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CDS Point-of-Care Reference 2022
How Are Solutions Being Adopted by Clinical Users?
Author
Joe VanDeGraaff
Author
Jennifer Hickenlooper
CDS reference tools enable clinical users to follow standard treatment recommendations and more quickly and confidently make clinical decisions. However, tools that lack strong content, searchability, and EMR integration are not efficient for point-of-care workflows and can frustrate users, especially those already experiencing burnout. Some CDS vendors are addressing user frustration and report their solutions have evolved to be more user friendly. To understand the customer experience and how each solution is being adopted, this report draws on feedback from a subset of clinical users (defined in this report as physicians, nurses, and pharmacists) as well as feedback from vendors’ general customer bases.
Wolters Kluwer: UpToDate Improves Patient Care & Workflow Efficiencies for Clinical Users at Point of Care
Customers of market-share leader Wolters Kluwer report that UpToDate is easy to use due to its broad, deep, and digestible evidence-based content. Many interviewed physician and nurse users report being able to efficiently find needed information at the point of care, especially when using the mobile functionality. Clinical users also appreciate being able to earn and track CME credits. Pharmacists report using the tool to verify medication and IV compatibility and rate the solution’s ease of use higher than that of Merative’s pharmacy-specific Micromedex Solutions.
“I have yet to experience a situation where I haven’t been able to find the subject I want. . . . The vendor’s strength is not only the breadth of content but also the incredible host of people who write for Wolters Kluwer. They have developed an incredible system. They have somebody who is an expert in a particular area, and that person recruits people to write particular chapters.” —Physician, clinical user
“A place where the vendor has improved over the years but could still grow is making the information that they are presenting really easy to navigate. The system needs to get to the point without requiring us to read paragraphs and paragraphs of information. If I am looking up something that I heard about in a meeting or that I want to know more about, I need to have the luxury of time. However, my use of the system is during patient care when I am already running behind and super busy. I want to be able to look up my question and get the answer quickly.” —Physician, clinical user
Regarding Wolters Kluwer’s overall customer base, most are satisfied with the product and support experience. Amid this satisfaction, some customers are frustrated with the cost, finding the tool too expensive due to increasing costs year over year. Many also cite concerns about the vendor’s contracting processes. Some respondents would like to switch to a cheaper solution but feel they can’t due to clinical users’ strong loyalty to UpToDate.
EBSCO Information Services: Physician Buy-In Slow; Adopters Report Positive Point-of-Care Experiences
Clinical users currently make up a small portion of the EBSCO Information Services customers KLAS has interviewed, and they largely report a positive experience. Several interviewed physicians use the solution at the point of care and feel the quickly and easily retrieved information improves patient care. Some clinical users report low point-of-care adoption due to content gaps, leading them to use DynaMed Solutions with other CDS tools. However, clinical users (as well as some non-clinical users) feel more training and proactive support from EBSCO might benefit adoption. These users would also like to see continued improvement of integration, mobile usability, and content depth, though some say the latter has already improved.
“DynaMed Solutions is just as good at answering quick and easy questions as another solution we have used is. . . . Some of our staff think that DynaMed Solutions is much easier to use than our other solution is. And when the staff is busy and has to see patients, the staff doesn’t want to put on their informatics thinking caps. DynaMed Solutions provides a better experience for getting articles than the other solution does.” —Physician, clinical user
“To use DynaMed Solutions, I have to log in to the solution’s website rather than being able to launch the system from our EMR. EBSCO Information Services gives us a URL to get to the system, but I have to launch a different web browser.” —Physician, clinical user
Among EBSCO’s overall customer base, most users are satisfied with DynaMed Solutions’ ease of use and content quality. Several note EBSCO is responsive and willing to help when support is needed. A small percentage (16%) of respondents report plans to replace EBSCO, largely due to adoption and integration problems.
Merative (IBM): Pharmacists Value Drug Content; User Interface Seen as Outdated
Merative is a new company from Francisco Partners, who recently acquired many IBM assets. Overall, customers of Micromedex Solutions are happy with the easy-to-use patient education content. The tool is most commonly used by pharmacists, who highlight its extensive drug content (including off-label drug use) and strong information regarding IV compatibility and pill/tablet identification.
“One strength of this product is that the vendor included a lot of anecdotal information. There have been a couple of incidents where someone has written up non-FDA uses and common side effects of a medicine. The product has great toxicology information. I use the tablet identifier almost exclusively. The compatibility is awesome too.” —Physician, clinical user
“The user interface isn’t as easy to use as other solutions’ interfaces.” —Physician, clinical user
Non-pharmacist users (including some clinical users) also reference the drug content to verify information from other CDS solutions. Despite the strong content, some pharmacists note that the system is outdated and that navigating content isn’t always easy or quick. Pharmacists and non-clinical users mention that the Watson-enabled NLP functionality makes it easier for them to find what they need by retrieving content that is more relevant to their role or previous searches. Some customers across roles report improved EMR integration; others feel the integration is lacking.
Elsevier: Users Appreciate Deep Content for Complex Conditions; Point-of-Care Use Not Yet Validated
Validated usage among clinical users is relatively low, and adoption at the point of care is very limited, primarily due to concerns about ease of use. One validated physician user is optimistic about the tool’s potential to be used at the point of care.
“The product has gotten really good. I explored the vendor’s content when I got full access to it. Elsevier has done a bang-up job of catching up to their competitors. ClinicalKey Solutions deserves an opportunity to compete in the point-of-care reference space.” —Physician, clinical user
Most interviewed Elsevier customers are librarians.† They find the tool’s deep content helpful for unique, complex conditions, and all respondents would buy it again. Some customers report the vendor has updated the previously challenging search functionality, and a few say recent upgrades to the product interface have made it easier for staff to use. However, both clinical and non-clinical users note the ease of use could continue to be improved, and some feel better ongoing training could increase use of the updated product. Within Elsevier’s overall customer base, 21% of respondents feel the vendor nickel-and-dimes them for additional modules and content, leading these customers to feel the product is less valuable.
† Elsevier declined to share a list of clinical users for this research. The non-clinical users interviewed indicate that the solution is not often used by clinical roles in their organizations.
“Unless we know what we are looking for, it is hard to find something. We can’t just enter something in and expect it to float to the top of the search and help us immediately. That is especially applicable for deep, complex situations. ClinicalKey Solutions has such a deep knowledge base that the algorithm doesn’t pick up on the key knowledge. It doesn’t have a human interface to curate the knowledge. The vendor is improving the product in certain disease areas.” —Librarian
About This Report
Each year, KLAS interviews thousands of healthcare professionals about the IT solutions and services their organizations use. For this report, interviews were conducted over the last 12 months using KLAS’ standard quantitative evaluation for healthcare software, which 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 created a supplemental evaluation to understand how provider organizations are using their CDS solutions. KLAS asked interviewed participants about the strengths and weaknesses of their product and the impact it has had on efficiency, patient care, and treatment of complex medical conditions. The data was collected from March 2022 to September 2022.
Sample Sizes
Unless otherwise noted, 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. The table below shows the total number of unique organizations interviewed for each vendor or solution as well as the total number of individual respondents.
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
Natalie Hopkins
Designer
Breanne Hunter
Project Manager
Robert Ellis
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.