Even as the healthcare IT industry awaits the official definition of "meaningful use" from the federal government, a new report from KLAS examines which electronic medical record products should fit that description.
The report, "Meaningful Use Leading to Improved Outcomes," assesses how well core clinical vendors are delivering solutions for CPOE, nursing automation, medication administration and other key areas.
Nine EMR vendors are profiled in the report: Cerner, CPSI, Eclipsys, Epic, GE, McKesson, Meditech, QuadraMed and Siemens.
"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.
Physician adoption
While EMR vendors Cerner, Eclipsys and Epic are the most successful with regard to physician adoption, according to the KLAS report, Meditech has the largest number of clinical information system customers with more than 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 with more than 200 beds with deep CPOE adoption – that is, where more than 50 percent of all orders are entered electronically by doctors. Only 3 percent of Meditech customers have achieved this level of adoption.
Among the market share leaders of clinical information systems, McKesson exceeds Meditech in this area with 5 percent of its customer base showing deep adoption, while Cerner leads both McKesson and Meditech at 23 percent. GE, QuadraMed and Siemens also enjoy some success with CPOE adoption, the report notes.
Beyond CPOE, the report also evaluates vendor offerings for nurse charting, an electronic medication administration record (eMAR), patient-monitor interfaces to the EMR, electronic flow sheets and barcoding at the point-of-care for medication administration. For each solution area, KLAS evaluates the risk the vendor poses to provider customers who want to achieve a comprehensive EMR implementation.
No vendor is perfect in every area, Gale says, but Cerner and Epic are the strongest, followed by Eclipsys.
Among the three, only Cerner extends to meet the needs of both larger facilities over of more than beds and some community hospitals, KLAS concludes. 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, some providers are reporting 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. Specific CPOE adoption and integration improvements related to the latest versions of McKesson and Meditech EMR products have not yet been reported to KLAS.
