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EMR Market is Growing, But It’s Not What It Was

Posted on September 11, 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.

The EMR market is likely to grow at more than 7 percent per year through 2016, according to a new report.

The estimate comes from London-based research and advisory firm TechNavio. The company wrote in its analysis, “Global Hospital-based EMR Market 2012-2016,” that “demand for advanced health monitoring systems” and for cloud-computing services were major contributors to demand.

On the other hand, according to the company, implementation costs could be a limiting factor.

The TechNavio figure is actually a compound annual growth rate of 7.46 percent. That means substantial opportunity for the many companies referenced in the report, including Cerner Corp., Epic Systems Corp., AmazingCharts Inc. and NextGen Healthcare, to name a few.

Another research firm, Kalorama Information, in April reported that the EMR market reached nearly $21 billion in 2012, up 15 percent from the year before, driven by hospital upgrades and government incentives.

About 44 percent of U.S. hospitals had at least a basic EHR in 2012, up from 12 percent in 2009, according to the Office of the National Coordinator for Health IT.

In the United States, at least, future growth might require more resources and creativity to achieve. You might remember the recent post “The Golden Era of EHR Adoption is Over,” by Healthcare Scene’s John Lynn, positing that the low-hanging fruit for EMR vendors, the market of early adopters and the “early majority,” is gone, leaving a pool of harder-to-convince customers.

But the TechNavio report is broader, considering not only the Americas but also Europe, the Middle East, Africa and Asia Pacific. That’s truly a mixed bag, as while health IT is at a preliminary stage in many developing markets, it’s highly advanced in countries such as Norway, Australia and the United Kingdom, where, according to the Commonwealth Fund, EMR adoption by primary-care physicians exceeds 90 percent.

When EMR initiatives get a firmer foothold in countries such as China, where cloud-based solutions could well prevail, growth rates for those areas might exceed — several times over — the overall figure predicted by TechNavio.

And in the United States, certain pockets, such as the rural hospital market, still present huge opportunity. Fewer than 35 percent of rural hospitals had at least a basic EMR in 2012, but the enthusiasm is clearly there, as that number was up from only 10 percent in 2010, according to the Robert Wood Johnson Foundation.

It looks like it’s still a great time to be an EMR vendor. But it’s not the same market that it was even a couple of years ago, and success in the new era might require looking at new markets and approaches.

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.

My EMR Market Share Projection – 50% in the Next 5 Years

Posted on March 1, 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.

A lot of people like to throw around a lot of market share numbers for EMR and EHR adoption. One thing that’s clear in pretty much every number I’ve seen (and I’ve seen a lot) is that we still have a long way to go. Across all of these numbers there’s also a few other generally accepted principles:
-Small practices have a much lower EMR adoption percentage as compared with large practices
-Specialists have a higher EMR adoption percentage than general medicine doctors
-No one knows how to truly define what EMR adoption is in a survey

Taking in all my experience reading study after study and also my experience talking with hundreds and thousands of doctors, EMR vendors, consultants, etc about EMR adoption I’d put current EMR adoption somewhere around 25%. This isn’t any sort of scientific survey or approach. It’s just my feeling based on all my experience. Some might put it a little higher and some might put it a little lower, but I’d say most of that change is likely due to how they define EMR adoption.

A question I asked a number of people at HIMSS was where EMR adoption will be after the EMR incentive money has run its course. It’s a fun discussion to have amidst all your EMR and HIT nerd friends. However, it’s also an important business of healthcare question with lots of impacts based upon how EMR adoption goes.

My personal projection is that ONC should be really pleased if they achieve 50% EMR adoption by the end of the HITECH act (approximately 5 years). A number of really smart and involved people at HIMSS agreed with me on those numbers.

Yes, so I’m predicting that we’ll see about 25% of doctors adopt an EMR over the next 5 years. After those 5 years, I predict that the EHR adoption will really accelerate and we’ll see the other 30-40% EHR adoption in 2 years. Unfortunately, we’ll probably still have 10-20% on paper for various reasons.

I must admit that 50% adoption in 5 years still feels like we’re going to be missing out on some of the benefits of widespread EMR adoption. However, 90% adoption in 7 years doesn’t sound so bad. Maybe the older I get the shorter 7 years starts to sound.

While I like the sound of 90% EMR adoption, we can still do a lot of really good things in healthcare with only 50% adoption. Hopefully, the work I do on this and my other EMR websites helps to move the needle of EMR adoption a little bit. Not to mention help improve the rate of successful EMR adopters. That’s the goal.

What’s your take on where EMR adoption will go over the next 5 years?

EMR Vanity Metrics

Posted on October 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.

I’m still mulling over my post on EMR and EHR about EMR market share. Add in my mulling over my post about creating an EMR pricing comparison website and my mind is kind of overwhelmed with ways to try and get providers better information.

One of my hobbies is learning about internet startup companies. In fact, I’m starting one of my own. In my reading about internet startup companies I found this really provocative post by Eric Ries about entrepreneur speakers lying on stage. Here’s the money quote for me:

This is the same issue we see with vanity metrics: companies are giving the appearance of sharing information while actually engaging in spin or outright deception.

I call this the vanity ratio: the amount of apparently interesting information given divided by the amount of useful information contained therein. The higher the vanity ratio, the more effective the PR. Unfortunately – also – the more misleading the story is as a help to others.

Of course, since I’d just recently written the post I linked above about EMR market share, I quickly drew the line to EMR vanity metrics. Or as Eric Ries might say it, EMR vendors lying about their market share.

I really don’t know any way to solve this problem since Eric is right that the vanity ratio applies. The higher the vanity ratio, the more effective the PR. I guess the key is to educate providers about the skewed numbers that EMR vendors like to provide. These posts are my effort.

EMR Market Share

Posted on June 17, 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.

I regularly am asked what the market share of the various EMR companies is. Unfortunately, I think this is an impossible question to answer even if people would love to know the top EMR vendors. EMR vendors just don’t publish the number of EMR implementations they have for strategic purposes (usually). Plus, those that do publish numbers aren’t usually very truthful in the number they give out.

For example, they might say something like they have 500 offices using their EMR. Then, you’ll find out that they’ve actually only sold 20 offices and one of those has 250 actual offices. Then, you’ll find out that the they have 250 offices and plan to implement the EMR in all of those offices, but they’ve only done it in 2 pilot offices right now.

Another example, EMR vendors love to say that they have XXXXXX thousands of doctors using their system. Of course, what they don’t tell you is how many of those thousands of doctors used it once and left it. How many of those doctors only log in to write prescriptions. How many of those doctors only use 10% of the features of the EMR (hardly can be considered using an EMR). We really want to know how many doctors have that EMR, log into it every day and do almost every part of their work in the EMR. Even that’s a hard number to calculate. Should we count them if they print off their scripts or do they have to ePrescribe?

That’s why it’s really brave of Software Advice to try and estimate the EMR market share. No doubt the market share listed is off. I think the most significant number that’s off is likely the list of “Other EMR vendors.” There are 300+ EMR vendors and more being launched every day. I’m pretty sure that this other EMR vendor category actually dwarfs all of the EMR vendors that are on the list.