What Really Differentiates EHR Companies?

My post yesterday on EMR and HIPAA called “Does Spending More on EHR Mean You Get More?” started me thinking what does differentiate one EHR company from another. I think there’s a real disconnect between what most people selecting an EHR use to differentiate EHR companies with what really matters to the users of an EHR.

First let’s take a look at some of the many ways that I see doctors and hospital CIO’s using to differentiate EHR companies. Many use price as an indicator of quality. Hopefully this post puts that to bed. Price matters, but it’s not a great indicator of EHR success. Many are swayed by great sales and marketing by EHR companies. It’s hard to deny that seeing an EHR vendor with a full HIMSS booth doesn’t have some effect on what you think of that EHR vendor. Going along with this is having the big, well branded name recognition. Although, what’s in a name if the EHR software doesn’t meet your specific needs?

Another differentiator that many use is KLAS or other ratings. When I’ve dug into all of the various EHR rating and ranking systems, there are flaws in all of them. Some lack enough data to really draw conclusions. Some use bias methods for collecting data. Some EHR ranking services don’t use data at all. It’s amazing how interested we get in a list that may or may not have any legitimate value. Every EHR vendor has some flashy numbers to share with you. Just remember that numbers can lie. You can make them appear any way you want.

I’m a little torn on the idea of EHR certification and access to EHR incentive money being a point of differentiation for EHR vendors. There are so few that can’t get you there, that it’s almost a non-issue. Sure, if you really want to get the EHR incentive money, you could and should talk to the users of that EHR that have gotten the EHR incentive money. However, because almost every EHR vendor is a certified EHR that can get you to meaningful use, not being certified might actually be a more exciting. The story is reasonable: our EHR focused on what doctors care about in an EHR as opposed to some random government requirements. Could be a compelling message. Especially for those doctors who don’t qualify for the EHR incentive money.

What should be used to differentiate EHR companies?

The number one thing that I think doctors should look for in an EHR is efficiency. A large part of the coming Physician EHR revolt is due EHR software’s impact on physician efficiency. Yet, most doctors selecting an EHR pay little attention to the effect of an EHR on efficiency. This data is harder to get, but a good survey of existing EHR users can usually get you some good information in this regard.

Another area of differentiation with EHR companies should be around their EHR support and training. How quickly an EHR vendor answers support requests and how well an EHR gets you up and running on an EHR is extremely important. As someone on LinkedIn mentioned today, EHR is not plug-n-play software. There’s more to an EHR implementation than just plugging it in and going. It requires some configuration and learning in order to use an EHR in the most effective way.

How come we don’t use the quality of care that an EHR provides as a method of differentiating EHRs? The answer is probably because it’s a really hard thing to measure. I wonder if any EHR has found a way to show that their EHR provides better care. There’s plenty of anecdotal examples, but I wonder if anyone has more data on this.

Another point of differentiation that I think matters is how an EHR company approaches its relationship with the users. Does the doctor, practice and hospital feel like a partner of the EHR company or are they a distant customer. You can imagine which situation is better than the other. This relationship will matter deeply as you run into problems that are unique to your environment. I assure you that this problems will come.

I also see technology approach as a really important factor for EHR companies. When I say this, I think most people start to think about SaaS EHR vs Client Server EHR. Certainly that is one major component to this idea, but it should go much deeper. You can tell by the way an EHR’s technology approach if they’re focused on the right things. Do they take shortcuts when they implement technology? Are they thoughtful about what really matters to the EHR user? Do they implement something on a whim or do they think deeply about the impact of a feature? While every EHR company has limits on what they can put out in a release, they can still provide a great roadmap of the current release and their plans for future releases which shows that they understand the needs of the users.

I’m sure there are many more good ways to differentiate an EHR company. I look forward to hearing more of them in the comments. We just need to expand the discussion to things that really matter as opposed to basing our EHR decisions on vanity metrics.

About the author

John Lynn

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

11 Comments

  • “The number one thing that I think doctors should look for in an EHR is efficiency. A large part of the coming Physician EHR revolt is due EHR software’s impact on physician efficiency. Yet, most doctors selecting an EHR pay little attention to the effect of an EHR on efficiency. This data is harder to get, but a good survey of existing EHR users can usually get you some good information in this regard.”

    I invented an acronym.

    S.Y.S.T.E.M.

    An EHR should…

    Save You Substantial Time, Effort, and Money.

    SAVE

    Minimize encounter length, wait times, staff idle time, mental and physical effort, and Total Cost of Ownership.

    YOU

    You serve your patients; your EHR should serve you. (OK, its portal serves your patients, too)

    SUBSTANTIAL

    Lots of:

    TIME

    Save time: see another patient; spend more time with each patient; go home on time.

    EFFORT

    Minimize mental and physical effort to learn and use.

    MONEY

    Time is money. Save time, save money. Shift tasks from expensive personnel to less expensive personnel (but monitor task progress so nothing falls between the cracks).

  • Nice article, John. I think that your key components can really be placed into the second one: support and training.

    When a company is truly focused on their customers, they work to meet all their needs, within reason and scope of the product. If the vendor truly does have a customer-first culture, then the efficiency component would be addressed early because the company is in tune with their customers. Additionally, support engineers would have recorded and passed along issues to the development team to assess and address in future releases of the product.

    Truly listening to provider customers and their needs takes complete commitment, requiring hard work and time. When a vendor is a true partner, they work to fix problems in the product, not just get customers past the problem and back to business as usual.

    Two vendor philosophies that are not customer-centric:
    1- Those that develop and test the product in a silo, sell the heck out of it and do little in terms of customer service after implementation. Customer support is understaffed, under-trained, both, or are pushed to simply meet their quota of closed support tickets.
    2- Product developers call all the shots. Developers can do amazing things with software, and they know it, and they want to prove it. However, if the amazing things they develop are not driven or desired by the customer it will just create confusion and headache. Feedback from customers (which can only occur after trust is built) and product managers who are aware of the changing health IT landscape should guide the product.

    Just my thoughts. Thanks for the forum, John.

  • Good point Chad. Although, I’d just add that being a customer focused company is really easy to say and really hard to do. Even companies that work really hard to be customer focused can not actually deliver the goods. It’s one thing to understand the customer and another to try and understand the customer.

  • Chandresh,
    I like your view of it. I agree that from a functionality standpoint most are so similar. It’s from a usability and business perspective that many fall short. Plus, it’s worth noting that some fall short for certain doctors, but are great for other doctors.

  • Very nice article. I believe that determining what differentiates one EHR vendor from another, or which EHR vendor offers the best product is a highly subjective question since every practice/specialty would have different workflows. The first step for any practice to determine which EHR vendor provides the best product for their practice would be to determine their workflows and inefficiencies so that they can plan on an adoption approach for the practice. Although each vendor has their own baseline script built into the system, how easily the system can adapt to the practice’s clinical scenarios would be critical. Besides, there are many websites out there falsifying comparison charts which differentiate one EHR vendor from another.

  • Hello John, and Prasad, well said.

    The bar being raised, it is really up to the practices – providers and office managers to step up to the plate in terms of evaluating systems that match their needs.

    A part of the problem I have seen is many practices are unable to articulate their needs well, leaving the door open to manipulation by vendors with razzle-dazzle, great reviews, etc. Nothing wrong with that, but as you’ve pointed out John, what works well for one practice may not work for another. Does not mean one is a bad system versus others.

  • Nice piece , John. Working support for an EMR vendor I have a slightly slanted perspective. but I have to agree that service and support are key. Responsiveness to calls, knowledge of product, iplementation experience, industry insight, and a personal touch make for successfull relationship with practices.

  • What differentiate EHR’s is whether the solution and the business model are proven. These will define the market going forward:

    1. Which EHR’s is proven and preferred? Studies and physician satisfaction surveys exist
    http://blog.medsphere.com/114/

    2. Affordable and sustainable total cost of ownership
    http://blog.medsphere.com/a-tale-of-two-studies-what-are-the-actual-costs-of-an-ehr/

    3. Partnering for results without vendor lock
    http://blog.medsphere.com/189/

    With all the EHR’s out there in the market, we must look for where they have been adopted and used to achieve results: broad adoption, satisfaction and cost effective quality care. That is where the differentiation is.

    Edmund

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