More than half of community hospitals across the country are unhappy with the usability of their EHR systems, and nearly 20 percent of those hospitals are actively looking to replace their EHR vendors, according to a recent survey.

That’s the finding of a new survey of 277 community hospital providers from healthcare research firm peer60. At a time when community hospitals—particularly rural hospitals—are struggling with financial challenges, these healthcare organizations are also finding the implementation of EHRs to be an unsatisfying experience: 54 percent of respondents indicated that they were unhappy with the usability of their system and 53 percent said their system lacked functionality. 

According to peer60, the introduction of federal Meaningful Use guidelines “has not been particularly good for community hospitals.” While 53 percent of providers in their survey have attested for Stage 2 Meaningful Use, a sizable portion of hospitals (36 percent) said they are still in the middle of attesting and 11 percent said they have not even started.

Shannon Sorenson, CEO of Brown County Hospital in Ainsworth, Neb., testified last month before a House Ways and Means Health Subcommittee hearing on rural healthcare disparities that the EHR Incentive Program should be closing—not widening—the digital divide between rural and urban providers. However, data from the Centers for Medicare and Medicaid Services indicates that critical access hospitals in particular are facing an uphill battle with a lower Meaningful Use achievement rate compared to non-CAH hospitals.

“While the impact of the incentive has been a positive experience for us, we are struggling with an older population which has less access to computers; consequently making it difficult to meet Meaningful Use requirements for the patient portal,” Sorenson said.

However, community hospitals are not alone when it comes to EHR buyer’s remorse. Last year, according to the HIMSS Analytics Database, 245 hospitals switched EHR vendors and 36 changed their EHR systems but did not change vendors. And, a recent survey from AmericanEHR and the American Medical Association reveals that compared to five years ago, more physicians are reporting being dissatisfied or very dissatisfied with their EHR system. The survey found that close to, or more than half of all respondents, reported a negative impact in response to questions about how their EHR system improved costs, efficiency or productivity. 

Also See: Making the EHR Switch

Michael Lovett, executive vice president for health IT vendor NextGen Healthcare, argues thatnearly half of all providers are dissatisfied with their EHRs and with good reason.

“Back in the day, providers needed systems that had just enough functionality to qualify for Meaningful Use Stage 1 incentives,” according to Lovett. “Today, providers are finding their systems lacking and they are frustrated—in fact, beyond frustration. Providers are ‘outgrowing’ the limited functionality of their first EHR investment. In addition, providers are dealing with rapidly obsolete or inadequate systems that won’t qualify them to meet Meaningful Use Stage 2 certification.”

To help providers who are seriously considering the daunting task of replacing their systems, NextGen Healthcare has published an ebook guide to EHR replacement. Among the top barriers to replacing EHRs, according to the vendor, are: cost, training, data conversion, implementation, and loss of productivity.

Cost, in particular, can be a big financial hurdle for providers such as community hospitals that are struggling with declining volumes and shrinking patient care reimbursement. According to the National Rural Health Association, 55 rural hospitals have closed since 2010 and 283 more are on the brink of closure. However, in the final analysis, the cost of moving to a new EHR system may not be as high as the cost of staying on a system that doesn’t meet a provider’s long-term needs, argues Gary Wietecha, M.D., director of clinical product management at NextGen Healthcare.

According to Wietecha, one way providers can offset the cost of a new EHR is to outsource their revenue cycle management needs, such as billing, collections, and claims, to “help you significantly improve your bottom line by fixing revenue leaks, addressing payment delays, and enabling effective and profitable business operations.”

In addition, more and more community hospitals are giving up their independent status to partner or merge with larger health systems to not only survive financially but to access capital resources to fund technology infrastructure investments such as EHR systems that might otherwise be out of reach. In the peer60 study, 7 percent of hospitals were currently undergoing a merger or acquisition, which the report concludes “will continue to create churn in the marketplace for EHR solutions.”

The report can be downloaded here.

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