KLAS examines which vendors have potential components of meaningful use'
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"Since the introduction of the stimulus package and its provisions for health IT, much of the market rhetoric and industry debate has centered on the concept of meaningful use-what will it entail and how will it impact the receipt of stimulus dollars," said KLAS Founder and Chairman Kent Gale. "Whatever the final definition of the term, if improved patient outcomes are indeed the ultimate goal, then some form of clinician adoption will be critical.
"In particular, deep adoption among physicians is pivotal to the overarching success of an EMR implementation," Gale said.
The need for physician adoption
The report noted that while EMR vendors Cerner, Eclipsys and Epic Systems are the most successful in regards to physician adoption, Meditech has the largest number of clinical information system (CIS) customers over 200 beds (327 hospitals), followed by Cerner (263) and McKesson (242).
However, the Meditech customer base, encompassing the Magic and C/S product lines, has the smallest number of hospitals over 200 beds with deep CPOE adoption--that is, where more than 50 percent of all orders are entered electronically by doctors, the firm said. Also, only 3 percent of Meditech customers have achieved this level of adoption. Among the CIS market share leaders, McKesson exceeds Meditech with 5 percent of its customer base enjoying deep adoption, while Cerner leads both McKesson and Meditech at 23 percent. GE Healthcare, QuadraMed and Siemens Healthcare also enjoy some success with CPOE adoption.
The report noted that the speed it takes to go live may be paramount to meeting federal timelines. From start to finish, Epic has the most successes in getting new acute clients over 200 beds live on CPOE in less than two years, followed by Eclipsys, then Cerner, and finally McKesson.
Beyond CPOE, the report also evaluated vendor offerings for nurse charting, an electronic medication administration record, patient-monitor interfaces to the EMR, electronic flow sheets and barcoding at the point-of-care (BPOC) for medication administration. For each solution area, KLAS evaluated the risk the vendor poses to provider customers who want to achieve a comprehensive EMR implementation.
KLAS noted that BPOC at the time of medication administration is a strength for CPSI, McKesson and Siemens, but a weakness for Eclipsys and QuadraMed. Epic has had nearly 40 hospitals go live in the past year with BPOC. Cerner, which originally purchased Bridge Medical as its BPOC solution, has now proven that it can deliver its own integrated solution, Care Mobile, with reasonable adoption.
Cerner and Epic are the strongest, followed by Eclipsys, across all hospital sizes with some variation in strengths and weaknesses. However, KLAS said that only Cerner extends to really meet the needs of both larger facilities over 200 beds and some community hospitals. Meditech has a broad install base across all hospital sizes and covers virtually every aspect of automation, with nurses using the product across the country; but Meditech's Achilles' heel is the lack of adoption by physicians. Other vendors deliver functional solutions but face a variety of challenges that have hindered deployment, such as the lack of tight integration among McKesson's core clinical modules or Siemens Soarian clients awaiting version C6 availability.
In light of these challenges, however, some providers reported that new versions of several EMR products are eliminating some of the historic issues. McKesson Horizon 10.1, Meditech 6 and Siemens Soarian C6 all represent new product upgrades, each with the potential of improving CPOE adoption rates and integration issues. Soarian C6, already live in at least one hospital, is reported to remove a painful CPOE software issue with an immediate impact of additional doctors now entering orders, the report noted. Specific CPOE adoption and integration improvements related to the latest versions of McKesson and Meditech EMR products have not yet been reported to KLAS.
The firm said that individuals representing more than 2,000 hospitals contributed to the information in this report, the majority of whom were executive level.