Back in 2014, when the respected online medical publication Medscape last asked physicians how they felt about their EHRs, the overall winner was the VA’s Computerized Patient Record System (CPRS), the core patient record component of the broader VistA system. Two years later, the results are the same.
Asked to rank EHR systems based on ease of use, vendor support, overall satisfaction, connectivity and clinical usefulness, physicians gave CPRS an average score of 3.65 on a 5-point scale. Epic is the second most popular system overall with an average score of 3.45.
Naturally, VistA had to fare well in individual categories to stay number one overall. For both Connectivity and Usefulness as a Clinical Tool, survey respondents gave VistA the top spot. In terms of Satisfaction, Ease of Use and Vendor Support, VistA placed third, third and fourth, respectively.
Among hospital and health network survey participants, Epic was far and away the most commonly used system at 41 percent. Cerner was second at 13 percent and VistA was tied for fourth position at 4 percent with Allscript, eClinicalworks and NextGen.
Funded by taxpayer dollars, VistA code exists in the public domain and is available through the Freedom of Information Act. A number of companies, including Medsphere, a few hospitals and several national health systems are successfully and affordably using VistA to improve both the quality and efficiency of patient care.
Beyond EHR preferences, the Medscape survey is interesting for what it says about the aspects of EHRs physicians find most useful and the impact EHRs have on tasks and workflows.
- Most helpful EHR components: More than half—62 and 57 percent, respectively—of physicians appreciate e-prescribing functionality and the ability to easily locate and review patient records.
- Impact on practice function: In terms of documentation, patient service, clinical operations and bill collection, a strong majority in each category said the EHR had either improved practice operations or there was no change. The most significant result was in documentation, where 56 percent saw improvement.
- Face-to-face interaction: Predictably, physicians said EHRs limited their face time with patients and made it harder to see as many patients as they had before implementation. Still, fewer physicians said EHRs made these types of interactions worse than did in the 2014 survey.
- Perceptions of vendors: While most physicians are very satisfied, somewhat satisfied or neutral on their EHR vendor, there has been an uptick since 2012 in those that are somewhat dissatisfied (14 to 15 percent) and very dissatisfied (7 to 12 percent).
Even though more than 95 percent of hospitals have an EHR system, analysts say that around 30 percent of hospitals are shopping to replace unsatisfactory solutions. Expect to also see shifts in physician satisfaction with EHRs as vendors improve the applications they have and doctors and patients get more comfortable with healthcare IT. This, along with probably more dramatic shifts in payment models and the insurance industry, should keep things interesting for the foreseeable future.
D'Arcy Gue is Director of Industry Relations for Medsphere Systems Corporation.