Comparing vendor prices at the time of a purchase is just the start for hospitals and health systems that want to get their money's worth from an EMR system, concludes a new report from research firm KLAS. Epic and MEDITECH come out on top for meeting expectations.
 
KLAS examines the recent buying experiences of 146 healthcare organizations. Looking at the elements involved in the true cost of ownership, such as getting the money's worth, scope, how well the vendor kept its promises, cost surprises and physician/clinician adoption, the KLAS report Acute Care EMR, Getting Your Money's Worth: The Overall Experience looks beyond the quoted price of an EMR in a contract to the realized cost of owning a system.
 
Because the process has matured, there are fewer pioneers and buyers are savvier, it is less likely today that an EMR project will go way beyond budget. MEDITECH is reported to be most consistently within or under budget delivering its solution, with Epic a close second. Cerner, Eclipsys, McKesson (mainly Horizon clients but with several Paragon included) and Siemens are tightly grouped in the second tier. Being within budget is significant but only one primary measurement in ownership.
 
Monetary ties to meaningful use and HITECH Act requirements put a focus on the proactive development of physician friendly solutions and CPOE that leave some providers hesitant about the ease of use of CPOE options available.

"Some of the less expensive EMR adoptions may sacrifice depth of CPOE to keep costs low," said Kent Gale, author of the report and KLAS founder. "Deep physician adoption typically has a major budget impact and requires significant investment."
 
Getting past general clinical use to deep CPOE adoption typically requires significant additional staffing, vendor and consultant costs.

Purchasers question the overall expense and value a particular EMR solution could bring to their organization. "When purchasing an acute care EMR solution, providers wonder if they will be able to count on what they have budgeted, if they will experience major cost overruns, and if they will get their money's worth especially when it comes to physician use," continued Gale.
 
Epic is the only vendor in the report with high ratings for money's worth, contracting and costs - and Epic projects have the largest scope of any vendor.

MEDITECH clients report little variation from what they expect compared to what they get in the MEDITECH contract, delivery and post-live selling events. However, clients suffer with MEDITECH's lack of proactive help in getting their money's worth.

When it comes to keeping promises, GE is the outlier. Since the acquisition of IDX, GE clients have reported a downward trend in GE's meeting commitments. "Keeping contractual commitments is tough for almost all vendors," Gale explained, "especially in the implementation and go-live phases."