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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.

Pricing for iPhone EMR App

Posted on September 20, 2011 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.

The other day I was browsing the EMR Update forum (where I started my EMR education) and found this interesting comment about the e-MDs iphone app.

EMDs is charging $250 to “install” it even though the phone does the installation for you and then they are charging $35 a month per device for “support”. I guess they are trying to lose all of their long term customers to other EMRs that are free like Practice Fusion. I find these charges to be outrageous.

Note: I tried to verify this pricing on the e-MDs website, but it’s conveniently not listed on their mobile page. Although, they do have a “free trial.” Is that a $250 install to get the free trial? I also found their website tagline ironic: “Affordable EHR software”

I find this comment really interesting on a number of levels. First, it comes from someone who has indeed been a long time e-MDs user and long been a fan and vocal spokesperson for the e-MDs EHR software. The above seems like such a small amount of revenue to alienate your happy EHR users over.

Second, $250 to help the user install the EMR iPhone app? Really? That just feels wrong on every level.

Third, $35/month for support? Of course, this is on top of the doctors existing e-MDs support contract. Such a terrible plan by e-MDs. If they felt like they needed to get some money for the support that would be required for their iPhone EMR app, then they should have rolled it into the existing support contracts. Then, no one would complain. At least not as loudly.

Now I’m starting to wonder what other EHR vendors are charging for their apps. Let me know what you’ve been charged for your EHR app. A while back I posted about all the various EMR Android apps. All of them were free.

First EMR Stimulus Checks

Posted on January 12, 2011 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 expected the first EMR stimulus checks have been issued and we’re starting to learn who the first providers are to receive the checks. There’s even the obligatory big check picture accompanying the coverage of the first EMR stimulus checks.

According to a Government Health IT article, University of Kentucky Healthcare received a $2.86 million payment. That’s a nice chunk of change and represents a third of the hospital’s overall expected payment from CMS. I think most hospitals would enjoy a check like that. Of course, what we don’t know is how much University of Kentucky Healthcare spent to purchase and implement their EMR. I’m sure we’ll see those numbers come out as more people get their EMR stimulus checks.

The first EMR stimulus checks on the ambulatory EMR side seem to have gone to two physicians at the Gastorf Family Clinic in Durant, OK (pictured above). They each got $21,250 for showing “meaningful use” of a “certified EHR.” Of course, e-MDs was quick to issue the press release about this clinic being e-MDs users. Not a bad move for them to try and be the first. Sounds like the Oklahoma REC (OFMQ) also deserves some credit for helping them get the first EMR stimulus checks.

Related to this, we’re also starting to see the first numbers come in as far as those registered with CMS for EHR incentives. In the Government Health IT article linked above they report in the first four days since the launch of registration, about 4,000 healthcare providers registered (as of January 6). Not a bad start and I’m sure that will continue to grow day by day since many won’t care to register until after they’re close to showing the 90 days of meaningful use.

EMR Safety Event Reporting

Posted on December 1, 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.

The PDR Network in partnership with the iHealth Alliance has launched a new reporting system for adverse EHR events called EHREvent.org. Some of these adverse EMR events might include: software problems, inadequate user training, security breaches and near-misses. Here’s a short quote from the press release about the new website:

Using a standardized online format, EHRevent will collect reports from physicians and other health care providers who use EHRs, and create reports that medical societies, professional liability carriers and government agencies such as the U.S. Food and Drug Administration (FDA) will use to help educate providers on the potential challenges that EHR systems may bring.

The form breaks out the EHR safety events into 4 categories:
Incident: An EHR event that reached a patient, whether or not the patient was harmed.
Near Miss: An EHR event that is not believed to have impacted a patient.
Non-Patient Issue: An incident or near miss that impacted staff, employee(s), visitor(s).
Unsafe Condition: A circumstance that increases the probability of an EHR event.

I tried out there form and they had a lot of the EHR vendors listed, but there were a few missing. For example, it didn’t have the popular free open source EMR: OpenEMR. I wonder where they got their list. Especially since the list is changing so rapidly.

The form was relatively simple, but it did have like 9 screens that you had to answer. After the fifth I was feeling like it was a bit lengthy and I was just submitting a test. Although, when an adverse EHR event happens, users are usually pretty motivated to tell their story. At least they will be until they get to the page on the event reporting where they have to turn over all their personal information. I’m sure many will be turned off by that little detail.

One more quote about EHR and safety events from the press release:

Alan Lembitz, M.D., vice president of Patient Safety and Risk Management for COPIC Insurance Company, added “Our experience indicates that EHRs have the capacity either to induce or to reduce medical errors in very unique ways, and we have seen data that indicates that EHR adoption may reduce physician liability. It will be increasingly important to understand best practices to improve patient safety for EHRs and for their users, and EHRevent will help both.”

It’s going to be interesting to see how this evolves. Is this something that EMR vendors will support. It seems like e-MDs is on board since Michael Stearns, MD and CEO of e-MDs is quoted in the press release.

Over the years a lot of people have asked me where they could report a situation related to their EHR. This seems to be the best we have so far. As the press release points out, “Professional liability carriers who insure doctors against malpractice claims are among the strongest supporters of EHRevent.” Of course they are. The more information they can get the better they can do their job. We’ll see how many doctors and practices get on board and support this type of EHR reporting initiative.

EHR Discussions Website by e-MDs

Posted on May 7, 2009 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.

Someone pointed me to a new website created by e-MDs called EHR discussions. The site says “Welcome to EHR Discussions, a moderated discussion forum that will feature discussions on health information technology.”

When someone suggested that it was a discussion forum about EHR that was hosted by an EMR company I was really interested. Unfortunately, I was sorely disappointed by what I found. There was almost no discussion on the website and it was really hard to even figure out how someone could comment. Basically, it’s just a real simple blog implementation. They do allow comments, but they require you to register before you comment. If you’re trying to create discussions about EMR, then that’s the very worst thing you could do.

At the end of the day, it all goes back to expectations. I was hoping for a killer forum for people to really discuss important EMR topics. That’s what I was told it was and it says it’s going to be at the top of the website. When that expectation wasn’t met I was disappointed.

If e-MDs would have just said they started a blog about important EHR topics, I think I wouldn’t have been nearly as disappointed. They actually have created a good post about the HITECH act for example. Certainly it shows a lot of vendor bias perspective and doesn’t do any real hard core analysis, but for information purposes it’s interesting.

Just don’t expect this information intensive type of website to engender a lot of conversation around EMR. Do expect it to be a nice marketing tool for e-MDs. I’m a strong advocate for blogging by EMR companies that want to increase their presence online.