Allscripts leads EHR vendors for user satisfaction among large ambulatory practices, according to an annual survey by Black Book Market Research.

More than 27,000 EHR users participated in this year's survey that asked about adoption plans, budgeting and vendor awareness from 6,000 participants that have not yet fully implemented EHR systems.

The other top-ranked vendors are Greenway, McKesson and athenahealth.

All four top vendors made significant investments in user experience and client satisfaction over the past year, according to Black Book.

Among respondents who used products from one of the top four vendors, 90 percent said their vendor solicited physician feedback; 60 percent said their vendor had made clinical workflow improvements and 33 percent said their vendor had made sufficient investments in population health management features that could help in the transition to value-based care models.

"EHR firms with a wide offering of products including health information exchange, population health tools, revenue cycle management services, patient portals, dashboards and analytics are emerging as the next wave of healthcare technology leaders," said Doug Brown, managing partner at Black Book.

Surprisingly, the survey found that overall user satisfaction with EHRs has increased. While 92 percent of multispecialty groups in 2013 said they were dissatisfied with their EHR products and vendors but 71 percent of physicians surveyed in 2015 said their vendor was "meeting or exceeding" expectations.

Just 18 percent of providers said they were planning to replace their EHR by 2016. However, 71 percent of respondents who had implemented an EHR before the end of 2012 reported high levels of dissatisfaction with their systems; and 38 percent of primary care and specialty providers in large practices said they have not yet returned to pre-EHR productivity levels.