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Large Ambulatory EMR 2021
Are Vendors Enabling Provider Success?
Author
Aaron Gleave
Author
Alex McIntosh
Clinicians often see the EMR as an obstacle and not an ally. That does not have to be the case. By analyzing feedback from over 180,000 doctors and nurses, KLAS’ Arch Collaborative† has uncovered keys to helping clinicians achieve EMR mastery and success. One of the most important is high-quality training, which requires significant internal organizational effort as well as support and resources from the EMR vendor. This study—focused on the experience of large ambulatory organizations (i.e., those with over 75 physicians)—examines how well EMR vendors fulfill their role to provide needed training, allow user-driven personalization, enable patient-centered care, and support continued progress in EMR proficiency. Data in this report comes from two sources: Arch Collaborative research and KLAS performance research.
† The Arch Collaborative is a provider-led effort to unlock the potential of EMRs in revolutionizing patient care. Through standardized surveys and benchmarking, healthcare organizations collaborate to uncover best practices and move the needle in healthcare IT.
Key Insights from 180K+ Clinicians: Good Training Makes a Big Difference for Clinician Experience
KLAS’ Arch Collaborative research shows that:
- Strong initial training leads to a significantly better EMR experience
- An EMR trainers’ knowledge and overall quality matter more than his or her credentials
- Clinicians need, at minimum, 7 hours of initial training and 3–5 hours per year of ongoing training
- A mix of training methods is more impactful than one single approach
- While most clinicians feel they are proficient with the EMR, nearly 60% want additional training so they can further improve
Training from Epic, NextGen Healthcare, athenahealth Helps Prepare Clinicians for Success
Data from KLAS’ Arch Collaborative research confirms that training for EMR success is difficult. Even the vendors that lead in training have room for improvement. Epic customers rate the quality of the vendor’s training comparatively high and partly attribute their clinicians’ EMR success to Epic’s training efforts. Clients say that Epic’s train-the-trainer model has been mostly effective; trainers at client organizations receive high-quality EMR education from Epic and are then responsible for training their own organization. Additionally, because of Epic’s standardized implementations, the online training resources and documentation are well suited to help struggling clinician users. NextGen Healthcare customers feel training is most effective when the vendor’s trainers are involved with the implementation and build process and understand the customized provider workflows. Organizations using athenahealth credit user success with the system to the EMR’s intuitive nature, despite receiving minimal training from athena. Customers feel the EMR’s ease of use combined with a robust set of online resources allow clinicians to train themselves effectively; this results in average ratings for athena’s quality of training and strong ratings for how well the vendor sets clinicians up for EMR success.
All Vendors Offer EMR Personalization, but Epic, MEDITECH, and NextGen Healthcare Excel at Enabling Providers to Use It
Arch Collaborative research shows a direct connection between clinician EMR personalization and overall EMR satisfaction. Clinicians with the knowledge and opportunity to personalize the EMR to their workflow are more satisfied than those who do not personalize the EMR. Interviewed Epic clients express high satisfaction with their personalization tools; they feel they can personalize whatever they need and that personalizing the EMR allows users to be nimble. Multiple customers say personalization is the system’s “biggest strength,” allowing users to tailor system workflows to meet their needs. MEDITECH receives consistently high ratings for making EMR personalization tools available. Respondents say MEDITECH has stepped up in recent years, leading to a much-improved end-user experience with personalization tools. Organizations using NextGen Healthcare feel personalization capabilities are “robust” and a key strength of the platform overall—especially for specialty-specific needs. Among Allscripts and Cerner customers, some have been successful at implementing EMR personalization, while others feel their vendor doesn’t do enough to support personalization.
athenahealth, Cerner, and Epic Efficiency/Training Measurement Tools Help Identify Clinicians Who Need Extra Help
athenahealth’s CareCheck tool gives organizations granular-level reporting and dashboards on individual clinicians’ EMR use. Respondents praise the tool for allowing them to help clinician users grow more efficient and to focus on specific aspects of EMR use that need to be improved. Organizations leveraging Cerner’s Lights On Network solution describe it as an “incredible” tool; one respondent called it one of the best things Cerner has done in 20 years. Customers report the tool allows users to measure their EMR performance and benchmark themselves against their peers. Respondents using Epic Signal say the tool allows them to monitor individual providers’ EMR usage. These customers report Epic has continued to improve the solution and refine the available metrics to make them more meaningful and useful for ambulatory organizations. Provider feedback on NextGen Healthcare is split—some say that NextGen's new HealthCheck tool gives good insight into performance, while others say they were not aware such a tool exists. Those using Allscripts or eClinicalWorks share that their vendor does not provide tools to monitor EMR user performance.
Most Organizations See Solid EMR Support of Patient-Centered Care—Epic and MEDITECH Clients Give Positive Feedback
Epic customers benefit from Epic taking time during the implementation to help users learn to use the solution efficiently. Clinicians at these organizations feel that because their workflows can be personalized, they can get through encounters quickly and focus more on the patient. Provider organizations feel MEDITECH has made significant strides improving Expanse’s ability to support patient-centered care since the platform’s early days. Users say the solution is highly intuitive and lets them spend most of their time during patient encounters actually interacting with patients rather than working in the EMR. NextGen Healthcare customers feel the vendor has made great strides in improving the product to better meet provider workflow needs. Providers share that even when specific workflows don’t exist out of the box, the solution’s flexibility allows them to create customized workflows to meet their needs.
About This Report
Data in this report comes from two sources: (1) KLAS performance data and (2) KLAS Arch Collaborative data.
KLAS Performance Data
Each year, KLAS interviews thousands of healthcare professionals about the IT products and services their organizations use. These interviews are conducted using a standard quantitative evaluation, and the scores and commentary collected are shared in reports like this one and online in real time so that other providers and IT professionals can benefit from their peers’ experiences. The questions from the standard evaluation are organized into six customer experience pillars—culture, loyalty, operations, product, relationship, and value.
To supplement the data gathered with this standard evaluation, KLAS also creates various supplemental evaluations that target a subset of KLAS’ overall sampling and delve deeper into the most pressing questions facing healthcare technology today.
The performance data in this report comes from both evaluation types and was collected over the last 12 months; the number of unique responding organizations for each is given in the chart to the right.
KLAS Arch Collaborative Data
The Arch Collaborative is a provider-led effort to unlock the potential of EMRs in revolutionizing patient care. Arch Collaborative data is based on EMR-experience feedback shared directly by 180,000+ clinicians from more than 200 healthcare organizations.
The Arch Collaborative data in this report is used solely to demonstrate what best practices drive clinician EMR success regardless of vendor, not to differentiate vendor performance.
What Does "Limited Data" Mean?
Some products are used in only a small number of facilities, some vendors are resistant to providing client lists, and some respondents choose not to answer particular questions. Thus a vendor’s sample size may vary from question to question and may not reach KLAS’ required threshold of 15 unique respondents. When a vendor’s sample size 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.
Overall scores are measured on a 100-point scale and represent the weighted average of several yes/no questions as well as other questions scored on a 9-point scale.
Writer
Amanda Wind Smith
Designer
Madison Moniz
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. © 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.