We have written about health information technology (HIT) and electronic health records (EHRs) over the past few years given their critical role in advancing high quality healthcare, as well as various requirements institutions and healthcare providers must meet with respect to the use of HIT and EHRs. Consequently, a recent article from Software Advice gave a detailed analysis of EHR Software Systems and some of the trends, updates, and developments to look for.
There are several hundred electronic medical record (EMR) and electronic health record (EHR) systems available for just about every medical specialty and clinic size. EMR vendors have customized systems for outpatient care, inpatient care, solo practices, enterprise groups, primary care, therapy, mental health, ophthalmology, chiropractic and so on. Furthermore, various systems span the full range of pricing, from free to several hundred thousand dollars.
With so many medical EMR companies catering to so many specialties, physicians face a big challenge as they determine which medical software is right for their needs. As a result, Software Advice put together a “buyer’s guide—and list of the top 10 EMR software programs—to help physicians understand the market and know where to start.
Using data from the government—CMS—the company was able to capture EHR market size and share and quickly calculate the number of eligible professionals (EPs) in an ambulatory care setting (i.e. outpatient setting) that have attested for meaningful use (MU)–115,918 EPs.
According to their research, 107,112 of those are for a complete EHR, while 8,806 are for a modular EHR. This data is readily available in an Excel download at Data.gov, but only includes data through October 2012. They also identified 387 vendors that have attestations for a modular or complete EHR. Out of that number, 355 have attestations for a complete EHR. Surprisingly, the Office of the National Coordinator for Health Information Technology (ONC) lists 623 vendors in their Certified Health IT Product List (CHPL). “So there is a large number of vendors without any attestations,” they write.
The article notes that a large percent of EPs have not attested. According to the CMS December 2012 report, 350,844 EPs are actively registered (240,695 Medicare, 110,149 Medicaid). However, MU attestation data that includes the names of EHR products is only available through October 2012.
Their initial analysis from 2010 reveals the top five vendors haven’t changed. “Though, SOAPWare, Eclipsys and Sage Health are noticeably absent from the top ten. Eclipsys merged with Allscripts in August 2010, which explains their absence. Presumably, the other two have been beat by e-MDs, McKesson and/or athenahealth.”
Deployment Types
Buyers must consider if they want a stand alone EMR solution or one that has integrated billing and scheduling features. Buyers should consider a stand alone solution if they have unique needs that a vendor cannot address, if they outsource their medical billing, or if they have already invested heavily in an existing billing solution.
The benefit of an integrated system is having a centralized solution to manage all aspects of operating a medical business (clinical, administration and financial). EMR vendors such as GE Centricity, Allscripts and eClinicalWorks are all popular vendors that can provide both stand alone EMR options and integrated suites.
EMR Software Buyer Types
Assessing the type of buyer you are can help narrow your search to software solutions that can best fit your needs.
Small practice owners. Typically, these buyers manage a practice of one or two physicians. They’re looking for a simple solution that can integrate with labs as they upgrade from paper charts.
Medium to large-sized practice owners. Buyers in this market typically manage practices with anywhere from 5 to over one hundred physicians. In addition to improving the efficiency of their practices, these buyers need integration with healthcare network systems, track information at multiple sites and help provide consider regardless of provider.
Hospitals and inpatient care providers. These buyers typically work in a hospital setting and need a solution to manage rooms (and beds), nurse assignments, and physician rounds. Because of these needs, buyers in this market typically need robust EMR solutions that can also integrate with other medical applications.
Primary care (MD/DO) providers and related specialists. Physicians and assistants that work privately and offer internal medicine, family practice, Ob/Gyn, orthopaedics, urology, and other services. The buyers’ needs in this market typically vary and require templates for the speciality.
Specialists with special designations. These specialists may have a DC, PT, PhD, OD, LCSW, and other designations, and are commonly therapists, chiropractors, physical therapists and optometrists. These buyers often need very straight-forward, affordable solutions to help manage their practice.
Market Trends to Understand
Buyers should be aware to the biggest trends in the EHR Market. Here are a few important ones:
ONC-ATCB Certification. The American Recovery and Reinvestment Act (ARRA) ushered in the HITECH (Health Information Technology for Economic and Clinical Health) era in 2009. The HITECH Act includes almost $20 billion to incentivize adoption EHRs. Providers that successful attest “meaningful use” of systems that have been certified by the ONC-ATCB allow providers to be eligible for $44,000 in Medicare/Medicaid reimbursements.
Market Consolidation. We expect top companies to make key strategic purchases in the future to accelerate growth and increase market share. As a recent example, ADP acquired AdvancedMD and McKesson acquired Med3000. We expect this trend to continue and reduce the number of vendors in this market (currently over 300).
Software as a Service (SaaS). In Software Advice’s estimates, a quarter of buyers are interested in Web-based EHRs, and another half are open to the idea early-on in their research. Web-based EMR solutions are now viable options thanks to increased data security, encryption, backup methods and service reliability. In addition, many of these systems require less up-front investment thanks to Web-based solution providers’ monthly payment structure.
iOS 6 Support. Many popular EHR software providers support the latest version of Apple’s mobile operating system, iOS 6. MediTouch EHR by HealthFusion, for example, has been updated to take full-advantage of the new features in iOS.
New Mobile EHR Apps. In addition to support for iOS 6, many EHR vendors have developed other applications that support mobile devices. Aprima Mobile, for example, launched in July 2012 and can run on both iOS and Android devices.
Benefits and Potential Issues
There are a number of benefits that can be realized through successfully impleneting an EHR solution, including:
- Increased number of patient visits;
- Improved data collection capabilities;
- Improved care for patients; and
- Improved practice efficiency.
A common concern for healthcare providers is data security. Proper implementation is necessary to ensure both HIPAA compliance and data privacy. Most vendors provide the necessary resources to avoid security breaches, but healthcare providers should also be vigilant.
A second consider is the associated learning curve with electronic health records. Many vendors provider training and technical support to help providers learn to use navigate systems and utilizes features.
Finally, viability is the last common concern among buyers. If a vendor goes out of business or is acquired, its support levels may change or be discontinued. This makes the importance of assessing vendor viability (as well as the market share report data above) all the more valuable.