Black Book surveyed 738 emergency department administrative and nursing managers, and 1,104 ED physicians (over half are members of the American College of Emergency Physicians). 89% of ED leaders believe their hospitals rushed to purchase new EHRs and ED systems between 2010 and 2013 for meaningful use dollars, just to see productivity fall, liability rise and connectivity stall.

Seven of every eight US hospitals are reporting 18%+ increases in ED visits over a year ago, mainly sourced to the shortage of primary care physicians, an aging population, a data driven industry and the increase of high-deductible Obamacare insured patients. The increase is reportedly congesting facilities, overtaxing physicians, causing nursing shortages, and triggering descents in overall hospital patient satisfaction.

Emergency department managers and physicians are also attributing ED complications to the lack of Emergency Department Information Systems (EDIS) usability and interoperability to external providers, affecting a swiftly growing replacement market.

35% of hospitals over 150 beds are currently, or plan to replace their EDIS in 2016. The majority of replacements (69%) will be those now using enterprise EHR emergency modules, opting for best-of-breed EDIS systems that can integrate with the hospital’s EHR.

Hospital administrators are also including the ED physician and nursing staff on the EDIS decision, something that was rarely done just a few years ago when original systems were chosen primarily for government incentive dollars.

In 2010, Black Book surveys recorded only 7% of ED physicians and 2% of ED nursing staff were involved on the EDIS selection teams where enterprise EHRs were given as the only technology option for their respective EDs. In 2015, and 2016 pending EDIS selection processes, 70% of ED physicians state their feel incorporated, as well as 16% of ED nurses.

39% of hospitals with enterprise EHR emergency modules identify themselves as moderately to highly dissatisfied with their current EDIS, yet 90% of those managers and physicians claim they are stuck with making hospital-wide generic EHR systems work, and/or they have been denied budget funds for 2016 EDIS replacements.

Many of those EDIS purchases were made as part of EHR systems, some hospitals dedicated six months to two years in implementations, just to remove those systems for significant issues with patient satisfaction, physician productivity, even safety issues, according to Doug Brown, Managing Partner of Black Book.

“Most best of breed EDIS solutions, not all, are fined tuned for the emergency department environment and workflows,” said Brown. “In contrast, enterprise EHR solutions have typically been very generic with difficult customization processes and long implementations for emergency departments.”­

The survey, conducted August through October, found hospitals polled utilizing Epic Systems’ enterprise EHR solutions were most dissatisfied with the inability to integrate with best of breed EDIS solutions (86%) or provide widespread connectivity to obtain external records (83%).

Cerner, Allscripts, Healthland, Evident CPSI and Meditech enterprise EHR solutions faired much higher, all surpassing several long standing best of breed EDIS products in 2015. 79% of collective users of those EHR systems credit substantial enhancements in usability since 2010.

Hospitals employing the EDIS solutions from best of breed vendors T System and Optum (Picis) rated their experiences the highest including usability by ED nurses and order entry by ED physicians.

Hospitals ranked their six (6) most desirable features in a 2016 replacement EDIS, either best of breed or enterprise EHR based:

Coding Improvements, 42%

Reporting Improvements, 66%

Customer Services Improvements, 24%

Cost Reductions, 19%

Ease of Use, 86%

Improved Resource Planning, 23%

Diagnosis Enhancements, 70%

Physician Productivity Improvements, 89%

Staff Productivity Improvements, 63%

Patient Satisfaction, 68%

Interfaces, 29%

Revenue Cycle Improvements and Charge Capture, 43%

Interoperability & Connectivity (Internal and External Sources) 93%

Tablets/Smart Phones 87%

“An obvious game changers in the EDIS replacement environment are developments in EDIS interoperability and mobility,” said Brown.

The US EDIS market estimated by Black Book to now exceed $235M is expected to grow to $420M in 2018.

Other significant findings:

78% of hospitals that implemented a replacement EDIS in Q2 2014- Q1 2015 claim they have seen improved reporting capabilities in less than three months post deployment.

76% of hospitals that implemented a replacement EDIS in Q2 2014- Q1 2015 report improved customer services outcomes attributable to some feature or benefit of the replacement EDIS.

44% of hospitals over 200 beds that implemented a replacement EDIS in Q2 2014- Q1 2015, report reduced visit costs of between 4% and 12% as compared to the same period the year prior.

Black Book™ well known internationally for accurate, impartial customer satisfaction surveys in the services and software industries, conducted its annual emergency department software/technology user polls to determine the highest ranked client experience vendors for 2015. As part of a special research focus on hospital, healthcare networks and corporate users, Black Book surveyed the clients of EDIS vendors with the highest scores in customer experience in the functional areas of documentation, interfaces, connectivity and interoperability, data sharing, tracking, charge capture, order management/CPOE, and coding support.

"As hospitals and emergency room physicians grapple with intense pressure to optimize processes with ED visits predicted to rise by double digits again in 2016, EDIS has emerged as a powerful solution to the challenges of a rapidly changing healthcare model," said Brown.

The top ranked EDIS vendors for 2015 were identified as follows:

T Systems – Best of Breed EDIS

Cerner – Single Source Enterprise EHR/ED Solution

T System, Optum Picis and Cerner have jockeyed for the top spots for the past three consecutive years in the Black Book EDIS surveys.

Other top ranked vendors honored by clients in the customer satisfaction survey on 18 EDIS specific key performance indicators are: Optum (Picis), Wellsoft, Evident (CPSI), Healthland, and Allscripts.

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

Since 2000, 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 510,000 current healthcare software and managed services users. Black Book expanded its survey prowess and reputation of independent, unbiased crowd-sourced surveying to IT and health records professionals, physician practice administrators, nurses, financial leaders, executives and hospital information technology managers. Over 2000 users participated in the 2015 polls of EDIS client experience in a sweeping four month set of studies. Additionally, 900 respondents that have not yet fully implemented or optimally using emergency department technology provided insight on budgeting, adoption plans, factors driving EDIS decisions and vendor awareness.