Ambulatory EMR/PM

The Small Practice Ambulatory EMR/PM Market Today

 I am excited to kick off the year with a report that is sure to make some noise. The new 2019 report for Small Practice Ambulatory EMR/PM (10 or Fewer Physicians) includes some fascinating, revealing, and even painful data, but there is a lot to be learned for both vendors and providers in the small practice space. If you are interested in the latest and greatest in the space, you won’t want to pass up the information in this report.

Provider Priorities vs. Vendor Priorities

KLAS asked providers which things their EMR/PM vendors should focus on. Their responses are reflected in the chart below:



We also interviewed executives from all the primary vendors about their priorities. We then correlated their answers with provider data to see which vendors are really aligned with market needs.

Unfortunately, several vendors listed new technology—the last item on the providers’ list—as their top priority. Only a couple of vendors were closely aligned with their customers’ needs, and that showed in their satisfaction scores:



To read more about providers’ priorities, vendors’ scores, and the correlation between alignment and satisfaction, check out the report.

Don’t Forget the Fundamentals

One of the biggest things we see in the small practice space is vendors getting distracted. They’re focusing on things that either the industry or a business plan says to focus on. At the end of the day, the data we have gathered for this report shows that year after year, providers look for foundational elements in product functionality, usability, and support.

Vendors may be excited to chase something really shiny (AI, machine learning, blockchain, etc.), but if they shift their focus too far away from the fundamentals, that shows in the provider experience. And when providers aren’t happy, the vendors lose out. Even vendors who have been in the small practice space for many years can still lose focus over time.

New technology development often focuses on trends related to legislation, next-generation usability, and so on. Vendors that scale into the large-practice ambulatory space have to care about these bigger trends, but the small practices don’t generally care much about fancy, new technology.

Vendors need to remember that providers in small practices respond to and focus on different things than those in larger practices. Small practices are kind of in a bubble, so many of the changes in the industry don’t affect them. They care primarily about the fundamentals.

Some vendors do understand that. One executive shared the following:

“When it comes to product functionality, there are always new features that we add, but if our workflows are not streamlined, it doesn’t matter how good the functionality is; we are just adding complexity. The most important thing is a simple, streamlined workflow that makes the system easier to use, and that is followed by serving our customers.”

Once the vendors get the fundamentals down, they can start thinking about ways to improve the provider experience through new technology, partnerships, APIs, and ancillary systems that can add value.

What Caused the Dramatic Score Changes in This Segment?

This report data shows large drops and jumps in several vendor scores. I can’t include many details here, but I can say that many of the changes are related to vendor-provider relationships.

Take the legacy vendors as one example (those vendors with longstanding client-server solutions). Cloud vendors like to view the legacy vendors as dinosaurs moving toward extinction. But some legacy vendors are making real comebacks because of their great customer support and partnership approach.

Relationships fit under the umbrella of fundamentals. Providers at small practices don’t have the resources available at larger ambulatory groups or hospitals, so personal attention and handholding are critical to their happiness and success.

When a vendor starts off as a small company, they are often in a position to get top scores for their support. It’s relatively easy to give lots of love to a handful of customers. But then the vendors get awards and attention, and the number of their customers starts to rise or even skyrocket.

It’s hard to be successful without growing, and it’s hard to stay successful while growing. The consequences of scaling up almost always show in the vendor scores, and they are showing now. The small practice category scores are, on average, almost 10 points lower than just two years ago. Even vendors that mean well and really care about the customer experience still struggle with the problem of scaling their support models.

But relationships have two parties. With that in mind, KLAS asked the vendors involved in this report what their customers were doing to hold themselves back. One common answer was that providers aren’t investing in training.

It’s a common provider assumption that paying for basic training (and perhaps additional training) will line vendors’ pockets and only hurt the small-practice providers who count every penny. But KLAS’ Arch Collaborative data says otherwise. I hope more providers will invest in their own success and get as much training as possible, which has definitively been shown as one of the top contributors to EMR efficiency and future success

Coming Together

There are definitely some glaring problems within the small practice space. Well-meaning vendors are struggling to keep up with their own growth and jump through regulatory hoops, while providers are balancing delicate budgets and often feel unable or unwilling to make necessary investments in their own future success. Many purchasing decisions are made solely on price. Misaligned priorities create increasing provider dissatisfaction over time.  

Ultimately, vendors and providers need to come together and treat the EMR relationship as an important partnership. Both sides need to understand what is required of them to reach success and then commit to delivering on that. If you are interested, please review KLAS’ reports for more details about this compelling space.

Photo cred: Shutterstock, ESB Professional