Independent Thinking of Doctors Limits EHR Vendor Consolidation

Posted on July 13, 2011 I Written By

John Lynn is the Founder of the 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 and 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 not sure all the details of why this is the case (but I’m sure some will tell me why in the comments), but doctors are some of the most independent thinkers that I know. I’m not saying whether this is a good or a bad thing. It’s just an observation based on thousands of interactions with doctors from all specialties. This independence is shown in a plethora of areas from charting to treating to diagnosing to the business of medicine.

Turns out, this independence is part of why I’ve heard doctors say hundreds of times that they basically want their own EHR and not a mainstream one. Doctors want an EHR that fits their unique practice style. Thus they have an expectation that whatever EHR they choose should understand that each doctor is different and naturally adapt to each unique doctors need. Ok, that’s a pretty broad generalization and no one would ever vocalize it that way, but it’s an undercurrent that I’ve seen time and time again.

I believe this is an important characteristic of the EHR market that must be considered. If you don’t accept the broad theory of doctor independence in practice style and approach, then most of you will appreciate that doctors from various specialties have unique needs. The easy to understand examples are Pediatricians and OB/GYNs. Everyone can quite readily see that tracking child growth and pregnancy require different charting and documentation requirements. I believe each specialty could describe similar requirements that are unique to that specialty.

This doctor and specialty independence is why I’ve long argued against what everyone loves to call mass EHR vendor consolidation. Certainly we can all agree that we have too many EHR vendors right now. However, I’ve read many many people argue that there’s only going to be 3-5 EHR vendors left standing after the mass EHR consolidation (or EHR vendor failure). I just don’t believe that’s the case. If we get down to 100 EHR companies, I’ll be impressed.

There are two things that might partially affect my EHR consolidation prediction.

First, I won’t be surprised if some really smart company comes along and scoops up each of the best of breed EHR companies for various specialties. However, instead of sunsetting the acquired EHR software, they continue to offer that same EHR software to a specific specialty. Then, they do this over and over again across all the specialties. So, the larger company would own a pediactric EHR, an OB/GYN EHR, a Family Practice EHR, a Cardiology EHR, a Orthopedic EHR, an Oncology EHR, etc. You get the idea. Instead of getting benefits from software development consolidation, they get the benefits in other areas of their business. It would be really fun to run a company like this.

The other healthcare trends that could have a serious impact on this is the ACO movement and hospitals buying up clinics. I’m still not sure how those two trends are going to play out. However, this type of consolidation of healthcare entities could impact whether a specialty specific EHR is a viable option. Clinics that are bought by a hospital or become part of an ACO lose some of their independence. At least their independence in selecting an EHR software.

Are there things I’m missing? Any other trends that are happening that will change the EHR consolidation landscape?