Cloud-based electronic health record firms are tops in physician satisfaction rankings for small and solo practices, research firm Black Book Rankings reports. According to the firm's research, nearly 70 percent of small and single-physician practices are confident in Web-based EHR systems as usability gets better and connectivity issues improve.

With meaningful use attestations and multiple-system replacements behind them, independent doctors feel the cloud EHRs can help improve financial results, clinical outcomes and increase patient satisfaction.

Black Book Rankings conducted a four-month user poll to determine the highest ranked electronic health records for 2015. Thus, according to 83 percent of the more than 5,700 small and solo medical practices surveyed, the single biggest trend in physician technology is cloud-based EHRs. Reasons cited for the satisfaction include improved implementations, system updates, usability and customization improving satisfaction in small practices from 13 percent in 2012 to 81 percent in 2015.

The adoption rate of cloud-based EHRs in small practices in urban settings has increased from 60 percent in 2013 to 82 percent now, according to the research. The adoption by rural practices remains about the same as was in 2013, around 20 percent, but 91 percent of nonurban physicians in solo practice state that fear of Internet outages prevent them from changing to a cloud-based EHR, despite the benefits.

"The focus of healthcare technology vendors needs to be on mobile, cloud and data integration to successfully meet the future demands of the changing healthcare landscape," said Doug Brown, managing partner of Black Book. "The bigger issues of interoperability and population health outcomes, quality of care reporting and ICD-10 have framed the third-generation EHR vendor and the majority (69 percent) of small practices plan to increase their investment in the advancements made by their current cloud-based vendor."

Pricing is the main factor in purchasing a cloud EHR, according to 79 percent of small medical practices.

However, 38 percent of solo/small-practice physicians have moderate to serious concerns about the security and privacy of cloud-based EHR systems — even though 90 percent said they recognize the cloud EHR platform and infrastructure models have matured into being a top safeguard to protect health information.

Likewise, 81 percent of physicians employing server-based EHR software claim they are concerned that their system, device, server or files may be stolen or breached. And 92 percent of small-practice EHR users who switched to a cloud-based EHR from a server in the last six months feel their chances of a major patient record data breach are lowered, but 52 percent report their fears of system downtime have increased since the switch-over.

In 2013, 82 percent of physician practices reported implementation and deployment as the major EHR issue for their practice, falling to less than 20 percent of users in 2015. Currently, 91 percent of doctors now see the biggest challenge to improving clinical and financial performance is the lack of EHR interoperability between all providers and payers including ancillaries, hospitals, clinics, labs and physicians.

Black Book reports that 69 percent of small-practice physicians agree that first-generation EHRs have not lived up to expectations, particularly dissatisfied with cost add-ons, affected workflows and lost time with patients.

"An increasing number (79 percent in 2015 up from 64 percent in 2014) of new conversions are using software-as-a-service type implementations, driving the growing number of physician practices to cloud-based products," Brown said.

According to the report, Black Book forecasts the healthcare cloud market in U.S. and Europe is expected to grow nearly 24 percent by 2020. In the U.S., the market is projected to reach $3.8 billion, and the global healthcare cloud IT market is on track to surpass $7 billion worldwide in as few as three years, up from $2.4 billion in 2014.

From a field of 349 small-practice-focused vendors, server and Web-based inclusive, the top 20 highest ranked systems for 2015 were all cloud EHRs by nearly 5,729 survey respondents, polled from November 2014 to April 2015.

All top 20 ranked vendors scored above 90 percent in overall client satisfaction across 18 key performance indicators. Communications, connectivity, physician order entry, decision support, patient data management, and result review customer experiences were evaluated in ranking the vendors.

The highest ranked vendor for customer satisfaction in small and solo physician practices for 2015, across all medical and surgical specialties is Praxis EMR.

The other remaining top 20 solo and small-practice vendors for 2015 are (in alphabetical order):

  • ADP AdvancedMD
  • Allscripts
  • AmazingCharts
  • Athenahealth
  • Azalea
  • Bizmatics
  • CareCloud
  • CureMD
  • drChrono
  • eclinicalworks
  • e-MDs
  • Greenway
  • HealthFusion
  • Kareo
  • Modernizing Medicine
  • NexTech
  • Practice Fusion
  • Quest Care360
  • SRS Soft