Five EHRs for general practices to put on their shortlist
Most general practices’ EHRs must offer a general and easy to operate functionality that is user friendly, customer centric and cost effective. One can argue that all practices value these characteristics, however general practices particularly require systems that account for the unique needs inherent in general practices.
General practices are in the unique position of operating on a smaller scale, yet treating patients that present with a wide variety of conditions. As such an EHR should be able to allow for a range of data to be stored and used in a seamless fashion. Further, general practices must be able to transmit clinic data and coordinate care with little barriers related to connectivity. Lastly, given economies of scale, general practices cannot afford EHR-related losses in productivity due to adopting a system that diverts clinicians away from caregiving and administration through down time or endless journeys down the “rabbit-hole” with vendor customer support.
EHRs currently in use
In Fall 2016, Medscape published its EHR Report which surveyed EHR use among independent private practices who selected their own EHRs. The general practices surveyed were asked to rate their EHRs on five metrics: ease of use, vendor support, connectivity, and usefulness as a clinical tool. Individual ratings in each area were averaged to come up with an overall score.
Among independent practices using their own EHR systems, Epic ranked first with an average score of 3.5. MEDENT, Practice Fusion, Amazing Charts, and athenahealth, all at 3.4 all rounded out the list with a score of 3.4.
When looking at the top five systems in expanding on their performance under each individual category more insight can be gained into their strengths and weaknesses.
Epic’s EHR provides practices with a standard EHR suite that contains an integrated practice management system. The system is Meaningful Use Stage II certified, and is available in on-premises and cloud-based deployment.
Ranking first on overall score, Epic showed high and consistency scores across all metrics. On the metric of clinical use and connectivity and interoperability as the top system among all surveyed. Epic’s only departure from the top occurred under the area of vendor support whereby it scored a respectable 3.57 behind three other systems.
MEDENT's EHR offers billing and practice management software in addition to a standard EHR suite which can be accessed remotely through a companion mobile app. The system is Meaningful Use Stage II certified and can be used either on a client-server or a cloud-based deployment.
Second ranked MEDENT excelled in vendor support and usefulness as a clinical ranking first and second respectively among all systems surveyed. However, the system showed poor performance on interoperability and connectivity, scoring 2.84. For practices, that are heavily engaged in care management and cooperation beyond their office or have devices, in house, that require connection to an EHR this low score could be a deterrent.
Practice Fusion provides a free, cloud-based EHR who offer a standard EHR and practice management system in a dashboard interface.
Practice fusion scored at or near the top receiving high scores on the metrics of clinical usefulness and vendor support, however like MEDENT, the system scored poorly on connectivity and interoperability, with a 2.59 out of 5 placing them near the bottom of all systems surveyed.
Amazing Charts is a cloud-based, Meaningful Use Stage II certified, EHR. Amazing Charts excelled in vendor support receiving a 3.7 rating, which placed the system at the top of all systems surveyed, while on its usefulness as a clinical tool the system placed just slightly below the top rated systems. However, Amazing Charts ranked near the bottom in connectivity, scoring 2.59 out of 5.
athenahealth offers a cloud-based, Meaningful Use Stage II certified EHR that provides users with a standard suite of features. In addition to core EHR functionality the system also provides users with the benefit of fully-integrated practice management and billing solutions.
athenahealth's general practice EHR led all systems in connectivity and interoperability, scoring 3.6. A strong 3.3 in usefulness as a clinical tool indicates that technically and functionally it is among the best in its class. However, on vendor support its performance in connectivity and interoperability lagged behind scoring only a 3.0.
When considering what EHRs general practices should put on their shortlist, rather than simply provide a list of systems based on their popularity, for the purposes of ranking the systems it is important to consider how these systems perform on the metrics general practices care about the most. Given the practical realities of providing care in a general practice setting the systems rated in the overall top five performed well on all metrics with MEDENT, Practice Fusion and Amazing Charts all experiencing significant dropoffs in connectivity. Given these considerations, a general practice may be best served by examining their priorities and choosing based on what features best serve their needs.
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