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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.

CPA Comment on EMR Pricing

Posted on October 10, 2010 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.

In response to my previous post about possibly creating an EMR pricing comparison website, I got a really interesting set of comments from a CPA who’s been assisting their clients in their EMR selection process. You might laugh at the idea of a CPA participating in the EMR selection process. Interestingly, the CPA that I use has also been asked by their clients about the EMR stimulus money and so they were grateful they could ask me some questions.

This aside, I found this person’s comments interesting. I think they also illustrate some of the challenges in EMR pricing and some of the thirst for EMR pricing also. I removed some identifying information and some other comments about EMR and HIPAA. Otherwise, the comments are in tact.

I have been pondering trying to do some sort of price comparison myself, and you’re right, they all differ so it’s tough to just do one basic comparison chart. I’ve seen already how some have things all bundled (ie.Athena, and others do it in separate modules can add on – ie. Greenway)

I have featured remote demo’s for clients to listen/view through our firm so they can avoid the vendor pressure… I thought I would try to get info on others for comparison purposes, but in keeping with the theme… it is just not that easy.

There are a few challenging items for comparison purposes, one of them being support and related costs.
The support/training is many times where the wheels fall off the well-intentioned EMR wagons.
You just don’t seem to get an answer or know the true support/training costs until you have already tied the knot with your new EMR system. If you could get more comparative info on that aspect, that would be very helpful – or better yet, come up with an EMR Pre-Nup.

Another toughy is the interfacing costs
From what I hear a [EMR Vendor] system may charge $30k to interface with another EMR vendor.
The vendors call that “not playing nicely”.
So tack on another layer of subjective complexity to your pricing project.

And yet another cost factor I’ve noticed is what EMR system an affiliated hospital is getting preferred pricing on. There is a hospital by us in an arrangement with [EMR Vendor], and of course advising the outside practice physicians to use the same. I am not to thrilled with this idea, I think there are better products that are not spread so thin in so many markets.

I mention the patient portal separately below as some of my clients don’t seem quite ready for that yet.
They view it as another task and feel could attack it once get the EMR running smoothly.
I know they need it for MU [Stage 1 doesn’t require this, but future stages probably will], but they seem to want that a little later than sooner.

In any case, I think some possible approaches for a comparative pricing schematic would be to have different scenarios:
a) 1-5 Docs & Midlevel providers /Web Hosted/ EMR only/ PM Interface/ No Patient Portal
b) 1-5 Docs & Midlevel providers /Web Hosted/ EMR only/ PM Interface/ With Patient Portal
c) 1-5 Docs & Midlevel providers /Web Hosted/ EMR & PM Bundled/ No Patient Portal
d) 1-5 Docs & Midlevel providers /Web Hosted/ EMR & PM Bundled/ With Patient Portal
e) 1-5 Docs & Midlevel providers /Web Hosted/ EMR & PM Bundled/ With Revenue Cycle Mgt/ With Patient Portal

Existing EHR Vendors with CCHIT Certification

Posted on September 13, 2010 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 I mentioned in my previous post about the race to be the first EHR certified (and the first ATCB to certify an EHR), there’s a lot more going on in the battle amongst the EHR certifying bodies.

The first interesting detail surrounds the previous CCHIT certified EHR vendors. This turns out to be a really great move by CCHIT. A quick look at CCHIT’s website has 49 EHR products (or modules of products) that have been certified for either the CCHIT 2011 certification or for the Preliminary ARRA certification. That’s 49 pieces of EMR software (a few less since some are different versions of the same product) have paid $22k+ in order to be certified by CCHIT.

I’ve talked to one of these EHR vendors and they said that CCHIT did a call with all current vendors and said that they will be honoring their previous commitment to provide the real ARRA certification at no additional cost to these providers. This turns out to be really smart if it means that many of the big EHR players like GE, Elipsys/Allscripts, NextGen, Epic, Athena, Pulse, Cerner, etc all decide to continue forward with CCHIT.

Many would ask why they would pay another $20k to someone like Drummond Group if they could get the EHR certification for free from CCHIT. Turns out their is a possibility if CCHIT isn’t able to deliver their certification in a timely manner and Drummond Group is able to do it much quicker.

Remember the list above are HUGE EHR vendors where $20k is basically a drop in the bucket. It’s kind of scary to consider that, but that’s the reality for most of the EHR vendors. Sure, it’s not what they’d like to spend if they don’t have to, but when did large corporations start worrying about wasteful spending? Ok, that might be a slight exaggeration, but you get the point.

The good thing for Drummond Group is that there are still 300+ EMR vendors that will need to be certified. In fact, many of the non CCHIT certified EHR companies are likely moving to Drummond Group for EHR certification since CCHIT is giving priority to their existing EHR vendors.

Yes, that’s right. Over the next month and half CCHIT will spend all its time doing a bunch of free EHR certifications while Drummond Group will be making just under $20k for each EHR certification that they do.

One final thought about the fun that is EHR certification. When I recently talked to an EHR vendor that is CCHIT certified and will likely be getting their now free EHR certification, I found it really interesting to learn who from their company was on the CCHIT call. In this case, the EHR vendor’s VP of Marketing was on the call with CCHIT.

Of course, this begs the question why the VP of Marketing would be on a call about EHR certification standards and compliance. Shouldn’t the clinical director be the one that wants to be on that call? I think it sends a compelling message that I’ve been preaching on EMR and HIPAA for a long time. EHR certification is not a benefit to the doctor. EHR certification is not a benefit to the patient. EHR certification is a means for EHR vendors to market their EHR software.