CDS Order Sets and Care Plans 2014
Choosing the Best Option

WORTH KNOWING:

PROVIDERS STRUGGLE TO DEFINE IMPACT—SOME ZYNXORDER CUSTOMERS QUESTION VALUE

While most providers would buy order set/care plan content again, they generally couldn’t measure these products’ impact on patient outcomes, at times due to lacking tools. Many Zynx customers are early adopters of order sets, but now some are questioning the long-term value. Over the past two years, 15%–20% of Zynx customers (as opposed to 2%–4%for Wolters Kluwer) have reported plans to discontinue the product. The initial content is valuable, but high, ongoing costs and lacking EMR integration, which leads to duplicated effort, leave some (often larger organizations) questioning the value.

EMR INTEGRATION: HOPE ON THE HORIZON FORORDER SET CUSTOMERS?

Integration is still the top order set issue. However, Zynx and Wolters Kluwer each had one organization using EMR-supplied tools to better interface content into their EMRs. Most other providers who are successful with integration invest lots of internal effort.

CARE PLANS: ZYNX LEADS, INTEGRATION/OPTIMIZATION TRADE-OFFS EXIST

Zynx leads in overall performance with an easy-to-use product and effective training. ZynxCare is used in conjunction with many EMRs, but customers want better integration with their EMR workflows. Elsevier was the only CDS product rated highly for EMR integration (though it is used almost exclusively with Allscripts and Epic). However, Elsevier customers noted the need for optimization and better training: the content can be more difficult to navigate, as it does not seamlessly fit their EMR workflows. They also felt updates take longer since they must be coordinated with EMR upgrades.

ORDER SETS: WOLTERS KLUWER EDGES OUTZYNX IN OVERALL PERFORMANCE

Wolters Kluwer and Zynx are nearly equal in most areas. However, Wolters Kluwer slightly leads Zynx in overall performance thanks to strong performance in smaller organizations (often using MEDITECH). Providers also like the tie-in with UpToDate. Both vendors have poor ratings for EMR integration, though providers rated Wolters Kluwer lowest (especially with Epic and Soarian). Looking forward, Wolters Kluwer customers want additional content and updates. Zynx customers want additional content, additional tools, a refined update process,and more training.

Most providers noted their EMR vendor was cooperative with their CDS vendor, but better collaboration was still the top request. They are looking for content integration, tighter tie-ins to workflows, and better communication with CDS vendors. Providers want all EMR vendors to focus on collaboration but noted Epic was better at being cooperative.

BOTTOM LINE ON VENDORS:

Care Plans

ELSEVIER:

Best at integrating content into EMR (used almost exclusively with Epic and Allscripts). Less easy to navigate and understand, as content is not always smoothly tied to clinician workflow. Customers noted training could improve. Customers recommended investing time and money for optimization. Very proactive support and communication. 

ZYNXCARE:

Highly regarded content that is easily consumed and updated. Most customers do not have tight integration into the EMR. Providers want better integration as well as more content. Very good support and training.

Order Sets

WOLTERS KLUWER:

Current, easy-to-consume content. Smaller organizations very satisfied, especially with service/support. UpToDate guides providers to evidence- ased content. Lowest rated for EMR integration; EMR tools can potentially help. Customers newer in contract life cycle, and only one (2%) said the product was not part of long-term plans. 

ZYNXORDER:

Current, easy-to-consume content. Little difference in satisfaction between large and small organizations. Integration with EMRs a challenge for many—EMR tools can potentially help. Over past two years, 15%–20% of respondents have said Zynx is not part of their long-term plans: customers have noted initial content is helpful but ongoing cost is high, leaving them to question long-term value. 

Whether just starting to standardize content or working toward larger accountable care goals, providers most frequently advised mandating adherence to order sets/care plans. Regardless of content cource (third-party or self-maintained), providers felt that would positively impact patient outcomes more than anything else would. Next was involving multiple stakeholders to collaborate and finalize content. Workflow optimization (especially for Elsevier) was third-most mentioned.