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Never Sell Your EHR Company – According to eCW Founder

Posted on January 16, 2015 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 recently came across an interesting article in Entrepreneur magazine authored by Girish Navani, CEO and Co-founder of eClinicalWorks. If you read this site, you know doubt are familiar with the quite popular eCW EHR software. In this article Girish gives some interesting insight into the future of eCW as a company:

After grad school, I set out to create my own version of my father’s bridge. After working many odd jobs developing software, I created credit check software for an acquaintance’s business. This made him a lot of money, which prompted me to ask (perhaps naively) for a share of the profit. I had developed a very successful facet of the company – didn’t I deserve it? His response surprised me, but I will never forget it. He said, “If you build something you like, don’t sell it.”

Twenty years later, I still remember my acquaintance’s advice. For that reason, my company, eClinicalWorks is, and always will be, a privately-held company. I have no interest in selling it, regardless of any offer I may get. In addition, we don’t use investor cash or spend money we don’t have.

This is not a philosophy that is unique to eCW. #1 on Epic’s list of principles is “Do not go public.” I imagine that Judy Faulkner (CEO of Epic) has a somewhat similar philosophy to Girish. There are certainly a lot of advantages to not going public and most of them get down to control. I’ll never forget when I heard one of the Marriott children talk about their decision to stay a private company. He said that Marriott would likely be a lot bigger if they had become a public company, but they would have lost a lot of the company culture if they’d chose to do so.

I imagine this is a similar feeling that Epic and eCW share. However, there’s also some accountability that comes with being a public company as well. It’s not easy for an organization to assess the financial well being of a private company. During the golden age of EHR which we just experienced, that hasn’t been an issue for either eCW or Epic. However, as we exit this golden age of EHR that was propped up by $36 billion in government stimulus money, the financial future may be quite different.

As in most things in life, there are pros and cons to staying private or going public. It’s interesting that two of the major EHR players (eCW and Epic) have made it clear that they have no interest in ever going public. We’ll see how that plays out long term.

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.

The Golden Age of EHR Adoption is Over

Posted on June 6, 2013 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 ready to call the Golden Age of EHR Adoption Over. We’re not getting ready to enter the nasty, ugly, dirty, swamp filled waters of EHR adoption. If you’re an EHR vendor you likely already know this to be the case. That’s not to say that there’s not still real opportunity in the EHR space, but it will take on a very different form.

I think this image of the adoption lifecycle describes the EHR adoption cycle really well. I’m sure it will be familiar to many of you:
EHR Adoption Lifecycle

It’s very clear to me that we’re somewhere in the middle of the Late Majority cycle of EHR adoption. This plays out well since we’re somewhere between 50-84% EHR adoption. While the chart shows a downhill slope, the ride to get the Late Majority and Laggards on EHR is going to be anything but a downhill ride. I’d say it’s going to be more like climbing Mount Everest. It’s possible, but it’s going to take a lot of work.

The reality is that those who wanted to adopt EHR already have adopted EHR. That means we have left a group of practices and hospitals that for the most part aren’t EHR convinced. However, there is one advantage for those wanting full EHR adoption. Almost all of those who haven’t adopted EHR see the writing on the wall. They’re just going to take their time and make a deliberate choice based on the experiences of those around them.

EHR vendors will now start to focus on creating what I call Smart EHRs. Doing so will be how they battle each other in the next wave of EHR switching. Plus, this will usher in the next EHR Golden Age: Use.

Future Golden Age of EHR Use
While the golden age of EHR adoption is over, we’re entering a new EHR Golden Age. It’s the golden age of amazing EHR use. It’s still very early in this new cycle, but the innovators are going to really surprise us with the innovation that’s going to be possible on the back of an EHR.

Many of the changes will be subtle and we’ll take them for granted almost instantly, but they will be amazing in aggregate. Take for example, Jennifer’s recent post on EMR and EHR about her child’s well visit. How beautiful is it that her child’s record was available at a new clinic with no effort on her part. We’re not there yet, but we’re going to get there. Although, we wouldn’t get there if we were still at 25% EHR adoption.

Jennifer’s example is a simple, but powerful one. No doubt there are going to be much more complex and much more powerful examples to come. Many of which will actually save people’s lives.

The Golden Age of EHR Use is going to bring about dramatic benefits that would have never been possible without massive EHR adoption. The Golden Age of EHR Use will be so good that even the EHR adoption laggards will finally want to change.