Family Practice Management, an American Academy of Family Physicians (AAFP) journal has conducted a national Electronic Health Record (EHR) User Satisfaction survey semiannually. Kenneth Adler, M.D., a family physician and medical director of information technology at Arizona Community Physicians in Tucson, conducts the surveys in conjunction with Robert Edsall, editor-in-chief of Family Practice Management. The survey's sample size has steadily grown over the years from 408 respondents for the 2005 survey to 2719 respondents for the latest rendition in 2011.

The results of the most recent survey. Only 50% of family practitioners stated they were satisfied overall with their EHRs, and 30% stated they were dissatisfied. The most interesting statistic however from a vendor's perspective is that only 38% of practitioners stated they would purchase their system again! While there are clear leaders in the ambulatory EHR market, there were only 30 EHRs with more than 13 respondents (87%), it's clear that there is definite opportunity in the future for market shares to shift and for less-established vendors to grow.

What are vendors doing right? Well in the ambulatory segment, family practitioners are reasonably satisfied with their ability to customize their EHRs (78%), e-prescribing (70%), and e-messaging (69%). There has been great emphasis on the vendor side to have flexible EHRs, so there is definite success there. Where EHR companies fell very short is vendor support with only 39% of practitioners happy with the support companies provide, in fact over 30% were dissatisfied. Take note vendors, customer service is key!

It has been established that there are clear leaders in the market, yet this survey found that the major companies in the market were the vendors which were rated the lowest in terms of satisfaction. Despite these low satisfaction scores, certain vendors are still thriving. This may be due to the market itself and just how many players there are. The selection of an EHR is a daunting task and choosing well established big name companies is the safe option. So these large vendors are thriving and will likely continue to thrive, but there are clearly factors they can improve.

One attendee noted, Some of the highest rated EHRs were the ones in general that were the most simplistic and least costly. Indeed, this view was echoed by a programmer that works with physicians, When the system is simple, physicians are happy. When you build the system, make it more powerful, they are less satisfied. End of the day, it all comes down to usability, and it's clear that certain vendors are succeeding because they have a simpler system, I should not notice I am using an EHR, it should not intrude in hearing the patient's story, and evaluating them. The only thing that is tied to my satisfaction is usability, remarked a family physician from Ottawa, Canada who has used a comprehensive EHR for 10 years.

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