KLAS: Epic Leads in Functionality Adoption for FQHCs

What You Should Know:

• Federally qualified health centers (FQHCs) hold a significant and distinct place in US healthcare by providing low-cost, government-subsidized care to undererved populations. Due to FQHCs’ integrated care model and government ties, it is harder for these organizations to find comprehensive EMR and PM solutions that meet all care setting needs and are also reasonably priced.
• A new report by KLAS is the first look at HIT vendors who deliver needed functionality and reporting at a price point FQHCs can afford; additionally, the report examines how well these vendors help FQHCs achieve an integrated care model, their organizational mission, and integration with affiliated and non-affiliated hospitals.

Which Vendors Best Meet FQHCs’ Unique Needs?

Each year, KLAS interviews thousands of healthcare professionals about the IT solutions and services their organizations use. For this report, interviews were conducted over the last 12 months using KLAS’ standard quantitative evaluation for healthcare software, which is composed of 16 numeric ratings questions and 4 yes/no questions, all weighted equally. Combined, the ratings for these questions make up the overall performance score, which is measured on a 100-point scale. The questions are organized into six customer experience pillars—culture, loyalty, operations, product, relationship, and value.

Key insights from the latest report are as follows:

1. Epic Leads in Functionality Adoption for FQHCs: Epic Community Connect- Customers are most consistently satisfied with functionality and use more capabilities than other measured vendors’ customer bases. The EMR is unanimously cited as a core strength; respondents say functionality is stable, robust, and continually improved. Some note difficulties with accessing needed data and reporting for UDS measures, scanning, faxing speed, and the behavioral health and dental modules. athenahealth- Integrated EMR/PM solution is a core strength that allows FQHCs to document easily and operate efficiently. Some feel the vendor should better align the product with FQHC workflows and provide stronger UDS reporting. Virtual care is an adoption gap; customers want to do more virtual care but feel the module is too costly. Nearly 60% of respondents want the vendor to focus on improving the behavioral health module. NextGen Healthcare- Scores highest for functionality, but provider satisfaction with functionality is more variable. FQHCs say vendor’s key strength is reporting for UDS measures, A/R, and other financial metrics. Common issues among dissatisfied respondents include problems with the patient portal and insufficient patient intake capabilities. Greenway Health – Practice management system is noted as a strength and handles complex FQHC billing well; reporting is also seen as a strength. Multiple respondents report product shortcomings such as population health, patient intake, and virtual care; these FQHCs often use third parties to supplement gaps, leading to a low sense of value. eClinicalWorks (limited data) – Respondents note vendor offers a lot of functionalities for the price but that the cost is not worth the quality issues across modules. Vendor receives lowest score among measured vendors for providing needed functionality and for overall value.
2. NextGen Healthcare & Epic Best Help FQHCs Achieve an Integrated Care Model; Functionality Issues & Gaps Hinder Greenway Health & athenahealth Customers: Most FQHCs either plan to implement a comprehensive HIT solution or have already done so. NextGen Healthcare respondents highlight that the broad platform is more efficient than a less-integrated approach. Since the vendor operates exclusively in the ambulatory space, FQHCs feel the vendor can focus on their needs and provide desired technology and customizable workflows. Commonly reported challenges include integration with the patient portal and data flow between dental and PM modules. All Epic respondents are moving or plan to move to an integrated care model with the vendor. Greenway Health customers give mixed feedback on the functionality’s ability to support an integrated care model; some cite easy data sharing, and others note challenges sharing data between departments. athenahealth customers struggle to move toward an integrated care model; the vendor has historically not provided a dental solution, leading customers to use third-party solutions.
3. Strong Relationships & Technology from NextGen Healthcare Support FQHCs’ Organizational Missions: Strong relationships from NextGen Healthcare lead all interviewed FQHC customers to feel the vendor supports their mission to treat underserved populations. Respondents state the executives and account representatives are attentive and concerned with customers’ success. They also point to strong technology as a key driver of success, noting that the reporting, features, and workflow collectively help them achieve goals. Users of athenahealth appreciate how the strong clinical functionality supports their mission, and some say the vendor has gotten better at catering to FQHCs’ needs. Others feel athenahealth still struggles a bit and want improved UDS functionality, reporting, billing, and FQHC-based workflows. The Greenway Health customers who are most satisfied with the vendor’s ability to support their mission cite the clinical functionality, the vendor’s focus on FQHCs, and minimal integration issues. Respondents who experience integration challenges rate the vendor lower, saying the lack of easy data sharing hinders their mission. Customers also want the vendor to further improve the clinical workflow and practice management module. Epic users feel the solution is evolving to meet their needs and expect the vendor to continue to add FQHC-specific functionality that will support their mission. Several Community Connect customers have experienced problems with their hosts (including a lack of training and slow resolution times) and want more support for their mission via improved workflows.
4. Epic Customers Most Able to Share Data with Affiliated Hospitals & Other Epic Organizations: Epic integrates well with affiliated hospitals also using Epic’s software; customers highlight the ease with which they can send important data to other Epic facilities as one of the vendor’s greatest strengths. Epic clients that are affiliated with organizations using other EMR vendors are far less satisfied with integration and report they sometimes have to send faxes. Multiple respondents rate NextGen Healthcare high for integration and successful data exchange with affiliated hospitals. Less-satisfied customers cite interface costs, improperly interfaced HL7 connections, and sometimes having to use faxes. Feedback on Greenway Health’s ability to support data sharing with affiliated hospitals varies. Some satisfied FQHCs have found success using local HIEs. Others note issues with the vendor’s high integration costs; one respondent struggled to use CommonWell and has reverted to sharing patient data via Direct messaging.
5. FQHCs Are Dissatisfied with All DMS Solutions; Dentrix Enterprise the Only Vendor-Agnostic DMS Widely Mentioned: FQHCs are federally required to offer dental services to their populations but are generally dissatisfied with the dental management software (DMS) offerings’ integration with technology from their HIT vendors. Customers using NextGen Healthcare’s Electronic Dental Record (EDR) feel it integrates well with the EMR, dental equipment, and imaging software, and they are optimistic integration will further improve over time. Dissatisfied respondents report issues with billing data flowing from EDR into the PM solution. Some low scores for the vendor’s DMS integration come from customers who use EDR with EMR/PM solutions other than NextGen Healthcare’s. Greenway Health respondents provide mixed feedback about MediaDent—some say it meets their integration needs and data flows as promised, while others haven’t been able to achieve the expected level of integration between the EMR and DMS (despite the vendor promising to address integration issues). Epic customers using Wisdom feel it is still evolving; they cite implementation missteps, incomplete training, and fragmented integration as sources of dissatisfaction. athenahealth began offering their own DMS in 2023; respondents did not provide feedback about this solution, and most don’t use any DMS. Of those whose do, three use Dentrix Enterprise, and two use NextGen Healthcare’s DMS; all feel the integration is limited or nonexistent.

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