CLINICAL DECISION

SUPPORT 2016
PROVIDERS EXPECT EMRS TO DRIVE CDS IMPACT

| OCTOBER 2016 | PERFORMANCE REPORT

 CLINICAL DECISION SUPPORT 2016
PROVIDERS EXPECT EMRs TO DRIVE CDS IMPACT

Rather than relying on interfaces to third-party vendors, providers are looking increasingly to their EMR
vendors to drive clinical decision support and provide tools and content directly in the EMR.
% reporting EMR plays a significant or very significant role in their strategy.

Current Role 33%

(n=91)

Future Role 51%

(n=89)

HOW ARE PROVIDERS TACKLING CDS AND WHAT

HAS BEEN THE IMPACT ON OUTCOMES? †
Provider-created CDS content inserted into the clinician
workflow via EMR tools

100%
Largely Homegrown/EMR†; High Impact Largely 3rd Party; High Impact

90%
% Reporting Moderate to Significant Impact on Outcomes (n=83)

POC Disease Reference

Order Sets “Our [third-party] order
80%

sets . . . failed. The lack of “It is the most used tool both in and
interoperability with our EMR out of the hospital.” – CIO
70%
was a major hurdle.” – CMIO
Surveillance
60% Infection Control
Care Plans Diagnostic Support
“[Our EMR vendor's] infection "Impact on better outcomes is
50%
“We got rid of our care-plans control tool is not very well
“We use [a third-party tool] . . . but we minimal because we don’t use [the
systems. . . . We create care developed, and we struggle
have discussed whether we want to keep tools] very often.” – CMIO
plans ourselves now.” – CMIO with it.” – CNO
40% it or move to Epic’s system for surveillance.
. . . [Some] are worried about losing critical
pieces of functionality.” – CMIO
30%

20%

10%
Largely Homegrown/EMR†; Low Impact Largely 3rd Party; Low Impact

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
% Using 3rd Party Tools (n=83)

CDS Solutions Fall Short of Desired

Impact; VBC Driving Energy
The most adopted and impactful CDS tools,
WHICH CDS APPLICATIONS ARE A CORE FOCUS FOR
e.g., disease reference solutions and order
sets, are embedded in workflows. Disease
YOUR ORGANIZATION GOING FORWARD?
reference solutions often work seamlessly in the
Order Sets (n=74) 82%
background and won’t require a lot of attention
Surveillance (n=41) 46%
from providers in the future. Order set content
Care Plans (n=39) 43%
is a much larger focus; today, providers are
primarily the ones to update it since integration POC Disease Reference (n=30) 33%

of third-party solutions is a challenge. Once Infection Control (n=23) 26%

considered the next big area of CDS, surveillance Diagnostic Support (n=19) 21%
is still finding its way in healthcare. With the *17% of providers reported other applications as a core
focus, such as imaging or drug reference CDS tools.
shift toward value-based care, many still see
huge potential for enterprise-wide surveillance
to be used with interdisciplinary care plans and
conditions like sepsis, though neither use is
prevalent today.
®
REPORTS 2016
KLAS intended this research to measure the outcomes being achieved with third-party CDS applications.
However, many providers struggled to quantify their solution’s impact—a telling trend. As a result, this report
highlights other insights gleaned from KLAS’ interviews regarding providers’ CDS solutions. Today, providers
consider ease of adoption and clinical-reference quality when purchasing a system. What does the future hold
for CDS? What role will EMRs play, and which third-party applications do providers report having success with?

1 PROVIDERS LOOK TO CERNER AND EPIC FOR FUTURE CDS

INITIATIVES; MCKESSON, MEDITECH NOT READY
Due to ongoing integration goals, providers are EMR VENDORS’ ROLE IN FUTURE CDS STRATEGY
shifting their CDS strategies to focus on EMRs.
They want more EMR-supplied tools from Epic, *Limited Data

Epic (n=31) 61% 13%

Cerner, and Allscripts for order sets, surveillance,
infection control, and care plans, with Allscripts Cerner (n=19) 58% 32%

sites requesting deep customization. Some Allscripts* (n=10) 40% 40%

providers cite MEDITECH’s approach as too MEDITECH* (n=11) 36% 27%
reactive but are optimistic about forward-thinking McKesson* (n=6) 33% 17%
tools within the 6.x platform for things like sepsis. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

McKesson customers are focused on getting their Very Significant/Significant Moderate

EMR working smoothly. Note: Only go-forward platforms included

2 ORDER SETS: ZYNX, WOLTERS KLUWER DIVERGE IN

PERFORMANCE; EMR INTEGRATION STILL BIGGEST CHALLENGE
Having improved over the past two years, Zynx
Health has emerged as the top-performing
ORDER SETS
YEAR-OVER-YEAR VENDOR PERFORMANCE
order set vendor. Customers benefit from strong 100 pt Scale

2014 2016
service, better-set expectations (especially around 100
integration challenges), and good overall follow-
through. Wolters Kluwer generally meets needs, 90 (n=32)
Zynx Health
ZynxOrder (n=23)
87.4
but performance has dropped recently due to
(n=36)
unrealistic expectations around EMR integration. 80 Wolters Kluwer
ProVation Order Sets (n=30)
80.0
Overall, two-thirds of respondents are not using
70
a third-party vendor, since updating order set
content is laborious regardless of approach. 60

3
50

SURVEILLANCE: WOLTERS KLUWER BEST OF PHARMACY-FOCUSED

VENDORS; PROVIDERS LOOKING TO EMRS FOR BROADER IMPACT
Wolters Kluwer leads the third-party surveillance SURVEILLANCE: OVERALL SCORE AND FUTURE PLANS
vendors, coupling a stable product with attentive,
accommodating service. Responsiveness to *Limited Data
Overall Performance Score Part of Long-Term Plans
customer requests has declined since Premier 100-pt Scale

Premier TheraDoc
acquired TheraDoc. 35% of customers plan to Clinical Surveillance System (n=15)
78.4 65%
switch, many to their EMR vendor. The industry’s
shift to value is driving increased awareness Wolters Kluwer 85.0 83%
Pharmacy OneSource Sentri7 (n=24)

of enterprise-wide surveillance, with providers Below Konfidence

looking to their EMRs as the answer. Today, many IBM (Truven Health)
Micromedex 360 Care Insights Care Focus 86.7* 88%*
customers leverage Cerner’s sepsis tool; Epic (n=7)

has a few live surveillance customers; several 50.0 75.0 100.0 0% 50% 100%

MEDITECH customers have noted broad-ranging

surveillance applications within 6.x.
®
REPORTS 2016
4 CARE PLANS: LACKING IN ADOPTION AND IMPACT
Though Elsevier, Wolters Kluwer, and Zynx all
offer evidence-based content that meets nurses’
CARE PLANS: DEVELOPMENT AND FUTURE PLANS

expectations, care plan adoption has not taken off. *Limited Data

Care plans are a focus for 43% of organizations, Delivery of New Technology
1-9 Scale
Part of Long-Term Plans

who see interdisciplinary care plans as critical to Elsevier 7.4* 94%

Care Planning (n=15)
success with value-based care. All vendors have
generally good support, but each is cited for Zynx Health 7.9 94%
ZynxCare (n=14)

specific areas needing improvement: As with other Below Konfidence

vendors, Zynx’s content can be labor intensive Wolters Kluwer 6.6* 100%*
ProVation Care Plans (n=8)
to tie into the EMR; Elsevier’s usability and user
interface need enhancement; and Wolters Kluwer 4.0 9.0 0% 50% 100%

lags in development and post-implementation

follow-up.

5 POC REFERENCE: UPTODATE THE CLINICIAN PREFERENCE; A FEW

CONSIDERING EBSCO AS REPLACEMENT
Disease reference tools are the most widely POINT-OF-CARE REFERENCE TOOLS:
adopted CDS applications. Despite frustrations PERFORMANCE AND VALUE
over high cost, UpToDate’s ubiquity and workflow
*Limited Data
integration are unique factors positively impacting Overall Product Quality
1-9 Scale
Money's Worth
1-9 Scale
outcomes. A few organizations are looking at long- Wolters Kluwer 7.0 6.6
time librarian favorite and overall score leader UpToDate (n=26)

EBSCO as an alternative. They feel EBSCO’s EBSCO 8.0 8.3*

DynaMed and DynaMed Plus (n=16)
lower-cost DynaMed Plus content is on par with
Elsevier
UpToDate, allowing them to switch. Elsevier’s ClinicalKey (n=16)
7.5 7.2*

adoption lags overall, and their performance is

4.0 9.0 4.0 9.0
lower due to inconsistent support.
Diagnostic support vendors perform well, yet
lag in adoption. VisualDx offers strong tools for VisualDx
VisualDx (n=20)
8.4 8.0
helping diagnose various skin conditions. Isabel
Below Konfidence
offers broader diagnostics with an improved Isabel 7.7* N/A
engine. It has not caught on with physicians, who Isabel (n=6)

tend to follow their own guidelines and workflow.

6
4.0 9.0 4.0 9.0

INFECTION CONTROL: BD, WOLTERS KLUWER STRONG

OPTIONS; EMR VENDORS BEHIND
BD provides a robust product and works closely INFECTION CONTROL: OVERALL PERFORMANCE
with users to generate value. Wolters Kluwer’s AND FUTURE PLANS
product is easy to use, and the vendor has recently *Limited Data Overall Performance Score Part of Long-Term Plans
100-pt Scale
improved their service. Premier’s support has
BD MedMined
become increasingly inconsistent, ranging from (Carefusion) (n=21)
93.3 97%

amazing to unresponsive. 25% of respondents are Wolters Kluwer 89.5 89%

Infection Control (n=15)
planning to leave. Predicting an ROI for third-party
Premier TheraDoc 82.9 75%
solutions can be difficult, so providers are looking Infection Control Assistant (n=26)

to their EMR. Cerner’s solution is immature and Below Konfidence

has a minimal impact; providers are still optimistic Cerner

Infection Control (n=6)
69.2* 100%*
about its development. Epic’s platform is widely Vecna 87.4* N/A
anticipated; adoption is limited to date. No Infection Control (n=5)

MEDITECH or Allscripts customers mention an VigiLanz 91.0* 100%*

Infection Control (n=5)

infection control solution from their EMR vendor.

50.0 75.0 100.0 0% 50% 100%

® This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price.
REPORTS 2016 Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2016 KLAS Enterprises, LLC. All Rights Reserved.
REPORT INFORMATION
READER RESPONSIBILITY:
KLAS’ website and reports are a compilation of research gathered from websites, healthcare
industry reports, interviews with healthcare provider executives and managers, and interviews
with vendor and consultant organizations. Data gathered from these sources includes strong
opinions (which should not be interpreted as actual facts) reflecting the emotion of exceptional
success and, at times, failure. The information is intended solely as a catalyst for a more meaningful
and effective investigation on your organization’s part and is not intended, nor should it be used, to
replace your organization’s due diligence.

AUTHOR KLAS data and reports represent the combined opinions of actual people from provider
ADAM CHERRINGTON organizations comparing how their vendors, products, and/or services performed when measured
adam.cherrington@klasresearch.com against participants’ objectives and expectations. KLAS findings are a unique compilation of candid
opinions and are real measurements representing those individuals interviewed. The findings
presented are not meant to be conclusive data for an entire client base. Significant variables
including organization/hospital type (rural, teaching, specialty, etc.), organization size, depth/
breadth of software use, software version, role in the organization, provider objectives, and system
infrastructure/network impact participants’ opinions and preclude an exact apples-to-apples
vendor/product comparison or a finely tuned statistical analysis.

We encourage our clients, friends, and partners using KLAS research data to take into account
these variables as they include KLAS data with their own due diligence. For frequently asked
questions about KLAS methodology, please refer to the KLAS FAQs.

COAUTHOR/WRITER COPYRIGHT INFRINGEMENT WARNING:

JON CHRISTENSEN This report and its contents are copyright-protected works and are intended solely for your
jonathan.christensen@klasresearch.com organization. Any other organization, consultant, investment company, or vendor enabling or
obtaining unauthorized access to this report will be liable for all damages associated with copyright
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ANALYST regarding your specific obligations, please refer to the KLAS Data Use Policy.
MICHAEL WOOD
michael.wood@klasresearch.com
ABOUT KLAS:
For more information about KLAS, please visit our website.
CO-ANALYST
ALAN HINTZE OUR MISSION:
alan.hintze@klasresearch.com
KLAS’ mission is to improve the delivery of healthcare technology by independently measuring and
reporting on vendor performance.
DESIGNER
RYAN PLUMB NOTE:
ryan.plumb@klasresearch.com Performance scores may change significantly when including newly interviewed provider
organizations, especially when added to a smaller sample size like in emerging markets with a small
number of live clients. The findings presented are not meant to be conclusive data for an entire
PROJECT MANAGER client base.
AMY GOODSELL
amy.goodsell@klasresearch.com

630 E. Technology Ave. Orem, UT 84097

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