It should come as no surprise to anyone following the health IT sector that electronic health records vendor eClinicalWorks is currently in the midst of its own Delta Airlines moment.

The damage to eClinicalWorks' image is evidence of continued fallout from a settlement between the firm and the U.S. Department of Justice. The company was found negligent in withholding information from its certifying entity, including information as to how its software reportedly wasn't able to meet certain criteria for standardized drug codes, according to DoJ officials.

eClinicalWorks — along with several of its executives and employees — agreed to pay $155 million in May to resolve allegations that the company violated the False Claims Act. However, eClinicalWorks President Girish Navani recently told Healthcare IT News that it has been winning new customers, and that second quarter sales for 2017 were above $120 million on its EHR, patient engagement and population health software and cloud services.

But the allegations from the DoJ were not a minor blip, suggesting that eClinicalWorks misrepresented the abilities of its software and paid kickbacks of at least $392,000 to specific customers in exchange for promoting its product.

Enter KLAS Research. A new report by the firm says the majority of eClinicalWorks' customers (66 percent) said that the DoJ settlement worsened their view of the company.

It is worth noting that the report, titled "eClinicalWorks 2017: Snapshot of Customer Reactions to the DOJ Settlement," featured responses from only about 50 of eClinicalWorks' 15,000 or so customers — not a representative sample. Even with the tainted vision of the company, KLAS says that only 4 percent of the company's customers said they plan to replace their EHR because of the settlement.

However, 24 percent said they were dissatisfied and planning to replace the vendor, up from 20 percent of respondents prior to the settlement. And 35 percent of customers said they were still satisfied with eClinicalWorks and plan to keep the vendor, compared to 37 percent prior to the settlement.

Healthcare IT News Editor-in-Chief Tom Sullivan spoke with Navani, asking about the KLAS report and why so many clients want to evacuate the company now.

"I don't know about those numbers, but I know we have 15,000 customers," Navani said. "I don't know if they (KLAS) talked to 1,500 of them or 50 of them, but we continue to see not only new business but growth with existing customers, expanding with population health and patient engagement.

"So I don't agree with that. I don't know if the sample size is big enough to understand what it is in terms of the big picture. Focus on customers, do the right thing, and you'll be fine."

When asked what he and others at eClinicalWorks had learned since the DoJ settlement, Navani pivoted the conversation, saying he is not one to look back — he only has his eyes on the future.

It's worth noting, though, that another survey from earlier in the summer — this one from Reaction Data — provided different details than the one KLAS released. Specifically, of the 113 respondents, more than half were not even aware of the legal trouble.

Among those who did know about the settlement, 11 percent of current eClinicalWorks clients said they will finish their contract with eCW and then search for a new EHR vendor. The largest portion — 48 percent — indicated they plan to finish out their contract and then re-evaluate the situation.

The Office of the Inspector General took unprecedented action in late July and posted a YouTube video in an attempt to address the eClinicalWorks fraud settlement. It means to address the electronic health record segment specifically, but takes a somewhat dramatic turn and names eClinicalWorks directly.

"eClinicalWorks was causing healthcare providers who use its software to submit false claims to what is called the Medicare and Medicaid EHR Incentive Program, and it was doing this because its software actually didn't meet the criteria required for a software to be certified in this program," HHS OIG senior counsel John O’Brien said in the video.