Customers of eClinicalWorks are more or less of two minds about their EHR vendor's recent legal settlement with the U.S. Department of Justice, says KLAS Senior Research Director Erik Bermudez.

Reaction ranges from, "Yeah, this leaves a bad taste in my mouth but I'm not really going to do anything about it," to, "You know what, this news really pushed me over the edge to the point where I'm absolutely going to make a switch," he said.

Actually, the eClinicalWorks' client base is currently divided fairly equally into thirds, according to the KLAS report: Those planning to jump ship, those who "feel stuck in their contract but would like to switch and may do so when their contract expires," and another third who are still satisfied with their customer experience.

[Also: What eClinicalWorks just told customers about 7 known certification risks in its EHR]

While 34 percent of the providers surveyed plan to migrate to another vendor, however, only 4 percent specifically said they're leaving because of the settlement.

Still, that number could shift in the months ahead. The DOJ compelled the vendor to agree to a series of conditions that would make migration to a competitor easier than it ordinarily would be. On one hand, the corporate integrity agreement signed by eClinicalWorks calls for customers to get software updates free of charge. On the other, it compels eCW to transfer data to competitors' EHR "without penalties or service charges," if that's what customers ask for.

"I spoke to many eClinicalWorks customers who have expressed interest in leaving, and as they have those discussions with eClinicalWorks there's a pretty big price tag – an "exit fee" – to get their data off eCW and onto the new platform if they switch to a competitor," said Bermudez. "So having that (fee) off their plates if they do decide to leave is huge."

At the same time, a small percentage of eCW clients said the aftermath of the DOJ settlement has actually increased their esteem for the company.

"I talked to one CEO of a pretty large customer who said, 'What's interesting is this actually enhanced my impression of eClinicalWorks and brought us closer in terms of a working relationship,'" said Bermudez.

"He said, ‘Within 48 hours we had individual phone calls, numerous calls, with their CEO and their CMO to discuss how this happened, what oversight eClinicalWorks had, and what processes are now in place to make sure this doesn't happen again. And how is the company going to lift themselves back up to hold themselves to a higher standard based upon what they did in this settlement."

But wasn't the norm, he said. In addition to tracking customers' migration plans (or lack thereof), KLAS also sought to assess just how the settlement news affected clients perceptions of eClinicalWorks.

There, the numbers were a bit more decisive. Nearly two-thirds of eCW customers said they're downgraded their opinion about the company. More tellingly, "about one fifth describe the settlement using words like 'unsurprising,' indicating that their personal concerns about the vendor's ethics and business practices have now been confirmed," according to the report.

Healthcare CIOs quoted anonymously in the report pointed to low expectations for the beleaguered EHR vendor.

[Also: Healthcare pros more suspicious of all EHR vendors after eClinicalWorks scandal]

"I wasn't surprised to hear what eClinicalWorks has been doing," said one. "They have been cutting corners, and it has caught up to them. I feel like I have a good relationship with them, but we are already in a mode to replace them. We are just deciding who to go with. This news just makes me double down on my opinion that eClinicalWorks is not doing things the right way."

"None of the legal issues surprised us," said the another. "We have complained repeatedly over the years about many of these issues, such as poor software control, the lack of change control, and the lack of a process for addressing patient-safety issues or tracking. Our belief is that eClinicalWorks will not be able to develop the business structure needed to address these issues."

Still, a few others were more optimistic. 

While the report found that most users now view eClinicalWorks more negatively than they did before, a small group – few than 5 percent of those surveyed – feel the increased governmental oversight will lead the vendor to improve.

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com

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