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Cloud-based electronic health record systems are the highest ranked EHRs in terms of physician satisfaction among small and solo practices, according to Black Book Rankings.

The firm reports that the top 20 ranked vendors for 2015 were all cloud EHRs and all of them scored more than 90 percent in overall client satisfaction across 18 key performance indicators. Further, 83 percent of the more than 5,700 small and solo medical practices surveyed by Black Book indicated that the single biggest physician technology trend is cloud-based EHRs.

Thanks to improvements in web-based EHRs including implementations, updates, usability and customization, the survey reveals a reversal in overall EHR satisfaction in small practices from barely 13 percent meeting or exceeding expectations in 2012 to 81 percent in the second quarter of 2015.

Also See: EHR Adoption Increasing Among Solo and Small Practices

While 69 percent of small practice physicians agree that first generation EHRs have not lived up to expectations, 51 percent of solo physicians currently using cloud-based EHRs reported improved productivity results from their current cloud-based system as compared to both cloud- and server-based EHRs they implemented previously.

In addition, the adoption rate of cloud-based EHRs in small practices in urban settings has also increased from 60 percent in 2013 to 82 percent currently. However, Black Book notes that the adoption rate by rural practices remains about the same as it was in 2013—around 20 percent—as most rural physicians say the fear of Internet outages prevents them from changing to cloud-based EHRs.

Although 38 percent of solo/small practice physicians have moderate to serious concerns about the security and privacy of cloud-based EHR systems, 90 percent recognize that the cloud EHR platform and infrastructure models have matured into being a top safeguard to protect health information.

At the same time, 81 percent of physicians using server-based EHR software claim they are concerned that their system, device, server or files may be stolen or breached. Ninety-two percent of small practice EHR users that switched to a cloud based EHR from a server in the last six months feel their chances of a major patient record data breach are lowered, but 52 percent still reported fears of system downtime have increased since the switchover.