Medscape’s story last week about new KLAS research ranking EHRs for practices of 1-10 physicians had some helpful insights.

The top system, Athenahealth, was praised for its high level of service and continuous improvement of the product — despite getting dinged by some respondents for its “high cost.”  (Specific product improvements or features that were most appreciated were not mentioned, but I have to wonder if Athena’s tight integration of EHR and PMS was one reason its clients were happier.  As I’ve posted before, I think this integration is a huge factor in getting the most from billing technology — and will only become more apparent with the ICD-10 conversion.)  Athena wins, even though it is the high cost provider — does that mean low cost solutions can’t satisfy?

Not necessarily, according to the survey: PracticeFusion, the famously free EHR, came in third — and its score of 86.3 was not far off from Athena’s 86.9.  Like Athena, it got points for ongoing development, but did get a few criticisms, though, for missing features.  We have often suggested that practices check out PracticeFusion if cost is their primary concern, but to be prepared to evaluate if it fits their specialty; this data seems to bear out the idea that PracticeFusion can be a great solution for many practices, but there’s no substitute for actually trying it out for your own to be sure it fits your specialty, meets your functionality expectations and can be efficiently integrated into your patient flow.

Unfortunately, while I don’t want to call out any particular offenders, suffice to say that many of the EHRs on the bottom of the pile have been troublesome for practices we’ve worked with.  In some — but not all — cases, this is at least partly because the vendors have historically been much more focused on (and effective with?) larger networks and hospitals.

Perhaps the most interesting aspect of this story from our point-of-view is that churn in the EHR market continues — and it’s a good thing.  When more practices feel free to switch from an unsatisfactory EHR, we’ll see more benefit from these (painful) adoptions.  The trend of about half of all EHR purchases being replacements continues, according to the article — and that puts pressure on vendors to improve, and allows practice managers and physicians to feel more confident with the decision to switch.

There’s even a story-beneath-the-story — one of the commenters, an internal medicine MD, mentions that she’s on her 4th EMR, but finally has one she doesn’t just like but loves!  Now that’s the inspiration so many practices need to learn from their bad experiences but leave them behind — and get motivated to try something new.

One question left unanswered, though: was interoperability a part of this survey at all?  This is going to become such an important factor in the next few years, as coordination of care and the patient-centered movement take priority.  I’d like to see someone do some rankings on these measures next; small practices will really need help from their EHR vendors to deliver on these promises.

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