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Smart Pump/EMR Interoperability 2020
First Look at Customer Satisfaction
Author
Jackson Tate
Author
Paul Warburton
For the first time, adoption of bidirectional smart pump/EMR interoperability is high enough that KLAS can examine customer satisfaction—at least among BD and ICU Medical users on the pump side and Cerner and Epic customers on the EMR side. How well do these four vendors support their customers’ pump/EMR interoperability efforts? Are specific vendor combinations more likely to achieve success? In addition, this report examines what progress (if any) other pump and EMR vendors have made with interoperability development and adoption.
Pump Vendors: Support & Guidance
ICU Medical Delivers Strong Guidance at All Stages; BD Has Adoption Momentum, Struggles with Ongoing Optimization
ICU Medical, who currently has 26 unique organizations live with interoperability, delivers strong guidance that precedes and extends beyond the implementation, bringing boots on the ground during the preplanning and build phases and monitoring EMR upgrades to address errors as they arise. Customers value that ICU Medical tracks customer success metrics, offers suggestions, and leverages user groups to drive product development and improvement. KLAS will continue to monitor ICU Medical’s level of partnership as they expand their customer base and scale to larger organizations.
BD, the interoperability market share leader (104 organizations live), has a standardized implementation approach that meets the majority of customers’ needs, allowing BD to bring many hospitals live—including many large, advanced organizations—and ensure consistent autoprogramming compliance regardless of EMR. KLAS has validated that BD has recently begun to offer additional implementation consulting services. However, some customers say BD’s standard implementation resources are unable to answer questions or make recommendations outside the standardized approach—e.g., end-user training and workflows for less common areas—and the burden of figuring out these issues falls mainly to the customer. BD customers also report less ongoing optimization help, citing staff turnover and BD’s recent disbanding of their interoperability advisory board.
Interoperable vs. Noninteroperable Customers
Regardless of their interoperability status, ICU Medical customers feel the vendor collaborates well, leading to a consistently positive overall experience across customers. BD’s low ongoing presence is felt more acutely by their interoperable customers, who have more optimization needs.
EMR Vendors: Interoperability Development
Cerner Workflows More Streamlined; Both Cerner and Epic Could Improve Reporting & Timeliness of Updates
Organizations feel that both Cerner and Epic could do more to make smart pump/EMR interoperability a priority, specifically when it comes to interoperability updates, documentation and verification workflows, and actionable reports. The organizations that report the most satisfaction with their interoperability are often those who leverage their own staff to drive process improvement and build reports.
Smart Pump/EMR Interoperability Updates
Epic customers say the vendor listens (including holding bimonthly collaboration calls) and that updates have come slowly. They would like updates to be more of a priority for Epic. Cerner customers receive some updates, but they are generally a long time coming. No interviewed Cerner customers mentioned user groups or panels intended to guide development of smart pump/EMR interoperability.
Documentation & Verification Workflows
Cerner’s workflows for standard types of infusions work smoothly. Customers express concerns about less standard things, such as workflows for neonatal patients, adjusting for changes in a patient’s weight, and incorporating vitals into documentation. Documentation can be problematic for Epic customers, especially for drug bolus verification and validating multiple infusions at once. Customers feel Epic has listened to their feedback regarding these issues.
Actionable Reports
Many organizations look to their EMR vendor’s reporting for insights regarding interoperability usage and opportunities for improvement. On average, organizations are not particularly satisfied with this reporting and don’t feel it is transformative or insightful. Customers find Epic’s compliance reporting valuable and are also able to build their own reports. Dissatisfied users often want more details in reports, like the rate and type of infusion and the number of programming attempts. Cerner’s reporting module provides a breadth of information. Still, several customers would like more standard reports so that they don’t have to do as much manual manipulation to get the information they want.
Which EMRs Are Being Integrated?
Almost two-thirds of hospitals that are live with pump interoperability use the Epic EMR; just under a third are Cerner customers. The remaining few use MEDITECH or Allscripts, who recently made pump/EMR interoperability available to customers. These four EMR vendors account for 78% of the hospitals in the US, and though they all offer pump/EMR interoperability, just 10% of the nation’s hospitals are currently live with it, underscoring the challenge interoperability can represent in terms of cost and complexity.
Note: For MEDITECH customers, EMR/smart pump integration is achieved through third-party vendor Iatric Systems.
Which Pump/EMR Combos Are Most Successful?
ICU Medical/Epic, BD/Cerner Customers Most Satisfied
Successful interoperability requires collaboration from the pump vendor, EMR vendor, and provider organization. ICU Medical/Epic customers generally report higher satisfaction than other customer groups. Many have been live for several years and have already resolved most workflow and reporting challenges. They see the biggest need for improvement on Epic’s side, including improved end-user workflows. BD/Epic customers report more frequent issues. Most striking are the gaps in post-implementation engagement and a need for better BD/Epic collaboration on reporting. Customers would also like Epic to improve documentation workflows. BD/Cerner customers report a better experience. They get helpful insights from the reporting, allowing them to be successful with less ongoing guidance from BD. There are currently too few ICU Medical/Cerner customers for satisfaction data to be shared.
Status of Bidirectional Smart Pump/EMR Interoperability
Technology Is Only Half the Story
While the pump and EMR vendors are responsible for providing and properly setting up technology that delivers seamless, easy-to-use autoprogramming workflows, provider organizations must make sure that things like proper governance and a sufficient Wi-Fi structure are in place. Training is a responsibility shared between vendor and customer.
Vendor Bottom Lines
Baxter: New Spectrum IQ LVP is the vendor’s first with the capability for bidirectional integration. KLAS has validated two Spectrum IQ hospitals live with integration. Because of positive experience with the Sigma pump, some customers looking for interoperability will consider the Spectrum IQ. Others say they may move to other vendors because Baxter lacks a syringe or PCA pump and has been slow with development.
B. Braun: Adoption low though interoperability has been available for several years. Added one customer since KLAS’ previous interoperability report (2017). Percentage of infusions customers complete via autoprogramming is well below other vendors’ averages. Cost is a barrier for customers, and none have yet rolled out interoperability to all hospitals in their organization. Most pump customers are smaller hospitals; many will need to improve infrastructure (e.g., Wi-Fi) to make interoperability a success.
BD: Leads in customer adoption of interoperability by wide margin, in part because of the multimodular Alaris platform’s large customer base. Has brought many organization types and sizes live and has experience setting customers up for success (e.g., helps with interfacing, uses a single server). Has helped all customers achieve good (sometimes great) level of autoprogramming compliance. Not often described as playing a strategic, involved role in ongoing optimization.
ICU Medical: Distant second in size of interoperability customer base. Strong customer guidance (pre-, during, and post-implementation). Close partnering (with customers of all sizes) enables nimble delivery of interfaces and consistent feedback loop. Plum 360 is the go-forward pump, though older Plum A+ is still in use. The few Plum A+ customers that are interoperable report lower compliance rates and satisfaction.
Smiths Medical: Offers syringe and PCA pumps; interoperability available only for the syringe pumps. One hospital is live with bidirectional interoperability. Several others have unidirectional integration (just autodocumentation or just autoprogramming). Customer adoption is low as organizations tend to prioritize interoperability for LVP rather than syringe pumps.
Writer
Elizabeth Pew
Project Manager
Mary Brown
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.