The list of reasons why specialists don’t like their EHRs could go on for pages, but what it really comes down to is this: most EHRs try to satisfy everyone’s needs, an impossible feat in a world with hundreds of medical specialties. Hospitals and primary care practices can sometimes make a one-size-fits-all EHR work, but specialists have a much harder time adjusting to having an EHR as part of their workflow.

A recent Black Book Rankings survey found that specialists are much less happy with their current EHR than family physicians are. However, most physicians place the blame on themselves. The top three reasons for considering a vendor switch all have to do with picking the right EHR:

  1. Solution does not meet the individual needs of the practice, including workflow (80 percent)
  2. The practice did not adequately assess its needs before selecting the original EHR (79 percent)
  3. Design of EHR is not suited for the practice specialty (77 percent)


Moving forward, specialists are taking a lot more care in picking their next EHR, focusing on more than just qualifying for government incentives. According to Black Book, here are the top five “must haves” for a replacement EHR vendor:

  1. Vendor viability (84 percent)
  2. Provider data integration and network data sharing (83 percent)
  3. Demonstrable return on investment (78 percent)
  4. Adoption of mobile devices (75 percent)
  5. HIE support and interoperability

With the EHR market in a constant state of shuffling out the unpopular EHRs, practices are most concerned with an EHR’s past success and future prospects. Practices want proof now, not just promises.

Another reason specialists are unhappy with their EHR is that most EHRs follow the traditional, point-and-click model, which is the culprit behind lost productivity and user frustration. Of the physicians surveyed in the Black Book study, 93 percent said they would prefer to replace—or at least enhance—their current EHR model with one with voice capabilities. Voice-driven EHRs not only eliminate transcription costs, but they also improve productivity quite a bit. Doctors can save two hours a day by using an EHR that takes full advantage of voice capabilities (i.e., voice commands, faster dictation, etc.).

Many practices aren’t in a position to switch EHRs just yet, but 96 percent agree that they will never achieve their pre-EHR productivity levels with their current EHR.

With 2013 labeled the “Year of the Great EHR Switch,” it will be interesting to see what the theme for 2014 will be. EHR replacement is still going on, but it looks like those who will be most affected this year are the vendors who fail to provide stellar customer service, keep up with government requirements like meaningful use and ICD-10, and to continue to improve the usability of their products.

“The high performance vendors that will emerge as viable past 2015 are those dedicating responsive teams to address customers’ current demands,” said Doug Brown, Black Book’s managing partner.