Impact Insights

Week in Review 3/6/15

A new report from KLAS finds that competition between Epic and Cerner is “closer than it has been in years past,” with a greater number of potential customers undecided on a specific EHR vendor. In fact, KLAS found that the percentage of sites that are “up for grabs” this year is almost twice as high as 12 months ago. According to the press release, the new “energy in the market is being driven largely by legacy customers looking to make a purchasing decision.” (Note: the chart below pertains just to organizations looking to make a purchasing decision.)

 KLAS chart_030615

(Source: KLAS Research, February 23, 2015)

Impact Advisors’ Thoughts: We don’t have access to the full study, but we suspect that in addition to an increase in the percentage of sites that are “up for grabs,” there has also been an increase in the number of hospitals considering a change – especially given consolidation in the EHR market and concerns among providers about the long-term viability of some vendors.


Despite an increasing number of data breaches in healthcare, fines from HHS’ Office of Civil Rights are rare. According to the story from ProPublica, there have been 1,142 data breaches affecting 500 people or more since October 2009, but only seven (!) of those breaches resulted in a fine.

Impact Advisors’ Thoughts: We knew that fines from HHS after data breaches weren’t particularly common, but we are surprised that they are this rare. That being said, it is almost a moot point. If the staggering costs associated with suffering a breach and the news that hackers are increasingly targeting healthcare organizations aren’t enough motivation for covered entities to be proactive about information security, we doubt increasing the number of fines will have much of an impact either.


A fascinating study in Health Affairs finds significant variations in national hospital rating systems. Researchers looked at Leapfrog, Consumer Reports, U.S. News, and HealthGrades and found that there were not any hospitals that were rated as a “high performer” by all four systems (!). In fact, only 10% of hospitals that were rated a high performer by one site were also rated a high performer by one of the other three. Remarkably, 27 hospitals were actually listed as a high performer on one site and a low performer on another!

Impact Advisors’ Thoughts: The rating systems researchers looked at have different methodologies, but all four are well-respected. The study is a great example of why it is so hard to quantify something that is inherently a bit subjective – such as which hospitals are the “best” or “safest” – and why trying to empower consumers with that kind of information is easier said than done.


A literature review published in Health Affairs finds there is “little evidence” of the impact health information exchange has on the costs and quality of care. According to the authors, the issue is there is a “dearth of rigorous studies that link HIE adoption to clear benefits.” There have been a number of “observational studies” published, but the authors found that no studies have produced actual high-quality evidence on the benefits specifically attributable to use of HIE. In December 2014, an article published in the Annals of Internal Medicine about Health Information Exchange initiatives echoed a similar theme.

Impact Advisors’ Thoughts: To be clear, the study doesn’t dispute that health information exchange can improve outcomes and lower costs when supported by the right processes and technology. Rather, the authors are essentially just saying that there hasn’t been any good scientific research done to definitively prove those benefits.