Regret and frustration appear to be common feelings among hospitals and health systems that switched EHR systems in the past three years.
Black Book Market Research conducted a survey of more than 1,200 hospital executives and 2,100 user-level IT staff regarding expectations and outcomes of their EHR replacements, and the outcomes are heavily negative.
Here are 10 key findings from the survey.
1. Eighty-seven percent of financially threatened hospitals regret the decision to change EHR systems.
2. Fourteen percent of hospitals that replaced their EHR since 2011 said the pace at which they are losing inpatient revenue threatens their ability to support the cost of their new EHR. "It was a risky decision as hospitals were facing the fact that they would not b back to their pre-EHR implementation patient volumes, inpatient or ambulatory, for at least another five years," said Doug Brown, managing partner of Black Book, in a news release.
3. More than six in 10 non-managerial IT staff said healthcare delivery was negatively affected due to the EHR replacement.
4. Nursing staff reported being highly affected by the EHR replacement, but had virtually no say in the replacement decision, according to the survey. While 90 percent of nurses said EHR replacements reduced their ability to effectively provide hands-on care, 96 percent of nurses said they were not included in EHR replacement planning.
5. However, just 5 percent of hospital leaders said the EHR replacement process had a negative impact on care, which Mr. Brown said suggests executives are reticent to address the issues. "In our experience polling, most executives will not admit they were oversold or that their IT decisions had adverse bearing on patient care," Mr. Brown said. "On the other hand, workflow changes and productivity issues may have added to the disappointment nurses felt after being left out of replacement EHR product evaluations."
6. Executive leaders were concerned about their job security during EHR replacements, as 63 percent of executive-level respondents said they or their peers felt they were in "employment jeopardy."
7. A handful of manager- and executive-level respondents (7 percent) said they were fired or asked to resign due to cost or productivity effects of the EHR replacement.
8. Among hospital staff, 19 percent experienced intermittent or permanent layoffs due to implementation delays, cost overruns and underestimated budgets.
9. Clinician buy-in was oversold, according to 78 percent of non-physician executives, who said such buy-in touted by vendors never proliferated. Eighty percent of IT staff reported having to "coerce" network physicians to adopt replacement EHRs.
10. The vast majority (88 percent) of hospitals that replaced EHRs said they could not report any competitive advantages to attract physicians based on their new system.
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