As the EHR replacements, provider consolidations and meaningful use uncertainties come to resolutions this year, the client loyalty spectrum discernably ranges from those hospitals with high EHR and HIT satisfaction, clinician usability and business analytics, to other hospitals unmistakably stuck with systems nominally operative, trapped with vendors due to huge capital investments, and in deep debt.
This week, Black Book Rankings unveiled its HIT Loyalty Index, a framework for measuring loyalty and assessing the stability of a vendor’s customer base. The Black Book Loyalty Index is a versatile approach, providing physicians and hospitals with a practical means to leverage the voice of the customer for improved business performance. 2,577 hospital users provided feedback on their intentions to renew current contracts, purchase additional products and services such as HIE, population health tools and revenue cycle management, and the propensity for the client to recommend their inpatient EHR/HIT vendor to peer hospitals.
The report finds hospitals and medical centers over 250 beds ranked Allscripts #1 in client satisfaction for a third year, after displacing Epic Systems, which had maintained the top client bestowed honors for the previous three consecutive years in the academic teaching facility and large hospital category. Clinical users prefer the Allscripts functionality highest in major medical centers.
Cerner retained its 6 year top spot for Community Hospitals ranging from 101 to 250 beds. Cerner also scored highest in nursing user satisfaction in the 2014 and 2015 Black Book polls including over 15,000 hospital nurses regardless of bed size they were currently employed. Hospital corporations, groups and chains, a category ranked only by CIOs and IT managers, selected Cerner as the #1 best EHR for hospital systems.
Overall, loyalty to inpatient EHR/HIT vendors declined 8% from 81% committed clients to 75%. Roughly a quarter of all hospitals currently feel their loyalty to their vendor is based on administrative directives due to high capital investments than on actual satisfaction, usability or product suites available within the brand family.
Black Book Loyalty Index Overview
The Black Book Loyalty Index takes a statistically validated approach to the theory of customer loyalty to create a pragmatic solution to understanding the two dimensions of customer loyalty: customer behavior and the perceptions and attitudes that support these behaviors. The motivation in creating a Loyalty Index was an early recognition by Black Book that the conventional metrics of customer affinity, namely satisfaction, repurchase intent, and client recommendations, were in isolation, insufficient metrics to full understand the complexities of EHR customer behavior and underlying motivating forces.
The Black Book Loyalty Index is structured so the two axes represent two aspects of loyalty – attitude and behavior. This forms four quadrants that are defined as follows:
– Highly Loyal – These HER/HIT customers have every intention of continuing the business relationship and have a positive attitude toward the EHR vendor. They are likely to increase spending in other brand product and services lines, and recommend the EHR to others.
Reachable – These EHR clients have a good attitude about working with the EHR company but do not plan on enhancing their relations. An odd combination, this is a small percentage of clients and indicates something has changed with the hospital or physician group’s business strategy, changing vendors after an acquisition (as dictated by the acquiring hospital or organization), product offerings, or are discontinuing the services or products you purchased. They still speak highly of your firm and provide recommendations to others but aren’t purchasing more.
Locked or “Trapped” – These customers show every intention of continuing business with the EHR but they are not satisfied or happy with some important aspect of the relationship. They feel trapped in the relationship, many times because of large capital expenditures already made, contractual obligations, or regional dictates which make doing business with this EHR imperative for interoperability or ACO development. This is common with hospitals locked into long term agreements making it too hard to switch EHRs. Typically, trapped clients find a better option and are not likely to continue long term business with the IT vendor on other product/service lines.
High Risk – These customers are seeking or entertaining other vendor options. They do not intend to return and have a bad attitude about the relationship, products, service, broken promises or undelivered obligations. These customers and will speak poorly of you in the HIT marketplace.