Cloud-based EHRs popularity grows among small practices

By John DeGaspari

Nearly seven out of 10 small and solo physician practices have affirmed their confidence in Web-based electronic health records, according to a recently published survey by Black Book Market Research.

The results are based on a four-month user poll among 5,700 small and solo physician practices across all medical and surgical specialties. According to 83 percent of the respondents, the single biggest trend in physician technology is cloud-based EHRs.

Improvements in Web-based EHRs--including implementations, updates, usability and customization--have reversed overall EHR satisfaction in small practices from barely 13 percent in 2012 to 83 percent overall, small practice EHR users said in the second quarter of 2015.

The adoption rate of cloud-based EHRs in small practices in urban settings has also increased from 60 percent in 2013 to 82 percent in 2015. However, the adoption by rural practices remains the same as was in 2013, at 20 percent. Of the solo-practice rural physicians, 91 percent stated that fear of Internet outages has prevented them from changing to a cloud-based EHR.

"The focus of healthcare technology vendors needs to be on mobile, cloud, and data integration to successfully meet the future demands of the changing healthcare landscape," Doug Brown, managing partner of Black Book, said in an announcement.

Other findings of the report include:

  • 79 percent of small practices cited pricing is the main factor in purchasing a cloud EHR. Of small practices that switched EHRs between June 2014 and May 2015, 48 percent reported that the financial burden of changing EHRs has put the practice in an unstable financial position.
  • 38 percent of solo and small practice physicians have moderate to serious concerns about the security and privacy of cloud-based electronic health record systems, despite 90 percent recognizing that the cloud EHR models have matured in this regard.
  • 81 percent of physicians employing server-based EHR software say they are concerned about breaches, while 92 percent of small-practice EHR users that switched to a cloud-based EHR from a server in the last six months feel their chances of a major patient record data breach are lowered.
  • 69 percent of respondents said first-generation EHRs have not lived up to expectations, and are particularly dissatisfied with cost add-ons, affected workflows and lost time with patients.

"An increasing number (79 percent in 2015, up from 64 percent in 2014) of new conversions are using software-as-a-service type implementations, driving the growing number of physician practices to cloud-based products," Brown said.

The lack of interoperability was cited by 91 percent of respondents as the biggest challenge to improving clinical and financial performance, while concerns about implementation and deployment has fallen to 20 percent from 82 percent in 2013.

In March, the U.S. Department of Health and Human Services and the Office of the National Coordinator for Health IT released Meaningful Use Stage 3 proposed rules to support nationwide interoperability. The proposed rules have come under fire from industry groups, which find them complicated and "unworkable." 

"As risk sharing increases, so will the demand for meaningful, robust data sharing between providers and payers regardless of the model EHR employed," Brown said. If interoperability issues are not resolved, they will drive another round of cloud- and server-based EHR replacements, he added.

To learn more:
- read the announcement