— Black Book Research (@blackbookpolls) April 6, 2015
This is a really fascinating stat from Black Book. I’d like to dig into their methodology for this question. Defining what’s a “poor” fit is really hard when you realize that a poor fit is defined by hundreds and possibly thousands of EHR users in a hospital.
What I’ve found is that it’s really hard to make broad statements about EHR satisfaction at a hospital. The doctors may hate it, but the executives love it. The front desk may be annoyed by it, but the pharmacy is really happy. The nurses may love it…ok…I don’t think I know of any EHR that’s loved by nurses, but that’s a discussion for another blog post. Nurses often get left out in the EHR design and we’ll leave it at that for now.
With that disclaimer, let’s think about what it means that 20% of hospital EHRs are a poor fit. Does that mean that we’re going to see a wave of EHR switching in the hospital EHR world? I don’t think so.
The reason I don’t think so is that the hospital EHR is too expensive. Plus, changing EHR is so disruptive that you have to be really down on your EHR to actually switch. Sure, some of them are that down on their EHR that they’ll switch EHR. However, most of them don’t like it, but they aren’t ready to go through heart replacement surgery and take out their current EHR and replace it with a new one.
Some other factors at play is that they may not like their current EHR, but it’s the devil they know. That’s a powerful reason not to switch. Also, is there really a better alternative? Many who aren’t satisfied with their EHR aren’t convinced that switching to another EHR will be much better. Plus, many of these organizations are in the middle of meaningful use. If you switch EHR vendors in the middle of meaningful use, you might as well announce that you’ll be taking a year off from meaningful use (and all that entails…ask Intermountain).
While I don’t think we’ll see a wave of immediate EHR switching, once the renewal licenses come up, we’ll see more switching of EHR. Plus, if someone can come out with a high quality cloud based EHR for hospitals, then that could help with switching costs as well. However, until then, hospitals have mostly chosen their horse and now they have to ride it out. Of course, this assumes they don’t get acquired by a larger hospital system and are forced to switch EHR. That’s happening in a big way and is likely to continue.