Community Hospitals Judging the Replacement Value of Integrated Cloud EHR Investments, 2020 Black Book Survey

The acquisition wave of cloud-based community EHR is building momentum among small, rural, specialty and critical access hospitals.

Nearly 6 in 10 surveyed hospitals under 150 beds confirm they are doubting their current health information technologies really deliver business value, while more than a quarter of them are actively assessing cloud-based replacement systems, according to the latest Black Book Q1 2020 user survey.

With over seven hundred polled participants in total, 448 are current users of EHR systems in community, rural and critical access hospitals; 247 identified they are administrators in the evaluation stages; and 55 are EHR clients currently implementing a replacement cloud-based EHR system.

“Small and midsize hospitals, including specialty hospitals and critical access facilities, are often too busy trying to survive to focus on what’s involved in an EHR system replacement or upgrade,” said Doug Brown, President of Black Book Research. “To them, time gets translated into daily cash flow, and without the staff to evaluate and implement a new system or upgrade, a community hospital can end up worse off than if they never attempted to begin with, so this option is gaining their attention.”

EHR users in this category ranked the five key reasons for their respective small community hospitals, critical access hospitals and specialty hospitals to make the move to an integrated inpatient/outpatient/physician practice cloud-based platform. The top responses revealed a common focus on financial performance, user satisfaction and data sharing:

93%  To Improve Hospital Financial Situation, Collections and Concerns

90%  To Free Up Limited Resources now going to EHR operations & Reduce Costs

85%  To Improve Physician Satisfaction and Usability

81%  To Improve Employee Satisfaction and Usability

80%  To Enable enhanced Interoperability and Data Sharing between Non-affiliated providers & payers

Also important but not as crucial in the decision-making process at this time were:

30%  To Improve Data Security

30%  To Improve Clinical Outcomes

19%  To Improve Patient Experience

17%  To Improve Disaster Recovery

11% To Improve Application Management

10% To Participate or Prepare for Value-Based Care Reimbursement

10% To Improve Access to Analytics

According to respondents, the value of cloud-based integrated EHR software will come from its ability to satisfy the specific requirements of community and critical access hospitals.

93% of facilities currently implementing these systems responded that projects were on schedule to go-live.

99% stated they were on budget with the complete project.  

91% reported the current implementations of cloud-based integrated EHRs are causing only minor business disruption moving to the new system.

Integrated, Cloud-Based EHR Vendor Ratings

Of the 750 total respondents, 55 in current implementation, users evaluated product offerings on eighteen key performance indicators including those KPIs marked as most important to small hospitals in the buyers’ market: Deployment, Integration and Interoperability, Trust and Accountability, Scalability, Customer Service, and Breadth of Offerings.

Allscripts was rated highest by those in the evaluation mode and those under current implementations of integrated cloud-based EHR in community, critical access and specialty hospitals.

Cerner, MEDITECH and Allscripts also rated well in KPIs rated by current users of established products in the small hospital settings.

About Black Book

Black Book™, its founders, management and staff do not own or hold any financial interest in any of the vendors covered and encompassed in the surveys it conducts. Black Book reports the results of the collected satisfaction and client experience rankings in publication and to media prior to vendor notification of rating results and does not solicit vendor participation fees, review fees, inclusion or briefing charges, and/or vendor collaboration as Black Book polls vendors' clients.

Black Book's mission is to improve healthcare delivery by expanding the stakeholder's voice from the front-line employee, IT and financial managers, clinical and nursing staff through the C-Suite and Board, as well as healthcare consumers.

Since 2003, Black Book™ has polled the vendor satisfaction across over thirty industries in the software and services sectors around the globe. In 2009, Black Book began polling the client experience of over 690,000 current healthcare software and managed services users. Black Book expanded its survey prowess and reputation of independent, unbiased crowdsourced surveying to IT and health records professionals, physician practice administrators, nurses, financial leaders, executives and hospital information technology managers.

For methodology, auditing, resources, comprehensive research and ranking data see: or contact

Source: Black Book Research


Categories: Hospitals and Clinics

Tags: Allscripts, Cerner, Cloud Computing, Critical Access Hospitals, EHR, Hospitals, Interoperability, MEDITECH, Rural Hospitals, Small Hospitals

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Black Book Market Research LLC, provides healthcare IT users, media, investors, analysts, quality minded vendors,prospective software system buyers, and pharmaceutical manufacturers with client experience competitive analysis and purchasing trends.

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