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Most small practices say core health IT vendors fall short

According to a KLAS report, many small practices report that their core health IT vendors lack key functionalities beyond EHR and practice management, including telehealth.

Over 60% of small healthcare practices (1-10 physicians) report that their core health IT vendor does not meet their functionality needs beyond EHR and practice management, according to a KLAS report.

Practices are looking to third-party vendors to bridge functionality gaps, most commonly for patient engagement features such as telehealth/virtual care, patient outreach, patient intake and scheduling.

For instance, nearly 33% of interviewed Tebra (formerly Kareo and PatientPop) customers use a third-party telehealth tool because they feel Tebra's offering is expensive and doesn't work as expected.

Additionally, while CompuGroup Medical provides revenue cycle management services, more than 20% of respondents have opted for a third-party solution due to struggles with achieving desired collection rates. EHR and practice management (PM) users also want the vendor to improve their overall client support.

Elation Health customers use third-party software to fill a wide variety of functionality gaps, with almost 60% of respondents noting the vendor does not meet their expectations for telehealth and patient intake.

Several small practices use Epic Community Connect supplement with third-party tools because their host organization does not provide all the needed tools, like telehealth and population health, despite Epic offering those solutions.

Azalea Health and NextGen Healthcare Office customers are least likely to supplement their EHR and PM solutions with third-party solutions. Customers of NextGen Healthcare report that the technology often meets their needs for patient engagement and other areas.

Azalea Health often serves small rural practices that report fewer health IT needs, leading them to feel the EHR and PM solutions have fewer functionality gaps.

Most vendors not delivering all technology small practices need

The report found that many small practices want their core vendor to supply a comprehensive platform that includes all or most needed functionalities and services. However, practices note that their core vendors don't always deliver needed technology successfully or that delivery is slower or more costly than expected, leading to reliance on third-party solutions.

Some respondents also indicate better relationships and ROI with third-party vendors, which can decrease interest in using additional functionalities from their core vendors.

Customers of Azalea Health, CareCloud, CompuGroup Medical, eClinicalWorks, Greenway Health, Tebra and Veradigm report that their vendors aren't providing the functionality they need quickly enough. What's more, when functionality is delivered, they feel it often has bugs or doesn't meet their needs.

Since Kareo merged with PatientPop to form Tebra, customers report that the vendor has removed certain features. Additionally, Veradigm clients are frustrated that the company isn't consistently updating its EHR and PM software.

When asked what functionalities core vendors should prioritize developing, interviewed small practices most commonly note the need for a fully integrated patient intake offering.

While most measured vendors provide some patient intake functionality, they don't meet all client needs. Athenahealth, Epic and eClinicalWorks are the only vendors in this report that offer comprehensive patient intake functionality via patient portals or apps.

Customers of Athenahealth and Epic Community Connect have often said the stable, functional patient intake capabilities meet all their needs. However, a few respondents still use third-party patient intake tools to access more effective features.

EClinicalWorks has a new patient intake offering, Healow Check-In. Respondents note this offering has similar functionality challenges to other eClinicalWorks software, leading some clients to look elsewhere for patient intake tools.

Regardless of whether a core vendor offers capabilities outside of EHR and PM functionality, many small practices still need to supplement with third-party software to gain desired features.

NextGen Healthcare and Athenahealth customers underscore the vendors' strength in integrating third-party data with core solutions. Athenahealth respondents especially appreciate the vendor's Marketplace, which includes vetted solutions that integrate into the Athenahealth platform.

Tebra (Kareo) customers are less satisfied, mentioning issues with integration and system usability. Tebra respondents also said they struggle to get support from the vendor about these issues, which disrupt care delivery.

Clients of Elation Health, NextGen Health and Athenahealth have high trust in vendors' ability to improve workflows

Most Elation Health clients feel the vendor is invested in their success. The company recently released an EHR-integrated PM platform, which customers are rapidly adopting. Users of the combined platform are more satisfied than clients who only use the EHR, highlighting the integration, ease of use and streamlined workflow. Additionally, clients said the vendor continually looks for ways to boost efficiency.

NextGen Healthcare customers appreciate that the vendor's EHR and PM platform meets their requirements and allows them to focus on patients' problems instead of on technology challenges.

Interviewed Athenahealth customers and Epic Community Connect sites note confidence in the vendors' ability to deliver needed functionality due to continual investments in IT development.

"This -- as well as the strong external integration with outside healthcare entities -- supports these customers in providing high-quality care," the KLAS authors wrote.

Hannah Nelson has been covering news related to health information technology and health data interoperability since 2020.

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