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Freestanding Emergency Centers 2017 Freestanding Emergency Centers 2017
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Freestanding Emergency Centers 2017
An Early Look at An Emerging Market

author - Jackson Tate
Jackson Tate
author - Alex McIntosh
Alex McIntosh
April 18, 2017 | Read Time: 5  minutes

In 2009, the first freestanding emergency center (FEC) opened its doors. In the years since, hundreds of such facilities have opened in Texas. Several other states have also recently adopted or are considering legislation that would allow FECs to expand into the states and extend emergency services to underserved areas. This rapid growth has created an urgent need for EMR technology that meets the needs specific to FECs. To find out which EMR vendors are best helping FECs, KLAS spoke specifically to providers in Texas—the most mature FEC market—interviewing at least half of the EPOWERdoc, T System, CMR, and Wellsoft customers in the state.

† As reported by the Texas Association of Freestanding Emergency Centers

1. T-System’s Experience Inspires Trust; EPOWERdoc Widely Adopted

FECs feel confident in T-System largely because of the vendor’s proven and positive track record in traditional emergency departments. T-System understands the needs of FECs and has worked with them to create a tailored product that has great overall value and helps providers efficiently and effectively treat patients. An early entrant to the market, EPOWERdoc saw rapid growth. Although providers report low engagement from the vendor and complications surrounding new development, they feel that using the EMR allows them to spend more time with patients and shorten overall wait times.

freestanding emergency centers in texas

2. T-System and CMR Act as Strong Strategic Advisors; EPOWERdoc Seen as Technology Vendor

T-System engages with customers by providing a support environment that proactively addresses concerns (including new regulations) and ensures issues are addressed directly and quickly. Early data from nearly all FECs utilizing CMR shows that the vendor keeps communication open and works directly with users to improve the system’s quality and usability. Providers using EPOWERdoc report a different experience; many say the vendor acts as a technology provider only and is not a proactive, strategic advisor. They would like EPOWERdoc to address issues before they arise, provide needed template updates, and invest in customer success by offering advice and best practices instead of just simple, reactive support.

extent of vendors strategic engagement

3. T-System and CMR Set the Standard for Improving the Quality of Care

Of the six CMR customers KLAS spoke with, nearly all report that the user-friendly system has a positive impact on quality of care and increases efficiency. They also note receiving robust training from the vendor. One user praised CMR for leveraging the experiences of ER doctors and nurses to create a clinically focused system and subsequent training. Those using T-System feel that their vendor’s acute care ED experience has allowed T-System to create an easy-to-navigate solution that has useful decision support and built-in hard stops to ensure data accuracy. Some EPOWERdoc customers cite decision support as a strength. Many providers have mixed views on EPOWERdoc’s impact on overall quality of care, citing complicated usability and/or navigability as the source of their reservations. Early feedback from Wellsoft customers is positive due to the system’s customization features and built-in error checking.

vendor performance in improving quality of care

4. T-System Offers Most Consistent Positive Impact on Patient Experience; Variability Exists with EPOWERdoc and CMR

A preliminary look at how FEC EMRs affect the patient experience shows that all solutions have a positive impact, though to varying degrees. T-System customers consistently report shorter wait times and an increase in time that can be spent with patients. They also say that patient follow-up and reporting are easier with the EMR than with paper. Some providers using EPOWERdoc also report shorter wait times and improved patient interactions; however, nearly two in five feel the EMR has little or no impact on the overall patient experience. Feedback from CMR customers is divided—some report no change in wait time or increase in patient interaction, while others say that the system’s easy usability allows doctors to see more patients quickly. Early feedback from Wellsoft customers has been positive; physicians enjoy tailored workflows and a simple but efficient user interface.

impact on patient experience

Bottom Lines on Vendors

(According to feedback from FECs in Texas) Example Provider Quote


Early entrant to the market but has not seen significant growth. Strong partner that delivers solid integration with their registration, lab, and other systems.

"Our CMR system allows us to be efficient, which improves the quality of care at our facility. The efficiency of the flow allows my physicians and my nurses to be at the bedside more. . . . I have worked with several EMRs, and I have seen where an EMR can take away from patient care. CMR definitely does not do that. . . . The product gets the job done from a clinician standpoint.” —CNO


Traditionally adopted more widely by smaller organizations. Not seen as a proactive, strategic partner. Some complaints about usability/navigability. Overall positive impact reported.

"Whenever we need something, I can get one of our EPOWERdoc representatives to contact me back about getting something added. But EPOWERdoc doesn't reach out to ask how things are going and whether we need anything. I am always the one reaching out.” —Manager


Main choice for larger organizations; strong focus on creating partnerships with clients. Has leveraged experience and relationships in acute care ED and through T-Sheets to create an intuitive, functional system.

"When we moved from paper to T-System I was not excited about it and I had people say they would quit. We have had a very positive experience because T-System is very attentive to their people.” —ED Director


Newest entrant to the FEC market but hoping to leverage acute care ED experience. Early data shows a high level of functionality, support, and engagement.

"Wellsoft has been able to tailor care plans for us. They have also done assessments, physical assessments, physical exams, and other things that have helped with patient care. We spend less time charting and more time with our patients.” —Nursing Director

author - Alex McIntosh
Alex McIntosh
author - Natalie Jamison
Natalie Jamison
author - Robert Ellis
Project Manager
Robert Ellis
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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.