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EHR Replacement Roadmap to Success

Posted on July 29, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re just now starting down the road of the EHR replacement cycle. Meaningful use has driven many to adopt an EHR too quickly and now the buyer’s remorse is setting in and we’re going to see a wave of EHR replacements. Some organizations are going to wait until meaningful use runs it course, but many won’t even be able to wait.

With this prediction in mind, I was interested by this Allscripts whitepaper: Key Hidden Reasons Your EHR Is Not Sustainable and What To Do About It. I always learn a lot about a company when I read whitepapers like this one. It says a lot about the way the company thinks and where they’re taking their company.

For example, in the whitepaper, Allscripts provides a list of questions to consider when looking to replace your EHR:

  • How do you DEPLOY the right core IT systems to succeed with value-based care?
  • How do you CONNECT to coordinate care with key stakeholders and manage your population?
  • How do you better ENGAGE patients in their own health?
  • How do you analyze mountains of raw data to ADVANCE patient and financial outcomes?
  • How do you get everyone within your own organization to FOLLOW THE ROADMAP to EHR success?

You can see that these questions share a certain view of where healthcare IT and EHR is headed. Imagine how this criteria would compare with the criteria for EHR selection even five years ago. Although, I wonder how many doctors really share this type of approach to EHR selection. Do doctors really want their EHR to handle the above list? Should they be worrying about the above items?

I don’t doubt that doctors are going to be more involved in population health and they’re going to need to engage patients more. However, this list does seem to lack some of the practical realities that doctors still need from their EHR. In fact, as I write this, I wonder if it’s still too early to know what a next generation EHR will need to include. Of course, that won’t stop frustrated EHR users from replacing their EHR just the same.

Your EHR Vendor Isn’t Certified: Remove Barriers and Conquer Meaningful Use Stage 2

Posted on July 2, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I wrote previously about the “Triple Aim” of healthcare and even questioned if doctors really cared about the triple aim. For those not familiar with the triple aim, it includes: improving the health of our country, enabling less expensive care, and increasing patient engagement with their healthcare. All of these are noble goals and worthy of effort. Plus, even if providers aren’t moved by this goal, that doesn’t mean that much of the legislation and regulation that hits healthcare won’t be guided by this triple aim.

I was reading through this Allscripts whitepaper titled “Your EHR Vendor Isn’t Certified: Remove Barriers and Conquer Meaningful Use Stage 2” when I thought about how the triple aim is going to impact an organization’s decisions moving forward whether they like it or not.

The whitepaper underscores the shift towards more patient engagement, smart EHR tools, and population health. I think that generally summarizes meaningful use and is why it’s going to be really important that everyone in healthcare is involved in it.

Even if you don’t want to participate in the meaningful use program specifically, the overall trends that meaningful use represent are likely going to be with us for the foreseeable future. No doubt the government’s focus will continue this direction and I think payers are heading the same direction as well. They probably won’t adopt meaningful use entirely, but elements from it and other programs will likely be adopted by payers.

Check out the full whitepaper for more details on these trends and making sure your EHR is ready for them.

Your EHR Vendor Isn’t Certified – How Should You Approach MU Stage 2?

Posted on May 12, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

A recent study conducted by Wells Fargo Securities stated “Over 700 EHR vendors had solutions certified for Stage 1, but at this point about 40 have been certified for Stage 2. While there is still time, we believe 300-500 vendors will ultimately disappear from the government program.”

We talked about the possibility of many EHR vendors not being 2014 certified in our interview with John Squire. This is a real possibility for many EHR vendors. It will be interesting to see which ones choose not to tell their customers that they won’t be ready until it’s too late to switch EHR. I think that will say something about the company.

Allscripts has put out a whitepaper that looks at some of the meaningful use stage 2 challenges and what you should do to make sure you’re ready.

  • Where to begin with Meaningful Use Stage 2
  • The new requirements for Stage 2 attestation
  • Technology upgrade and replacement considerations
  • Meaningful Use reporting
  • Transitioning to population health management

I find the idea of using MU stage 2 as a way to get ready for population health pretty interesting. I know this is a challenge when an organization is overwhelmed by the day to day life of someone in healthcare.

Considering the abysmal meaningful use stage 2 numbers that were released, it seems that many organizations could benefit from some meaningful use stage 2 help this whitepaper provides. I’d be interested to hear if people think that MU stage 2 does help their organization move towards population health management. Is that a reasonable goal you can work on as you work on MU stage 2? Reminds me of those who are doing CDI (clinical documentation improvement) projects alongside their ICD-10 work.

#HIMSS14 Day 2 – Future of EMR and EHR Market

Posted on February 25, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As is probably going to forever be the case, much of my experience at HIMSS gets to benefit from the beauty of social media. Today was no different as their was the #HITsm chat where we played #HITsm account bingo. Somehow I ended up on stage competing against my fellow EMR and EHR writer, Jennifer Dennard, for one of the prizes. Happily she won. I cheered for her over me too. All in all it was a fun time hearing about the various people in the HITsm social media community.

The evening of day 2 was also highlighted by the New Media Meetup event. This is our 5th year organizing the event and I believe we can call it a great success. A big thanks to Stericycle Communication Solutions for sponsoring the event, and for everyone that attended. For those I didn’t really get a chance to see and talk with, let’s make up for it tomorrow. Although, as I always tell people, the best part of the event is that there are hundreds of amazing people you can meet.

Here were two comments attendees made to me about the event, “That conversation right there was more valuable to me than any of the sessions at HIMSS.” And then this one from someone who’s been to at least four of the meetups, “This is always my favorite event.” What a blessing for me to take part in such a tremendous HIMSS social media community.

Enough with my social media experience at HIMSS. Today I had a number of really interesting conversations. Some of them I’ll be saving for future posts. However, one thing stood out to me today in my discussions with a new EHR vendor called Viztek and the multiple EHR vendor, Allscripts.

When I decided to meet with Viztek, I was intrigued by the fact that they were just launching a new EHR software. I wanted to see who wave brave (or crazy depending on perspective) enough to launch a new EHR software at this point in the game. Are 300+ EHR vendors not enough? Plus, I thought the market was suppose to be contracting and not growing.

I was actually impressed by what I found at Viztek. No doubt, in the short time I had during HIMSS, I didn’t have time to dig in really deep to evaluate the breadth of the EHR they’ve created, it’s usability and feature set. Instead, with our short time I wanted to understand the why and EMR market conditions that prompted them to build and launch another EHR software.

What’s particularly interesting about Viztek is that they have a full PACS and RIS software system that they’ve already been selling for a long time. They saw offering an EHR software as a natural extension to this offering. Considering there’s still some growth available in the ambulatory market, and in specialties where they have deep PACS needs (like ortho) I could see an opportunity. One of the most compelling reasons for a practice to go with the fully integrated PACs and EHR software is that it leaves only one vendor to look to when there are issues. Don’t underestimate the value of this. I’m not sure of the pricing of their EHR, but I won’t be surprised if like many other vendors the EHR is just a way to get access to and solidify their main revenue stream (in this case PACS).

On the other end of the spectrum was my meeting with Allscripts. In my discussion, I almost got the feeling (although, they certainly didn’t state this specifically), that EHR has become almost a commodity. The idea being that everyone is going to have an EHR and that the EHR market is going to be a heterogeneous environment. I assure you that the later is true and will be for the forseeable future. So, it makes a lot of sense why much of the focus of our conversation was around Allscripts efforts with DBMotion to provide a platform that brings together all the data from the heterogeneous EHR systems.

I was really intrigued by each of these companies and how far apart they are in their approach to EHR. At the one side of the spectrum I see a new EHR that’s still trying to provide the right EHR software for the physician. On the other hand, you have a vendor that’s always been known as an EHR vendor (and quite frankly still is with so many EHR software under one roof) is now shifting much of their focus to population health and ACO technology.

I’ve previously written that the Golden Age of EHR adoption is over. We’re entering into a much bumpier and brutal period of EHR transition. We’ll see if doctors get some relief from ONC on Thursday. Word at HIMSS is that on Thursday they’ll be announcing something important in regards to meaningful use (likely during one of the ONC/CMS keynotes). At the CHIME event they said something to the effect of, “we’ve heard you and we’re going to help.” I’ll be on a plane home, but no doubt the details will be tweeted live.

There you have it. A few of my thoughts from day 2 of HIMSS. Tomorrow’s my last day at the event. I have too many things scheduled, but we’ll do what we can to discover interesting content and share more with you tomorrow.

Also, be sure to check out my #HIMSS14 Twitter Roundup – Take Two

One Platform to Connect to All EHR Software

Posted on February 6, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve talked for years with people who want to solve the problem of connecting their non-EHR software to all the EHR vendors out there. Entrepreneur after entrepeneur has asked me how they can connect their product to ALL the EHR vendors. It usually ends up being a question like, “Isn’t there just one company we could connect to that will connect us to all the EHR vendors out there?”

I’ve dreamed about this as well. In fact, I recently wrote a post on Hospital EMR and EHR titled “Meaningful Use Drove the Data Gathering” where I suggest things like “EHR data is a treasure trove of opportunity.” and “In the future, EHR vendors will be differentiated more on the marketplace of third party applications they support than on their own in house developed apps.”

The problem is that even if every EHR vendor were to open up their application to third party applications, a startup company doesn’t want to have to integrate with all 300+ EHR vendors out there. Instead, they’d much rather integrate with one company who can connect them to all the other EHR vendors.

While a simple solution to connect to every EHR isn’t available yet, In a recent chat with Thanh Tran, Founder of Zoeticx, he showed me the closest thing to this vision that I’ve seen.

This slide shows what Zoeticx has built so far and a little bit of their vision for the future. When I saw this slide, it looked very much like what I described above.
Zoeticx Data Platform

As the slide shows, it only connects to 4 EHR vendors (5 EHR software) right now. So, they still have a lot of work to do to make this model work across all 300+ EHR vendors. However, it displays a vision of what’s possible if a company like Zoeticx builds the right middleware to connect EHR software to third party software.

After talking with Thanh Tran, you could tell that he lived, breathed, and loved the middleware space. He understood what it took to build a great middleware. For example, Zoeticx has a number of applications that leverage the middleware that they’re building. Some might argue that this makes Zoeticx a product company and not a middleware company. However, those that say this don’t understand what it takes to make great middleware.

By Zoeticx having some applications which leverage their middleware, they accomplish a couple very important things. First, they are essentially “eating their own dog food” and get to see first hand the challenges of building an application that uses their middleware. This will improve the middleware product better than any other technique. Second, Zoeticx applications will serve as essentially a set of demo applications which can be used to demonstrate what’s possible. Without these essentially demo applications, it’s often hard for people to understand how an API like Zoeticx can be used.

Certainly it’s possible that the Zoeticx application business is so good that they don’t go after the middleware opportunity. However, knowing Thanh’s background makes me think that this is an unlikely possibility. He wants Zoeticx to be a middleware company.

Thanh Tran also said something really intriguing about the latest EHR that they connected to their universal patient clinical data model (Zoeticx Patient Clarity). He said that when they added the new EHR, they didn’t have to change the Zoeticx Patient Clarity side of the equation at all. I’ll be interested to see how this plays out as they connect to more and more EHR vendors.

In fact, I believe that’s the next key step for Zoeticx. They need to connect with the other EHR vendors. Although, my guess is that once they get enough momentum behind what they’re doing, then they can provide an API for EHR vendors and other software vendors to create a gateway to Zoeticx. Then, they’ll have something really powerful.

It’s still early for Zoeticx. We’ll see how they do at attracting third party applications to their platform. We’ll see how their gateways to EHR vendors go and how they’re able to scale up the number of EHR vendors they work with. However, their vision gave me some hope that we could have a simple model for entrepreneurs that want to connect their health IT software with multiple EHR software with one integration.

Allscripts Strikes Deal Supplying Clinical Data To Health Plans

Posted on September 24, 2013 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Allscripts has struck a deal with a health plan industry vendor under which users of its ambulatory EMR will be able to send data to payers, reports InformationWeek. Under the terms of the deal, vendor Inovalon will funnel data to payers, and providers will receive patient-level analyses of the data in return.

Inovalon aggregates claims, lab, pharmacy, durable medical equipment, functional status and patient demographic for payers, according to InformationWeek. For 10 years, Inovalon has also been collecting clinical data from providers for its health plan customers. In recent times the vendor has been collecting data from EMRs using export and “screen scraping” methods.

Allscripts customers who choose to take advantage of the Inovalon deal will be able to integrate with Inovalon’s system simply by giving permission. “When a provider or provider group authorizes the integration, they don’t have to do any more work on site,” CEO Keith Dunleavy told IW. “The back end [of Inovalon] handles the rest, coordinating the data exchanges for the providers.”

Going out of the gate, Inovalon wasn’t able to say which payers would be receiving Allscripts data. However, Inovalon already serves hundreds of health plans which collectively cover about half of the insured population, Dunleavy told IW.

So why should providers want to send data to health plans in the first place?, asks IW editor Ken Terry.  Inovalon CEO Dunleavy had several suggestions, including the following:

*  Regulatory compliance. Providers must submit clinical data regularly for varied reasons, including processes related to claims audits, and quality assessment.

* HEDIS chart reviews.  Health plans need providers to supply HEDIS data, which is required by many state insurance departments as well as CMS.

* Shared risk arrangements. As providers increasingly get into shared risk agreements with managed care plans sharing clinical and claims data effortlessly becomes critical.

I was particularly interested in the point Dunleavy made about the need for providers and insurers to share data smoothly as risk sharing arrangements mature, something that will have to happen if accountable care is to become a reality. Perhaps solutions like these will offer a more realistic approach to meeting ACOs’ data needs then the big money efforts deep pocketed industry leaders are trying out today.

EMR Market Share

Posted on July 18, 2013 I Written By

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.

Editor’s Note: This is the first post on EMR and HIPAA by James Ritchie. James is a longtime journalist including the past eight years as a staff writer with the Cincinnati Business Courier.

Practice Fusion announced in June that it led the EMR industry in market-share gains.

Citing SK&A reports, the San Francisco-based firm boasted that it controlled 5.8 percent of the market as of May, up from 3.8 percent in July 2012. Beyond Practice Fusion, only Epic, AthenaHealth and Cerner showed gains.

In this data, which represents physician offices only, Allscripts was the market leader, with a 10.6 percent share. Not far behind were eClinicalWorks, with a 10.5 percent share, and Epic, with 10.3 percent. (The report that Practice Fusion links to is actually dated January 2013.)

But there’s more than one way to look at the EMR share picture.

Epic was the clear winner in a report by the Austin, Texas-based consultancy Software Advice on meaningful use attestations. Epic, based in Verona, Wis., accounted for 20.3 percent of attestations for a complete EHR in an ambulatory setting.

The firm’s competitors were nowhere close as of the March 2013 report. Allscripts was the system of choice for 11.6 percent of attestations by eligible professionals, and eClinicalWorks accounted for 8 percent. Next on the list were NextGen Healthcare, GE Healthcare and, with 2.7 percent share, Practice Fusion.

Software Advice claimed that the figures, based on Centers for Medicare and Medicaid Services data, might be the best around. They at least provide a standard in a market where vendors “use varied criteria to calculate their customer base,” according to the company.

Companies “might count number of users (which could include everyone from physicians to administrative staff), number of medical providers (which could include everyone from physicians to midwives) or number of practices,” Software Advice noted on its website.

Practice Fusion, founded in 2005, claimed in its press release to have doubled both its monthly active user base of medical professionals and its patient population between 2012 and 2013. The company claims to reach “a community of 150,000 medical professionals serving 65 million patients.”

The prospects for the free model that Practice Fusion uses are still up in the air. Doctors might question whether they want ads, unobtrusive as they are at the bottom of the screen, to compete for their attention when they’re entering patient data. Data, by the way, might prove to be the real revenue generator for Practice Fusion. In June the firm launched Insight, an analytics product offering a population-level view of diagnoses, prescribing patterns and other information. It’s a model worth watching. If Facebook and google can build businesses on data, maybe Practice Fusion can, too.

The SK&A figures show just how fragmented the outpatient EMR/EHR market is. The top 10 vendors accounted for only 64.8 percent of attestations, leaving about 35 percent of the market to the “other” category. By Software Advice’s count, 560 firms logged at least one meaningful use attestation.

Eager to steal share are firms like Irvine, Calif.-based Kareo Inc. It launched its own free, cloud-based EHR in February based on technology acquired from San Mateo, Calif.-based Epocrates Inc. The firm reported in June that 4,000 providers had signed on, with a third of them moving from another EHR.

Of course, ambulatory adoption is only part of the EMR story.

Epic is No. 1 among the nearly 3,000 hospitals that have received federal incentives for using complete electronic records systems, according to Modern Healthcare. The company holds a 19.6 percent share, followed by Computer Programs and Systems Inc. with 15.5 percent, Meditech with 14.1 percent and Cerner with 11 percent. The late-May report was based on numbers from CMS and the Office of the National Coordinator for Health Information Technology.

The inpatient market is far less fragmented than the outpatient space. The top 10 companies control 92 percent of share, according to the report.

No matter how you count share, the EMR space will continue to be hypercompetitive because of the dollars at stake. The market amounted to $20.7 billion in 2012, up 15 percent from 2011, according to the research firm Kalorama Information.

National Patient Identifier, Allscripts Discontinues MyWay, EHR Incentive Payments Stopped, and Remotoscope — Around Healthcare Scene

Posted on October 7, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

EMR and EHR

HIMSS Pushes for National Patient Identifier System

An estimated 14 percent of medical records contain incorrect patient information. Because of this, deadly errors can occur. In an effort to cut back on these errors, HIMSS is trying to implement a national patient identifier system. A single identifier isn’t going to solve problems, but it’s a step in the right direction.

Dr. Nick, CMIO of Nuance Talks About Their Acquisition of Quantim and J.A. Thomas & Associates

In this interview, Dr. Nick discusses an important string of acquisitions by Nuance. This is an interesting move by Nuance and Dr. Nick does a good job of describing the vision of Nuance going forward with these acquisitions and their view of how healthcare documentation will happen in the future.

EMR Thoughts

Allscripts May Sell Out To Private Equity Buyer & Allscripts to Discontinue MyWay EHR

It has been a really busy week for Allscripts. First came the news that Allscripts was considering a sell to a Private Equity Buyer. This news is harder to read since it could mean a big sell or it could just be posturing. In what I think is even bigger news is that Allscripts is discontinuing their MyWay EHR. This is a big move on Allscripts part. It’s a necessary decision by Allscripts because they have too many EHR software to manage, but it’s going to leave a lot of doctors and a lot of VARs scrambling.

EMR, EHR and Healthcare IT News

HIMSS Opposes Call for Suspension of EHR Incentive Program

We’ll be writing some more pieces soon on the members of Congress that are calling for a halt on the HITECH Act and payment of EHR incentives. However, this was HIMSS’ response to the request to halt EHR incentive payments. It’s not a surprising response, but I do like the data that HIMSS provides to the conversation. Most people see this move as a political one, and not necessarily one that puts the HITECH EHR incentives at risk.

Hospital EMR and EHR

Smart Bed Technology Interview with Casey Pittock of BAM Labs 

Vice President of Sales and Marketing at Bam Labs was recently interviewed over at Hospital EMR and EHR. BAM Labs created the Smart Bed, a mat that is placed under a person’s mattress that can measure heart rate, breathing rate, and motion. Pittock discusses how it was created, the accuracy of it, and how providers can interact with the data.

Meaningful Health IT News

Attending Health 2.0? Donate Your Old Smartphone

If you have plans to attend Health 2.0 next week, be sure to bring along any old smartphones. Health eVillages will take the device and load onto it different medical materials and sent to doctors that are in third world countries. There are sites for Health eVillage in the countries of Haiti, China, Kenya, and Uganda, with plans to expand to more.

Wired EMR and EHR

The Naivete of mHealth

There are many mHealth creations coming out at a rapid pace. At first glance, these innovations seem incredible and life-changing. However, without supporting documents and proof of the effectiveness, the money and time that goes into implementing certain technologies might not be worth it. This post talks about a home monitor for CHF, and although it’s a great idea, unless a patient is really dedicated to following all the alerts, it may not be effective. Technology needs to be reliable and proven to work before it should be recommended for use.

Smart Phone Health Care

Remotoscope – Diagnose Ear Infections at Home Using Your iPhone

Many children get ear infections, and it’s no fun taking them to the doctor if the diagnosis of one is uncertain. Luckily, a new tool has been invented to help parents and physicians diagnose from home. The tool is a detachable clip that turns a smart phone into otoscope, and parents can take a picture of their child’s eardrum to send to their physician for further analysis.

Meaningful Use EHR Breakout by Percentage

Posted on June 20, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve seen a bunch of different websites listing the top 10 EHR vendors based on physicians who attested to meaningful use using their EHR software. This list is certainly interesting and worthy of a discussion. However, I think it’s also important to put these numbers in some context. Remember that these numbers are just for the ambulatory EHR space. The Hospital EHR numbers are a different story which I’ll probably cover on Hospital EMR and EHR.

Here are the EHR incentive numbers by EHR vendor and also the percentage of meaningful use attestations they had (Thanks to Dr. Rowley for the numbers):

EHR Vendor MU Attestations Percentage
Epic 11075 23%
Allscripts 5743 12%
eCW 4057 8%
NextGen 2237 5%
GE 2002 4%
Athena 1733 4%
Greenway 1650 3%
Cerner 1375 3%
MEDENT (Previously Community Computer Service) 1264 3%
e-MDs 1235 3%
Practice Fusion 1156 2%
Sage 1140 2%
Other EHRs (272) 14358 29%

As Dr. Rowley points out in his post, Epic is the largest vendor on the list, but they don’t market or sale their product to independent clinics or even independent physician groups. Epic’s ambulatory EHR is found in owned or affiliated clinics who use the ambulatory piece of the EHR an Epic hospital buys. So, the above Epic number actually provides an insight into how many ambulatory practices are associated with Epic using hospitals.

The numbers tell an interesting story if you take Epic out of the mix:

EHR Vendor MU Attestations Percentage
Allscripts 5743 15%
eCW 4057 11%
NextGen 2237 6%
GE 2002 5%
Athena 1733 5%
Greenway 1650 4%
Cerner 1375 4%
MEDENT (Previously Community Computer Service) 1264 3%
e-MDs 1235 3%
Practice Fusion 1156 3%
Sage 1140 3%
Other EHRs (272) 14358 38%

Once you take out the hospital dominance in the ambulatory market, the EHR market share for any one EHR vendor is quite small. In fact, the other EHR vendor category has 38% of the EHR market. The long tail of EHR software is definitely at play right now.

Plus, we have to be really careful using meaningful use attestation as a proxy for the EHR market. I recently saw a figure that only 20% of the ambulatory EHR market had attested to meaningful use. That’s right, the above numbers only represent 20% of the ambulatory market.

If my math is correct, that still leaves almost 200,000 providers that aren’t represented in the above analysis of 50k providers. Imagine an EHR vendor comes along that’s so great that they quickly capture only 20% of the 200,000 uncounted providers (no small feat). That would give them about 40,000 providers and using the above numbers they would have 45% of the EHR market (including Epic).

Of course, the current EHR vendors will continue to sale EHR software and many will switch EHR software vendors during that time as well. Plus, no doubt many of those who haven’t attested to meaningful use already have an EHR, but aren’t represented in the numbers above. They just either don’t care about meaningful use and EHR incentive money or they’re still working to get to the point where they can attest to meaningful use. However, I still think the above numbers illustrate that there’s plenty of opportunity available for an upstart EHR company to get plenty of EHR market share.

It’s going to be an exciting next couple years as we watch all of this shake out. We’ll take a look back at this post in a few years to see how far we’ve come.

EHSD – EHR Hunt Stress Disorder

Posted on May 10, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Dr. Gregg wrote an interesting post recently about what he called EHSD (EHR Hunt Stress Disorder). He does such a great job defining the funk, I’ll let his words speak for themselves.

Since I first broke the news about Allscripts’ sunsetting of my current EHR (Peak Practice) about a year and a half ago, I have developed a severe case of a newly defined malady: EHR Hunt Stress Disorder (EHSD). I am worn down, drug out, and generally pooped. I can’t figure anymore re: local host versus cloud versus disruptor / innovator versus corporate clout versus Quippe-able versus app-able versus templates versus NLP versus digital pens versus etc., etc., etc. I just can’t. I’m done.

I have seen a slew of systems — some great, some not so much. I’ve seen apps and clouds and cool tech. I’ve even had some had offers to work with some vendors. But, in trying to decide, I think I have run headlong into The Paradox of Choice wall. Too many options have led me to the paralyzingly dissatisfactional funk of EHSD. Can’t find that “just right” one.

I’ve seen this so many times. Sometimes it goes to outrageous extremes that you almost have to just laugh at the situation. I think the core of the problem is the 600+ EHR companies that are all vying for the physician’s attention. It’s an incredible challenge for physicians to sift through all the EHR noise.

One thing that I don’t think many people want to admit is that every practice could probably select a dozen or more different EHR software and be quite satisfied. Each of those dozen EHR software would have their own intricacies, annoyances and benefits, but they all would deliver some benefit to the practice. On the opposite end, there are at least some clinics who could select any of the 600 EHR vendors and have a terrible experience. Luckily, I believe this is the minority of clinics. Most clinics I know could find benefit from any 1 of a dozen EHR.

The challenge is that the dozen EHR that could provide benefit to a practice is different for every practice. The list of good EHR for a pediatric practice is different than for a OB/GYN or Family Practice Doc. The list of good EHR is different for a solo practice versus a large group practice or multi specialty group. The list of good EHR could be different for someone in California versus Ohio. You get the idea.

My best suggestion I first gave back in 2006 when I started blogging about EMR (The EHR term wasn’t in use back then). It is to quickly narrow your EHR selection to 5 EHR vendors. This will let you focus on 5 EHR and study them in depth. This doesn’t mean that you HAVE to select one of those 5 EHR. You can always add more later if you’re not satisfied with your first 5 EHR, but it gives you something manageable.

Just remember that the goal is to find an EHR that benefits your practice, not finding the perfect EHR. Setting reasonable expectations is a key to avoiding EHSD.