Black Book, the research firm known for its rankings of health IT products, has changed its survey process after an inspection of nearly 30,000 EHR survey responses found 33 hospital resellers casting ballots for 740 physician practices.
After examining the poll results, collected between the third quarter of 2014 and first quarter of 2015, Black Book officials say they performed supplementary audits and "extended resurveying" to resolve what it sees as intentional bias.
The research firm also found that 93 percent of physician practices and small hospitals that procured an electronic health record product directly from the CIO’s office of a flagship hospital felt obligated select that EHR from the hospital reseller.
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Of 740 resurveyed physician practices, 730 admitted they feared facing financial consequences from declining those EHR implementations including interrupted referral streams, segregation from clinician data sharing and accountable care organizations, and exclusion from important hospital communications.
"It’s not Black Book’s issue that community physicians were pressured into implementing a particular EHR from their leader hospital," said Black Book Managing Partner Doug Brown in a press statement.
Rather, he said, the issue "is that the hospital IT managers responsible for (re)selling and overseeing system implementations for particular EHR suites were also grading the product satisfaction and service delivery perceptions on behalf of providers they actually sold to."
A post-survey sampling of 800 community physicians and inpatient facilities under 100 beds identified 48 percent of larger hospital channel partners had scored the satisfaction of EHR products in network physician practices in place of, or in tandem with, independent end users, with or without the practices’ knowledge.
"That is no different than soliciting a salesman to rate his own merchandise, which in turn leads to improved or influenced sales," Brown argued.
As such, he said, “we determined it was judicious to disallow hospital channel partners from rating their physician clients’ satisfaction and loyalty, in order that Black Book could get a more accurate measurement of true user experiences in 2015."
Black Book officials say an internal review revealed that hospital managers selling EHR products directly to community physicians and other inpatient facilities also on average rated that EHR up to 49 percent higher in satisfaction and 73 percent higher in vendor loyalty than the actual physicians and staff using the product.
Other findings, according to Black Book:
- 96 percent of physician practices resurveyed said they were unsure whether the hospital reselling their EHR actually reap profits from the vendor from the sale or maintenance of the EHR
- 80 percent of physicians that replaced their original EHRs for a hospital's network EHR in 2014 felt the pressure to concede to the EHR the hospital that was reselling.
"We’ve had mounting objections through 2014 from end users and competitive vendors alike pleading Black Book to restrict provider channel partners reselling for vendors from scoring their own product satisfaction ratings," said Brown. "Going forward, that’s been rectified."
Black Book has delayed the release of its annual EHR rankings until mid-March, so as to complete the resurvey and audits of over 3,000 more respondents.
