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Comprehensive Ambulatory Platforms 2021 Comprehensive Ambulatory Platforms 2021
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Comprehensive Ambulatory Platforms 2021
What to Expect from a Single Source

author - Aaron Gleave
Aaron Gleave
author - Alex McIntosh
Alex McIntosh
December 16, 2021 | Read Time: 7  minutes

Looking to improve integration and reduce vendor complexity, ambulatory organizations have recently accelerated efforts to consolidate their technology solutions. However, their EMR vendor’s portfolio may have gaps or may not stack up in certain areas to the specialized functionality of best-of-breed solutions. To help organizations determine whether a consolidated IT approach is best for them, KLAS conducted in-depth interviews with ambulatory organizations that have broadly and deeply adopted their EMR vendor’s technology portfolio. These customers’ feedback reveals what technology is adopted today, where gaps still exist, and what benefits and potential pitfalls other organizations may want to consider as they move toward consolidation.

Vendors that offer a wide range of IT solutions for ambulatory practices were invited to submit a list of the organizations that have most broadly and deeply adopted their ambulatory portfolios (eClinicalWorks elected not to participate and MEDITECH did not have enough standalone ambulatory customers to qualify). Five “deep adopters” were interviewed for each participating vendor. Their insights are intended to help other organizations understand the current best-case scenario with a comprehensive ambulatory platform.

portfolio adoption vs third party augmentation

Epic, NextGen Healthcare & Cerner Get High Marks for Breadth of Portfolio; Virtual Care the Most Common Gap Filled by Third Parties

Organizations using Epic, NextGen Healthcare, or Cerner report the highest satisfaction with the breadth of functionality available from their vendor. Customers feel the vendors’ product portfolios are fairly robust and meet most (if not all) of the needs of an ambulatory practice. However, across all vendors (including the three above), there are still areas in which customers use a third party instead of their comprehensive vendors. The area in which deep adopters are the most likely to still be using a third-party solution is virtual care. Though all vendors in this research offer a virtual care solution, all have at least one interviewed customer using a best-of-breed solution instead. While most organizations would prefer to use their EMR vendor’s virtual care functionality, they continue with a third party for reasons such as better functionality, affordability, and provider and patient usability.

Cerner Has Obvious Gap in PM; RevElate May Be Opportunity for Improvement

Citing functionality shortcomings and concerns about Cerner’s revenue cycle track record, four of Cerner’s interviewed deep adopters use a practice management (PM) product other than Cerner Practice Management (Cerner’s primary, integrated PM solution). These customers note that Cerner’s persistent revenue cycle issues are one of the main factors preventing them from realizing the full benefits of a comprehensive ambulatory platform. The forthcoming RevElate product may be an opportunity for Cerner to improve ambulatory customers’ overall experience, provided it is a stable, high-functioning product that fills existing functionality gaps. Cerner says RevElate was designed to address clients’ current and future needs and will bring a Soarian-derived data model and advanced workflow automation.

Strong External Integration Leads to Improved Care for Cerner & Epic Customers

Many of the benefits highlighted by interviewed deep adopters stem from having integrated solutions and a seamless flow of data. However, customers of different vendors highlight different types of integration. Cerner and Epic customers are most likely to highlight the strength of their solutions’ external integration, which enables them to share data with local exchange partners and thereby provide better patient care. Several described specific instances in which primary care physicians were able to provide better care because they could see what treatments and medications their patients had received at other care organizations. Customers of the other measured vendors largely highlight improvements in efficiency and productivity, which they attribute to strong internal integration and good data flow between systems in their vendor’s portfolio. Beyond the aforementioned patient care benefits, several organizations also report improvements to the patient experience (and thus overall patient satisfaction); these include higher portal usage, a streamlined check-in process, and a more cohesive patient experience overall.

benefits achieved from adopting comprehensive hit strategy

All Interviewed NextGen Healthcare & Epic Customers Report Cost Savings or Gains in Revenue

Revenue and staff efficiency improvements are commonly cited by ambulatory organizations as primary reasons they chose to consolidate IT vendors. All interviewed NextGen Healthcare customers report that their system’s billing transparency has allowed them to reduce denial rates and increase collections. NextGen Healthcare customers—as well as Epic and Kareo customers—also say they have been able to increase patient volumes thanks to clinical and administrative workflow improvements enabled by their technology. Additionally, they have been able to reduce data-entry costs and eliminate duplicative work. Some customers of athenahealth, Cerner, and Greenway Health note that adopting a comprehensive IT platform has enabled them to reduce FTEs or reassign them to other tasks.

impact of comprehensive platform approach on revenue and efficiency

Depth of Functionality Most Common Roadblock to Comprehensive Approach

reasons third party was chosen over comprehensive vendorLack of deep functionality is the primary reason ambulatory care organizations bring in third-party solutions to supplement their comprehensive platforms. The biggest gaps are often with functionality for particular specialties—while no respondents report dissatisfaction with their portfolio’s primary care or internal medicine functionality, several expected more workflows and functionality for areas like dental care, behavioral health, ophthalmology, and orthopedics. These respondents weren’t prepared to have to supplement with additional technology. Some respondents note that the roadblocks they face are due more to their own internal issues (e.g., budget constraints, clinician training gaps, and poor change management) than to any fault of the vendor’s. Overall though, most roadblocks have been minor, and respondents still feel the benefits of a comprehensive approach are worth the investment.

Voice of the Customer

allscripts logo“Going with Allscripts has been positive because . . . our revenue stays strong. . . . A comprehensive model has helped us maintain our efficiency. . . . The product has been very user friendly for our providers, so it hasn’t slowed them down. . . . They are still able to maintain the same or a similar workload.” —Radiology manager

athenahealth logo“Our practice has become much more efficient. . . . A patient can see the schedule and schedule themselves. While they are doing that, they can fill out their registration piece. The efficiency for our staff is great. We are in a very short-staffed area, and our offices are very thin on staff at the moment. Taking some of that workload off of people is a huge thing for us.” —IT director

cerner logo“The comprehensive model has done nothing but enhance our revenue because we have more information at our fingertips so that we are doing the right thing at the right time. . . . That enhances revenue. When we have all the patient’s information at our fingertips in the same comprehensive record, we save a tremendous amount of time in going back and forth. The efficiency goes up tremendously in an integrated platform.” —CMIO

epic logo“We are way more efficient. We have standardized our work. We have taken in best practices. We have a singular system that connects the dots, and that makes more sense for our end users. It is also easier for us to support.” —IT director

greenway-health logo“We are much more efficient now. Everybody can see the record. The people in the call center can see whether a patient needs to be seen by dental, whether they have had their eyes checked, and what the insurance will pay for. Because everything is on one platform, we can see what a patient needs. Patient outcomes are better because we have this comprehensive system.” —CEO/president

kareo logo“Kareo’s system has had an impact on efficiency. The EHR is very good, and the billing module is efficient. Having the clearinghouse reports and the payments come directly into Kareo’s system makes us more efficient in terms of keeping track of everything.” —Clinical manager

nextgen healthcare logo“The comprehensive model has impacted our efficiencies with the communication between all departments. When the physicians order things, we can process those orders and get them turned around for the patient in a timely manner. That has had a big impact on communication within the practice.” —Business office director

About This Report

To understand the experience of ambulatory organizations that have adopted a broad swatch of functionality from a single HIT vendor, KLAS asked measured vendors to share lists of the customer organizations that have most broadly and deeply adopted their technology portfolios. We then interviewed five of these “deep adopter” organizations per vendor.

Interviewed organizations were asked to identify which functionality they have adopted from their comprehensive vendor and which functionality they still use from third-party vendors. In addition to validating their current adoption, interviewed organizations shared the benefits of going with a comprehensive HIT strategy, the roadblocks they have encountered, and their satisfaction level with various aspects of their vendor’s portfolio. The data was collected over the last 12 months.

about this report
author - Elizabeth Pew
Elizabeth Pew
author - Andrew Wright
Project Manager
Andrew Wright
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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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