Why Superior EHR Customer Service is Critical to Your Practice’s Success

In today’s increasingly complex environment, superior service and support from your EHR vendor are critical to long-term practice viability. Reliable customer service can no longer be viewed as just a box to be checked on the EHR scorecard during the selection process—it is vital to success.

Why Superior EHR Customer Service is Critical to Your Practice's SuccessThe EHR industry is characterized by fairly poor customer satisfaction—the average KLAS score for service sits at a low 73% (Ambulatory EMRs for 11–75 Physicians). Physicians who cannot rely on their EHR company for excellent support will find their productivity and success jeopardized. No longer is the impact of an EHR limited to its use in managing charts—the increasing demands of government and other payer programs have extended the reach of an EHR beyond the four walls of the practice, and success or failure now has increasingly significant financial implications. Physicians must be able to successfully share information, connect to HIEs, and report on clinical data. In the future, they will need to respond to new reimbursement models such as ACOs. All of these communications are complicated and fraught with potential technical challenges—even with the best EHR solutions—making access to the highest quality customer support vital.

Meaningful use incentives are foremost on the minds of most physicians right now, and the program’s requirements are complex, confusing, and challenging. Physicians rely on their EHR vendors not only for the technical support necessary to achieve meaningful use, but also for the educational resources required to successfully navigate the program. Unfortunately, this kind of support is not universally available within the industry. The findings of a recent survey presented to the HIT Policy Committee revealed that physicians cite vendors—in particular, the lack of adequate support and training and unresolved technical problems—as a major obstacle to achieving meaningful use.

Physicians want to know that their EHR company will be in business for the long term. In a recent post, “The EHR Bubble Will Pop—To the Victor Go the Spoils,” I maintained that significant market consolidation is inevitable, and that many, if not most, of the 472 EHR companies currently offering certified EHRs will not survive the shakeout. Customer service is a distinguishing feature among EHR companies that will be important in ensuring a vendor’s future viability.

So, what constitutes excellence in EHR customer service and support, and how do you see through the promises made by vendors during the sales process to ensure that you will receive the level of support that you need? The highest quality customer support requires a sufficiently large team of highly skilled, well-trained, eager-to-please employees, who are easily reachable and accountable for responding within a defined and appropriate amount of time. Where possible, they should be proactive, not just reactive. Such a team requires oversight by senior management, which is really only possible if the support department is not outsourced or sent overseas. You should rely on the real experience of colleagues—review the KLAS ratings and then validate them by doing your own due diligence.

Rome Wasn’t Built in a Day

In my last EMR Straight Talk post (Stage 2 Clinical Quality Measures—More Is Not Better), I maintained that simply adding a large number of new quality measures without addressing the underlying flaws in the reporting process will do little to advance the program towards its goals. So I was very interested in reading Joseph Goedert’s blog the following week in Health Data Management: “Why Must CMS Overreach on Rules?”

In discussing the proposed rule regarding Accountable Care Organizations (ACOs), Joe makes a similar argument to mine. He questions CMS’s proposal that, to share in an ACO’s savings, providers would have to report on 65 quality measures—including 28 new measures—when CMS will not even be ready in 2012 to electronically accept the considerably smaller number of quality measures associated with meaningful use.

In both cases, CMS is trying desperately to accomplish a long-term vision, albeit a noble one, in too short a timeframe. While formulating its proposal for Stage 2 meaningful use, the HIT Policy Committee had several intense discussions about the trade-off between (1) aggressively moving toward the end goal and losing people along the way because they were overwhelmed and feared failure, and (2) accepting a slower pace, but with a greater chance of success. The foundation of the programs have to be solid, or real progress will not be achieved.

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Reader’s Correction/Clarification:

In my EMR Straight Talk post on August 10, (“HIE’s and Information Sharing—Physicians Feel the Pressure”), I incorrectly stated that without membership in NYU’s UPN (University Physicians Network), “physicians do not have access to the group’s favorably negotiated reimbursement rates.” I received a comment from Robert Goff, Executive Director of NYU’s UPN, stating that “UPN does not negotiate with any payer or health plan outside of fully compliant shared risk arrangements,” and that the requirement regarding physician information technology “is part of a broad initiative to promote enhanced quality and the delivery of more efficient health care.”

I apologize for the misstatement.

Physicians: Don’t Count on EHR Support from Hospitals

Anthony Guerra, noted HIT industry blogger and editor of HealthSystemCIO, has written extensively about the pressures and stresses facing hospital Chief Information Officers (CIOs) due to the myriad government programs making demands on their skills and their time. His recent survey revealed that a mere 16% of CIOs manage to maintain a relatively normal workweek of 40–49 hours, while 35% report working over 60 hours per week. In my opinion, the current level of stress extends throughout all levels of the IT staff—a sentiment echoed at today’s HIT Policy Committee meeting as they evaluated the recommendations for Stage 2 meaningful use.

This is not surprising. In the midst of upgrading to meet meaningful use requirements—a bigger challenge for many hospitals than originally anticipated—IT departments are expected to simultaneously prepare their facilities to comply with the impending 5010 requirements and convert their systems from ICD-9 to ICD-10. Also looming in the not-too-distant future are the newly defined Accountable Care Organizations (ACOs), which will require significant and expanded data and reporting capabilities. All of this is compounded by a shortage of IT professionals in the healthcare arena.

So how does this relate to private-practice physicians—the constituency on whom I typically focus? I’ve cautioned in a previous post, One Size Does Not Fit All, about the mismatch between the EHR needs of hospitals and of physicians in private practice. Physicians should also be wary of adopting their hospital’s EHR if they are doing so with the expectation that the hospital’s IT resources will be at their disposal. They will be sadly disappointed—supporting private practice physicians, particularly specialists, will be low on the list of priorities for IT staff when their plates are already overflowing.