation asked respondents (1) what percentage of their clinical documentation is completed in the EMR, (2) why they chose their current vendor, (3) how well the EMR helps drive positive clinical outcomes, and (4) what percentage of physicians have adopted the EMR for clinical documentation.
Sample Sizes
Sample sizes displayed throughout this report (e.g., n=16) represent the total number of unique customer organizations interviewed for a given vendor or solution. However, it should be noted that to allow for the representation of differing perspectives within any one customer organization, samples may include surveys from different individuals at the same organization. Ratings from these individuals are aggregated in order to prevent any one organization’s feedback from disproportionately impacting a solution’s score. The table to the right shows the total number of unique organizations interviewed for each vendor or solution as well as the total number of individual respondents.
It should be noted that some respondents choose not to answer particular questions, meaning the sample size for any given vendor or solution can change from question to question. When the number of unique organization responses for a particular question is less than 15, the score for that question is marked with an asterisk (*) or otherwise designated as “limited data.” If the sample size is less than 6, no score is shown. Note that when a vendor has a low number of reporting sites, the possibility exists for KLAS scores to change significantly as new surveys are collected.
Writer
Amanda Wind Smith
Designer
Jess Wallace-Simpson
Project Manager
Natalie Jamison
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. © 2023 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.