Researchers at the Mayo Clinic found that it can take up to 17 months for patient satisfaction scores to return to pre-EHR switch levels.
Patient satisfaction decreases significantly after a healthcare organization switches its EHR system, and it takes several months for satisfaction scores to return to pre-switch levels, according to a study published in the Journal of Informatics in Health and Biomedicine.
The health technology market is saturated with over 680 vendors supplying health IT to over 384,000 providers, according to the study. And although there are 10 vendors that dominate most of the EHR field, there are three that are considered the most popular.
This means that at some point, there is a good chance a hospital will switch to one of those top three vendors. These medical providers should consider the adverse effective of an EHR change, especially when it comes to the patient experience and elements of a care encounter that are not tied to patient-provider interactions.
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“If switching to a new EHR significantly reduces identifiable components of patient satisfaction, leaders need information on the anticipated extent and duration of these effects,” the researchers said. “A significant change in patient satisfaction from an EHR switch could be an unintended major confounding factor that could interfere with analysis and interpretation of ongoing interventions aimed at improving patient satisfaction.”
Researchers at the Mayo Clinic were able to track EHR patient satisfaction because the health system made the switch from Cerner to Epic Systems in 2017 and 2018. The study was conducted at six hospitals across the country, tracking satisfaction with access, care provider, and moving through the visit.
Researchers found that out of the 24 patient satisfaction questions asked to the patients at the six Mayo Clinic hospitals, all were affected negatively by the EHR switch.
Although patient satisfaction decreased across the board, patient satisfaction in regards to access was impacted the most. Specifically, patients were less pleased with appointment scheduling, convenient office hours, registration staff courtesy, and the ease of getting a clinician on the phone. In this category alone, it took nine to 15 months for patient satisfaction to return to the pre-EHR switch levels.
Next, the “moving through your visit” questions were also highly affected. These two questions were about delays and wait time at the clinic.
“Practice assessment” questions also saw a high negative impact. These questions asked how the staff worked together and the likelihood of recommending the practice.
Following those questions, researchers gauged how long it typically took the patient to return to pre-switch patient satisfaction levels. Using the separate categories, it ranged anywhere from three months to nearly 17 months.
Researchers also observed that patients were able to sense an EHR change because they were being scheduled on two separate systems prior to the new go-live date. Because clinicians were in the act of using separate systems, they would ask patients to be put on hold to schedule or ask them to wait if the patient was physically in the office.
Although the Mayo Clinic said it was extremely prepared and diligent to make the EHR switch the least disruptive as possible, the clinic still saw a negative impact.
“Planning for the switch involved hundreds of employees working with Epic staff over several years before go-live,” the team wrote. “A healthcare financial journal and a local newspaper even reported that the EHR switch did not significantly impact Mayo’s earnings. However, other healthcare institutions should take note that even with meticulous planning there may be some patient dissatisfaction associated with an EHR switch.”
It should be noted the data did not reveal a significant drop in patient satisfaction with an individual’s clinician. Instead, patient satisfaction dropped with the process of care or the care experience itself. That is to say, an EHR switch affected how the patient interacted with healthcare systems and processes, not the interpersonal connecting a patient may perceive with her provider, the researchers said.
“Satisfaction with care providers may show no decrease or a smaller decrease compared with a larger drop in satisfaction concerning access, wait time, and information about delays,” wrote the authors. “After an EHR switch it may take several months to regain lost patient satisfaction.”
“Quality experts focusing on patient satisfaction interventions should be aware of a potential confounder associated with an EHR switch,” the authors concluded. “Healthcare leaders should consider changes in patient satisfaction associated with an EHR switch when looking at patient satisfaction on an institutional scale or at the individual provider level.”
Source: EHR Intelligence