Appendix to An EHR User-Satisfaction Survey: Advice from 408 Family Physicians

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1 Page 1 of 12 Appendix to An EHR User-Satisfaction Survey: Advice from 408 Family Physicians Edsall RL, Adler KG. Fam Pract Manag. October 2005: Available online at Table of Contents Respondent flowchart 2 Chart: Self-reported skill level 3 Respondents experience with the EHR systems reported (months) 3 Chart: Practice-size distribution for 11 EHR systems 4 Chart: Going back to paper records 5 Software interfaces 6 Average number of software interfaces present 6 Systems represented in the survey responses, with number of respondents per system 7 Chart: Systems represented in the survey responses, with cumulative percentage 8 EHR versions represented in the survey 9 Appendix to Edsall RL, Adler KG. An EHR User-Satisfaction Survey: Advice from 408 Family Physicians. Copyright 2005 AAFP. Downloaded from the Family Practice Management Web site at

2 Page 2 of 12 Respondent flowchart 415 Respondents 7 respondents omitted (3 for clear conflict of interest, 2 who could not be identified as AAFP members and 2 who reported no EHR system) 408 Respondents 125 Respondents reporting on EHRs used by < 9 respondents (15 using noncommercial EHRs) Analysis Group 283 Respondents (all using commercial EHRs) Of 408 usable responses, 49 records included no phone numbers, but of the rest, no more than two shared any one area code and telephone exchange, suggesting that no more than two of the responses with phone numbers came from any one practice location. Appendix to Edsall RL, Adler KG. An EHR User-Satisfaction Survey: Advice from 408 Family Physicians. Copyright 2005 AAFP. Downloaded from the Family Practice Management Web site at

3 Page 3 of 12 Chart: Self-reported skill level Responses to the question, "In general, and not just in terms of this EHR system, how would you rate yourself as a computer user?" Expert 15% Novice 0% 2 1% 3 3% Average user 17% 6 34% Novice 2 3 Average user 5 6 Expert 5 30% Respondents experience with the EHR systems reported (months) Minimum Average Maximum Practice Partner (N = 58) Centricity (Logician) (N = 55) e-mds (TopsChart) (N = 36) EpicCare (N = 28) SOAPware (N = 27) HealthMatics (N = 17) NextGen EMR (N = 16) Misys EMR (N = 16) Amazing Charts (N = 11) eclinicalworks (N = 10) Alteer Office (N = 9) All 408 Responses Appendix to Edsall RL, Adler KG. An EHR User-Satisfaction Survey: Advice from 408 Family Physicians. Copyright 2005 AAFP. Downloaded from the Family Practice Management Web site at

4 Page 4 of 12 Chart: Practice-size distribution for 11 EHR systems Amazing Charts (N = 11) SOAPware (N = 27) e-mds (TopsChart) (N = 36) eclinicalworks (N = 10) Alteer Office (N = 9) All 408 Responses Practice Partner (N = 58) HealthMatics (N = 17) Solo Small (2-5 physicians) Medium (6-30 physicians) Large ( physicians) Very Large (>100 physicians) Unspecified Misys EMR (N = 16) NextGen EMR (N = 16) Centricity (Logician) (N = 55) EpicCare (N = 28) 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Appendix to Edsall RL, Adler KG. An EHR User-Satisfaction Survey: Advice from 408 Family Physicians. Copyright 2005 AAFP. Downloaded from the Family Practice Management Web site at

5 Page 5 of 12 Chart: Going back to paper records If I could go back to paper-based records with no financial penalties, I would do so. Alteer Office (N = 9) Amazing Charts (N = 11) e-mds (TopsChart) (N = 36) SOAPware (N = 27) Centricity (Logician) (N = 55) Practice Partner (N = 57) eclinicalworks (N = 10) Disagree Strongly disagree Agree Strongly agree Unsure HealthMatics (N = 17) NextGen EMR (N = 16) All responses (N = 405) EpicCare (N = 28) Misys EMR (N = 16) -100% -80% -60% -40% -20% 0% 20% 40% Appendix to Edsall RL, Adler KG. An EHR User-Satisfaction Survey: Advice from 408 Family Physicians. Copyright 2005 AAFP. Downloaded from the Family Practice Management Web site at

6 Page 6 of 12 Software interfaces The survey asked about five software interfaces automatic connections between the EHR system and other potentially related systems: The practice management system (PMS), a laboratory system, a radiology system, a hospital information system and the information systems of commercial pharmacies. Every such interface has the potential to eliminate duplicate data entry and increase efficiency of operations. From the interface not present responses, it appears that only the PMS interface and lab interface are present in a majority of the EHR installations reported. Approximately 55 percent (224) of respondents say they do not have an interface with a radiology system, 65 percent (264) have no hospital system interface, and 72 percent (294) have no commercial pharmacy interface. By contrast, only 30 percent of respondents (123) have no PMS interface, and only 33 percent (133) have no lab interface. The number of interfaces present varied considerably from system to system among the 11 we analyze here (see Average number of software interfaces present, below). EpicCare was the EHR with the most reported interfaces; the average number installed in the 28 EpicCare installations reported on was 3.7 out of the possible 5. At the other end of the scale, SOAPware and Amazing Charts each averaged less than one interface per installation. Fifteen of the 27 SOAPware installations had no software interfaces, as did eight of the 11 Amazing Charts installations. This is not surprising, given that these two programs are relatively simple and inexpensive, and seem often to be installed as stand-alone systems. Average number of software interfaces present EHR system EpicCare (N = 28) 3.7 Centricity (Logician) (N = 55) 3.1 HealthMatics (N = 17) 3.0 Practice Partner (N = 58) 2.6 eclinicalworks (N = 10) 2.4 All 408 responses 2.4 NextGen EMR (N = 16) 2.3 Misys EMR (N = 16) 2.1 Alteer Office (N = 9) 1.6 e-mds (TopsChart) (N = 36) 1.5 SOAPware (N = 27) 0.9 Amazing Charts (N = 11) 0.6 Appendix to Edsall RL, Adler KG. An EHR User-Satisfaction Survey: Advice from 408 Family Physicians. Copyright 2005 AAFP. Downloaded from the Family Practice Management Web site at

7 Page 7 of 12 Systems represented in the survey responses, with number of respondents per system EHR system Responses Practice Partner 58 Centricity (Logician) 55 e-mds 36 EpicCare 28 SOAPware 27 HealthMatics 17 NextGen EMR 16 Misys EMR 16 Amazing Charts 11 eclinicalworks 10 Alteer Office 9 ChartWare 7 TouchWorks 6 Welford Chart Notes 6 Medent Medical Records 5 EMR ChartLogic 4 Companion EMR 4 Dr. Notes 4 EncounterPRO 4 LastWord 4 Siemens Clinical Manager 4 Amicore PenChart 3 Composite Health Care 3 System CPRS 3 Health Probe Professional 3 McKesson 3 PowerMed EMR 3 Cerner Millenium 2 ChartConnect 2 EpiChart 2 HealthConnect 2 IC-Chart 2 IHS EHR 2 Medinformatix 2 PracticeStudio 2 Praxis EMR 2 AcerMed 1 AltaPoint EMR 1 Berdy SmartClinic 1 Charting Plus 1 CIS 1 Clinical Chart 1 Clinical Workstation 1 Cottage Med 1 Custom 1 Dictaphone Enterprise 1 Workstation ecis 1 Electronic Patient Charts 1 Excelrex 1 HEALTHeFORCES ICDB 1 HealthRamp 1 Horizon Ambulatory Care 1 INFORMM Patient Record 1 Marshfield Clinic 1 MD Logic 1 Medical Manager 1 Medsite 1 Microsoft Office 1 OHM 1 OmniDoc 1 Open source VistA 1 PatientKeeper 1 Pick Systems 1 PowerChart Office 1 Practice Planner 1 Practice Solutions 1 Practice Today 1 PracticeOne Clinical 1 Prime Suite 1 PrognoCIS 1 QD Clinical 1 QUIPRO 1 SynaMed 1 Team Chart Concept 1 Vitalworks 1 WinClicks 1 WinMeds 1 Appendix to Edsall RL, Adler KG. An EHR User-Satisfaction Survey: Advice from 408 Family Physicians. Copyright 2005 AAFP. Downloaded from the Family Practice Management Web site at

8 Page 8 of 12 Chart: Systems represented in the survey responses, with cumulative percentage % 90 90% 80 80% 70 70% Number of responses Cumulative percentage of responses 60% 50% 40 40% 30 30% 20 20% 10 10% 0 WinClicks Vitalworks Team Chart Concept SynaMed QUIPRO QD Clinical PrognoCIS Prime Suite PracticeOne Clinical Practice Today Practice Solutions Practice Planner PowerChart Office Pick Systems PatientKeeper Open source VistA OmniDoc OHM Microsoft Office Medsite Medical Manager MD Logic Marshfield Clinic INFORMM Patient Record Horizon Ambulatory Care HealthRamp HEALTHeFORCES ICDB Excelrex Electronic Patient Charts ecis Dictaphone Enterprise Custom Cottage Med Clinical Workstation Clinical Chart CIS Charting Plus Berdy SmartClinic AltaPoint EMR AcerMed Praxis EMR PracticeStudio Medinformatix IHS EHR IC-Chart HealthConnect EpiChart ChartConnect Cerner Millenium PowerMed EMR McKesson Health Probe Professional CPRS Composite Health Care System Amicore PenChart Siemens Clinical Manager LastWord EncounterPRO Dr. Notes Companion EMR ChartLogic Medent Medical Records EMR Welford Chart Notes TouchWorks ChartWare Alteer Office eclinicalworks Amazing Charts NextGen EMR Misys EMR HealthMatics SOAPware EpicCare e-mds (TopsChart) Centricity (Logician) Practice Partner Appendix to Edsall RL, Adler KG. An EHR User-Satisfaction Survey: Advice from 408 Family Physicians. Copyright 2005 AAFP. Downloaded from the Family Practice Management Web site at 0%

9 Page 9 of 12 EHR versions represented in the survey EHR system Versions reported Number of reports AcerMed AltaPoint EMR 6 1 Alteer Office (N = 9) Amazing Charts (N = 11) No version given 2 Amicore PenChart No version given 3 Berdy SmartClinic Centricity (Logician) (N = 55) No version given 25 Cerner Millenium ChartConnect Charting Plus ChartLogic No version given 2 ChartWare No version given 3 CIS Clinical Chart Clinical Workstation Companion EMR Composite Health Care System II 2 Cottage Med CPRS No version given 3 Custom Dictaphone Enterprise Workstation Dr. Notes No version given 3 ECIS eclinicalworks (N = 10) No version given 4 Electronic Patient Charts e-mds (TopsChart) (N = 36) Appendix to Edsall RL, Adler KG. An EHR User-Satisfaction Survey: Advice from 408 Family Physicians. Copyright 2005 AAFP. Downloaded from the Family Practice Management Web site at

10 Page 10 of 12 No version given 2 EncounterPRO No version given 2 EpicCare (N = 28) IU 2 1 MU 3 1 MU EpiChart Excelrex Health Probe Professional SQL version 1 HealthConnect No version given 2 HEALTHeFORCES ICDB HealthMatics (N = 17) HealthRamp Horizon Ambulatory Care IC-Chart No version given 2 IHS EHR No version given 2 INFORMM Patient Record LastWord Marshfield Clinic McKesson ER9 1 MD Logic Medent Medical Records EMR Medical Manager Medinformatix No version given 2 Medsite Microsoft Office Misys EMR (N = 16) No version given 6 NextGen EMR (N = 16) No version given 8 Appendix to Edsall RL, Adler KG. An EHR User-Satisfaction Survey: Advice from 408 Family Physicians. Copyright 2005 AAFP. Downloaded from the Family Practice Management Web site at

11 Page 11 of 12 OHM OmniDoc Open source VistA PatientKeeper Pick Systems PowerChart Office PowerMed EMR Practice Partner (N = 58) 6.x x Practice Planner Practice Solutions Practice Today PracticeOne Clinical PracticeStudio No version given 2 Praxis EMR Prime Suite PrognoCIS QD Clinical QUIPRO Siemens Clinical Manager No version given 3 SOAPware (N = 27) x x 1 4.x 1 No version given 5 SynaMed Team Chart Concept TouchWorks No version given 3 Vitalworks Welford Chart Notes 4.7N 1 Appendix to Edsall RL, Adler KG. An EHR User-Satisfaction Survey: Advice from 408 Family Physicians. Copyright 2005 AAFP. Downloaded from the Family Practice Management Web site at

12 Page 12 of n 1 No version given 3 WinClicks WinMeds Appendix to Edsall RL, Adler KG. An EHR User-Satisfaction Survey: Advice from 408 Family Physicians. Copyright 2005 AAFP. Downloaded from the Family Practice Management Web site at