Most EHRs Disappoint Specialists

The vast majority of EHRs are outright failing the specialists. Is this news? Surely not to those physicians suffering EHR implementation disasters, but thanks to KLAS, we now have hard data to confirm the anecdotal evidence. It is provided in the recent KLAS report, and eloquently described by Ken Terry in his recent article in Information Week. His title, however, “EHR’s Aren’t Specialist-Friendly Enough,” underestimates the seriousness of the problem. And the problem will only get worse as more specialists rush to purchase EHRs under the pressure of impending meaningful use deadlines.

In an industry where the EHR satisfaction scores by specialty range from a paltry high of only 7.6 (on a scale of 10) for internal medicine and family practice to an embarrassing low of 5.8 for oncologists and ophthalmologists, most specialists rate their EHRs in the barely passing range between 6.2 and 6.8.


Source: KLAS as reprinted in HIStalk

Let’s look at these scores as grades—the best EHRs are only earning a C (76%); orthopedists are trying to make a go of EHRs that are squeaking by with a D (65%); and some specialists are saddled with EHRs that are simply flunking out (58%).

And these scores are averages. Assuming a normal distribution of responses (see example of bell curve for ophthalmology, below), there are many physicians who rate their EHRs considerably lower than the average—giving scores of 48%, 38%, or even lower. (Readers who are physicians know what happens to students who get a 38% on an organic chemistry final exam: dreams of medical school quickly disappear as these students are weeded out of the candidate pool!)

Of course, just as there are some specialists who rate their EHRs below the average, there are also some who score theirs at the high end of the bell curve (in the orange section). Oh, and guess where a vendor is going to take a prospective customer for a site visit?

So, what’s a specialist to do to increase the chance of EHR success? Play it safe and go with a name brand, generic EHR? Clearly not! That strategy is anything but safe. The legacy EHRs are all built to support the needs of primary-care physicians—it is no surprise that internists and family practitioners are less dissatisfied with their EHRs than their specialist colleagues are.

Here are some tips:

  • Start with the KLAS report, “Ambulatory EMR by Specialty Study 2012: Finding the Fit”, and identify those EHRs that have high ratings in your specialty.
  • Make sure that these vendors have a large network of providers in your specialty.
  • Perform comprehensive due diligence, calling physicians that you select.
  • Beware of vendor-selected site visits—these physicians should not be expected to be representative of the majority experience.

You can’t cheat when it comes to selecting an EHR. After all, it may be the EHR that gets the bad grade, but it’s you who is going to have to pay.