Tech Support Quality Emerges as the Highest Compelling Differentiator in Continued EHR Loyalty, Utilization and Overall Satisfaction, 2016 Black Book Survey Results

Price and features are no longer the only driving factors of EHR replacement competition according to nearly 2,200 health IT user responding in a Q4 2015 Black Book survey. Vendors must also provide an overall greater technical support experience after the sales are made to keep customers happy and loyal, but many pass the duty on to outsourcers.

​​​​​​Black Book™ surveyed hospital and network physician based electronic health record software users, employing eighteen key performance indicators specific to comprehensive technical support experiences in Q4 2015.  Managed tech support vendors evaluated included EHR and HIS vendors, EHR partnered consultants and IT firms, and independent outsourcing firms to determine variances in overall user satisfaction and the effects on long term vendor loyalty.

According to the user results, EHR firms not offering internally, or through a competent partnering IT support firm, an impressing customer technical support experiences stand to lose potential new customers, as well established clients.  82% of hospitals surveyed now insist comprehensive outsourced tech support from their EHR vendor will be a leading competitive differentiator in 2016, and a third of those are not presently pleased.

The usage of outsourced tech support centers is expanding quickly in the healthcare provider sector. 16% of hospital respondents outsource at least half of their tech support needs currently. By year end 2016, 35% of hospitals over 100 beds expect to increase their tech support outsourcing spend by 100%.

And the expertise and quality of tech support services offered are weighing heavily on users’ overall loyalty. 61% of hospital users prefer that their EHR provide direct, comprehensive tech support. 79% of those employing third party outsourcing tech support are significantly dissatisfied with their outsourcer’s level of response and the quality of their services.

Overseas offshored tech support centers scored the worst among healthcare providers on EHR, HIE, analytics and other applications. 97% of physicians practices and 93% of hospitals overwhelmingly prefer US-based, American-English speaking representatives. 100% of both surveyed groups confirmed that negative offshore experiences from outsourced tech support firms (either partnered with or provided by their HIS vendor) have tarnished the users’ overall perception of the vendor’s brand and product lines.

“Enterprise tech support is a highly complex and niche area in healthcare, where specialists can make a big difference in client loyalty by catering from Level 1 to Level 4 product support to ensure all the provider’s business goals are aligned with technology readiness,” said Doug Brown, Managing Partner of Black Book.

Cerner was determined to be the only EHR/HIT offering comprehensive, full, four level technical support with established clients among the 2,200 survey participants in Q4 2015.

“EHR and HIS vendors cannot afford bad customer experiences, and with new revenue responsibilities, tech support organizations can’t miss a beat to best serve established clients,” said Brown. “Unfortunately, many vendors leave tech support duties and quality to the users and third party outsourcers, yet it’s turned out to be one of 2016’s most critical components of client loyalty to their EHR/HIS.”

87% of hospitals over 50 beds are looking for ways to cut IT expense including outsourcing tech support to make budget room for other applications such as analytics, population health tools and revenue cycle transformations.

In the survey process, Black Book identified major trends in healthcare tech support through user interviews and polls.

“The key question to providers has to be, is your outsourced tech support provider, equipped to deal with the industry changes, or better yet help your organization create a competitive advantage?” said Brown. “EHR vendors should be asking themselves the same thing about their tech support firm partners.”


1.     Cloud Applications

With the increasing amount of providers selecting cloud-based EHRs, a key issue will be how EHR vendors provide a differentiated support service experience that allows users to click from within the application to get immediate help.

2.     Tech Support Communications via Video Chat

Hospitals are complex healthcare delivery organizations with multiple applications and skill levels operating the different segments of operations. Physician practice are demanding more live video support immediately, as well.  Video chats boost client service by speeding processing like claims management and patient financial services, providing important value-adds to users.

3.     Growth of high-accountability support model

Most EHR and HIS tech support centers, both provided directly by vendors and by outsourcers, organize around traditional escalation support models, which includes issue passing between tiers and areas of expertise.  But in 2016 and beyond, more tech centers will have to employ a high-accountability or ownership model for more efficient resource utilization. The majority of EHRs are not set up for this passing the parts or the whole process to partner and third party tech support firms.  With a high-accountability model, individual support personnel take ownership of the customer experience directly.

4.     Social media is an important channel of tech support communication

Patients and staff, alike, are increasingly venting complaints on their poor tech support experiences on social media. 69% of EHR/HIT users do not believe their vendors or tech support outsourcers monitor these channels frequently or effectively enough to respond to issues and deflect them.

5.     Predictive Analytics need Support

Making sense of healthcare Big Data is persisting and related technical support needs are on the table waiting to be addressed by EHRs.

6.     Support Service Transparency grows

An increasing number of EHR and HIS vendors are giving customers controlled access to support-related tools and information. Mobility will lead the way, giving health IT users more seamless and transparent interactions, which will ultimately give them instant access to data on their relations with EHR, HIE and, Population Health application vendors.   

7.     Shift in Channels of Tech Support Communication

2016 is seeing huge leaps in self-help, mobile and web along with a continued focus on voice for difficult provider application issues, especially engineering and analytics support.

Vendors scoring highest among the four levels of technical support are Cerner, Allscripts, MEDITECH and McKesson.

More results can be obtained at

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.

The 2016 Electronic Health Record satisfaction survey results, releasing in February 2016 will include additional key performance indicators on user loyalty, a new Black Book report feature.

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 530,000 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. Over 2,000 users participated in the 2015-2016 polls of IT tech support client experience in a sweeping three month set of studies.

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