Half of medical practice EHR shoppers not first-time buyers

As competition heats up in the electronic health record market, practices fed up with poor customer service or systems that only meet a fraction of the practices’ needs are recognizing an opportunity to jump ship and find a new vendor. Others are leaving their old systems to join forces with other health care organizations and form information-sharing networks built on matching EHR systems.

A report published in July by EHR market research firm KLAS found that about half of the 300 surveyed practices in the market for an ambulatory EHR system were not first-time buyers. The number of practices shopping for a replacement EHR jumped from 30% in 2011 to 50% in 2012.

“Some providers are changing vendors simply because their whole organization is moving onto one platform,” said report author Mark Wagner, senior director of clinical and ambulatory research for KLAS. “But the real sad story is the providers who are changing vendors because they can’t get the support they need or the functionality they expected.”

The health care system traditionally has supported a fragmented IT environment, Wagner said. Emerging models of care that focus on the exchange of data have led many to rethink IT strategies. Many practices that consolidated, or were acquired, are now looking to streamline disparate systems into one integrated network, he added.

“It no longer makes sense to have a fragmented system,” Wagner said.

As vendors deal with mounting pressure to comply with meaningful use requirements, they are letting customer support suffer, causing some practices to look for a replacement, said Marni Anderson, health IT specialist for the Wisconsin Health Information Technology Extension Center.

Some vendors are choosing to upgrade systems while sunsetting others, said Harry Greenspun, MD, senior adviser of health care transformation and technology for the Deloitte Center for Health Solutions. Some practices that are being asked by their vendors to switch systems are taking the opportunity to seek out a new vendor.

The growth in the marketplace has made switching vendors more attractive, said Carol Steltenkamp, MD, principal investigator for the Kentucky Regional Extension Center, housed at the University of Kentucky.

She said many new vendors who have entered the market in recent years offer products more specific to physicians’ specialities and sizes. For example, some are promoting their ability to respond quickly to the support needs of small practices.

More educated buyers

Karen Fuller, RN, principal in CSC’s health care delivery practice, said many practices have changed objectives and goals since they first adopted an EHR and might be looking for things they didn’t know they needed initially.

“Maybe what they had was good 10 years ago, but it just doesn’t meet the needs now,” Fuller said. “Even if the vendor upgrades or gets certified, maybe it’s not the system that is going to take them where they need to go.”

Practices also do not know the signs of a bad system until they have used one.

“Because we had never been on a system, we probably did not ask the right questions,” said Thomas Mohr, MD, CEO and president of Pediatric Partners, a nine-location practice in Temecula, Calif., speaking about his practice’s experience EHR shopping for the first time. Pediatric Partners adopted its second EHR system in December 2006 after a nearly two-year experience with an EHR that did not meet the practice’s needs.

“When you first buy, you don’t have the knowledge,” Dr. Mohr said.

While there are a few small practices switching systems, most small practices interviewed by KLAS are adopting for the first time, Wagner said. The survey found that 60% of all buyers, particularly first-time buyers, are considering a small vendor.

Many small vendors offer cloud-based solutions that are attractive to small practices because of their relatively low implementation costs, said Mark Anderson, client services executive for the health IT consulting firm CTG Health Solutions. Such practices cannot afford a more expensive, locally hosted system unless they integrate with a larger health care system that subsidizes the purchase.

Small practices have more options available to them than larger practices, Wagner said. The larger practices have complex IT environments that few vendors are capable of handling.