The percentage of eligible professionals and hospitals that have switched EHR vendors quadrupled between Meaningful Use program years 2013 and 2014, according to new data from the Office of the National Coordinator for Health IT.

Dustin Charles, a public health analyst at ONC, reported to Wednesday’s Health IT Policy Committee meeting thatthe percentage of EPs that “ripped and replaced” their EHR between 2013 and 2014 jumped from 2 percent to 8 percent, while the rate for EHs increased from 0 percent to 4 percent.

“We don’t know why they decided to rip and replace. There are many reasons why providers would want to change their own vendor,” Charles said. “We just looked at this mostly from the certification perspective and we wanted to see whether or not the 2014 CEHRT was available and how many providers are using it. We found the majority are getting it from their current vendor without needing the switch. But, we would like to look more into those who did switch and understand what’s going on.”

He told the committee that to attest to 2014 Meaningful Use 10 percent of EPs and 12 percent of EHs obtained 2014 Certified EHR Technology from a different vendor.

Also See:Making the EHR Switch

However, industry analysts are not surprised by the spike in EHR replacements and see the ONC numbers as a harbinger of things to come.

“We’re seeing an increase in system selection activity this year particularly on the EP side, which I think is going to manifest itself in 2015 and 2016 with even bigger numbers,” predicts Michelle Holmes, a principal at ECG Management Consultants. “I think a fair amount of the 2014 EP switch numbers can still be attributed to consolidation and employed physician growth versus purely switching from vendor A to vendor B without any other situational change.”

Holmes says that although the EP number from ONC is higher than ever before, it still isn’t nearly as high as some analysts were predicting in 2013 when they said 2014 would be “the year of the replacement.” At the same time, she notes that the EH number is much bigger than was expected.

“I didn’t realize it was as big as it was, but I’m not altogether surprised,” Holmes says. “The dominant vendors started making themselves more available to small- and medium-sized hospitals, and that combined with many organizations defaulting to the notion that ‘integration is king’ resulted in movement to a single vendor for both the acute and ambulatory care spaces where previously there were multiple systems.”

According to Holmes, the reasons providers replace EHR vendors fall into three categories: some kind of situational change (merger, acquisition, employment, consolidation, etc.); an integrated/single database strategy; and dissatisfaction with the current system/vendor that the provider doesn’t think can be resolved with any type of optimization effort. 

“Last year, organizations became particularly frustrated with vendors when major upgrades required for Meaningful Use and/or ICD-10—based on the previous deadline—didn’t go well,” she adds. “For many it wasn’t an option to wait and let the vendor work the bugs out of its upgrade, and a poor upgrade experience seemed to push some organizations from ‘keep’ to ‘replace’ if they were on the fence at all.”

Execs dissatisfied with EHRs 

Consultancy Impact Advisors recently surveyed 40 chief information officers, finding 70 percent of respondents agreed that the top IT priority for their organization in the next 12 months is projects that help them realize more value from their EHR investment. Only 8 percent indicated that they are not currentlyfocused on EHR optimization.

“I think it really underscores the growing internal pressure these days among providers to realize value from all the money that’s been spent on EHRs,” says Jason Fortin, senior research analyst at Impact Advisors. “Fifty-seven percent said their EHR investment has not helped their organization to realize clinician productivity and efficiency goals.”

Given this level of dissatisfaction among executives, Fortin would expect growing numbers of providers to switch EHR vendors for a number of reasons. “There’s definitely still a lot of frustration about usability and functionality,” he argues. “And, on the ambulatory side, there are a lot of specialists out there that are using systems that weren’t designed for their specialties.”

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