Total EHR Stakeholder Satisfaction and Loyalty Leaps for Vendors Generating Solutions for Next Wave of Hospital IT Needs: Cloud, Patient Access, Mobile Optimization, Security, Revenue Cycle and Tech Support; Black Book 2016 Survey Results

As the EHR replacements, provider consolidations and meaningful use uncertainties come to resolutions this year, the client loyalty spectrum discernibly ranges from those hospitals with high EHR and HIT satisfaction, clinician usability and business analytics, to other hospitals unmistakably stuck with systems nominally operative, trapped with vendors due to huge capital investments, and in deep debt.

Black Book’s annual inpatient EHR satisfaction user survey is augmented this year with (1) newly sampled indexes for HIT Loyalty, a Black Book framework for measuring loyalty and assessing the stability of a vendor’s customer base, as well as (2) New Generation EHR and advanced support solutions which polled hospitals find most desirable for their health systems. These include interoperability, cloud innovations, patient engagement, mobile optimization, security and privacy enhancements, big data and population health support, revenue cycle management support and technical support.

3,152 crowdsourced, current hospital EHR users provided feedback on their intentions to renew current contracts, purchase additional products and services such as HIE, population health tools and revenue cycle management, and the propensity for the client to recommend their inpatient EHR/HIT vendor to peer hospitals. Additionally, 640 IT leaders in some juncture of EHR replacement or installation, provided vendor-specific feedback on their impressions and opinions on the next generation of EHR support solutions.

In the first section of the research (Client Satisfaction), the vendors ranking first in client experience are:

Allscripts – Medical Centers over 250 Beds

Cerner – Community Hospitals 101- 250 Beds

Evident/CPSI – Small & Rural Hospitals under 100 Beds

Cerner also received top ranking for usability and functionality by hospital-based nurses and hospitalist physicians in the 2016 poll.

Allscripts, Cerner and Evident/CPSI are scored best in the four previous years among their respective hospital client categories,” said Brown. “With the added loyalty index and the extensive survey on next generation EHR solutions, it is notable that these same vendors have again emerged as the industry top performers in usability and functionality.”

Rising fast among smaller hospitals’ replacement interest are the cloud-based inpatient EHR solutions developing by athenahealth and eClinicalWorks, according to the 2016 survey results.

In the Loyalty research, Black Book found the highest increases in year-over-year brand loyalty among the inpatient EHR customers of  Allscripts, Cerner, Evident/CPSI, athenahealth.

Next generation EHR tools and support solutions among hospitals evaluating a switch or seeking to still replace their EHR system are among our most sought survey results, mainly by health systems seeking vendor selection assistance,” said Brown of the research reports detailing the results. The vendors found offering the most desirable and functional support solutions by users of other systems are:

Interoperability and Connectivity: Allscripts, athenahealth and Cerner

Cloud Innovations: athenahealth and eClinicalWorks

Patient Access and Engagement: Allscripts, athenahealth, Cerner, Epic Systems and Meditech

Mobile Optimization: athenahealth

Security and Privacy Enhancements – Allscripts, athenahealth, Cerner, Epic Systems, Evident CPSI, McKesson and Medhost

Big Data and Population Health: Allscripts, Cerner, Epic Systems, and McKesson

Revenue Cycle Management Support – GE Healthcare, Iatric Systems, McKesson and Siemens

Technical Support – Cerner and McKesson

The Black Book Loyalty Index takes a statistically validated approach to the theory of customer loyalty to create a pragmatic solution to understanding the two dimensions of customer loyalty: customer behavior and the perceptions and attitudes that support these behaviors. The motivation in creating a Loyalty Index was an early recognition by Black Book that the conventional metrics of customer affinity, namely satisfaction, repurchase intent, and client recommendations, were in isolation, insufficient metrics to full understand the complexities of EHR customer behavior and underlying motivating forces.

Overall, loyalty to inpatient EHR/HIT vendors declined 6% from 81% committed clients to 75%. Roughly a quarter of all hospitals currently feel their loyalty to their vendor is based on administrative directives due to high capital investments than on actual satisfaction, usability or product suites available within the brand family. 

“Customer loyalty has emerged as one of the most reliable metrics because of its forward looking nature,” said Doug Brown, President of Black Book. “Using a customer loyalty metric to complement historical metrics such as sales, profitability, operational metrics and satisfaction key performance indicators helps hospitals and physicians make better decisions based on customer insights.”

While many assert loyalty is simply repeat purchases, Black Book’s loyalty index is designed to address the elements of both behavioral loyalty as well as attitudinal loyalty. 

“For example, a client whose customers have both high behavioral and attitudinal loyalty are different from those customers who are loyal because of capital investments in the EHR, but feel trapped,” said Brown. “Customers who feel stuck in their EHR system can follow a downward decision making path towards eventual defection.  Highly loyal customers buy more IT products and service solutions as the EHR vendor adds more sources of revenue for the client.”

About Black Book ™

Black Book Market Research LLC, provides healthcare IT users, media, investors, analysts, quality minded vendors, and prospective software system buyers, pharmaceutical manufacturers, and other interested sectors of the clinical technology industry with comprehensive comparison data of the industry's top respected and competitively performing technology vendors. The largest user opinion poll of its kind in healthcare IT, Black Book™ collects over 450,000 viewpoints on information technology and outsourced services vendor performance annually. Black Book is internationally recognized for over 15 years of customer satisfaction polling, particularly in technology, services, outsourcing and offshoring industries.

Black Book™, its founders, management and/or staff do not own or hold any financial interest in any of the vendors covered and encompassed in this survey, and 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. Follow Black Book on Twitter at

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

Source: Black Book Market Research