Newly released federal data has allowed analysis of the EHR Incentive Program (Meaningful Use) based on two years of data. First-year users, both from 2011 and 2012, as well as second-year users (who started in 2011) can now be studied. A new comprehensive analysis is now available, and can be downloaded for review. This document is intended to be an indispensable resource for those interested in detailed insights from the policy perspective, from the vendor perspective, and from the investor perspective.
The Executive Summary is presented here:
Both hospitals and community physicians have increase their use of Electronic Health Records (EHRs) dramatically over the past few years, and have now reached a point where the norm has become EHR-utilizing, rather than paper-utilizing. This shift has been due to a several aligned pressures, not the least of which has been federal policy contained in the Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009. HITECH authorized Medicare and Medicaid to set up incentive payments to physicians and hospitals for demonstrating Meaningful Use of Certified EHR technology.
The Medicare part of the program is administered centrally by the Centers for Medicare and Medicaid Services (CMS), while the Medicaid part of the program is administered by each state, much like the overall Medicaid program is administered at the state level. Now with two years of experience, the Department of Health and Human Services (HHS) has published detailed data for the Medicare part of the program, indicating each successful Meaningful Use attester and which Certified EHR product was used. This is a rich data source for analysis, and allows insights into what kinds of providers are using the program, as well as how various EHR vendors stack up against each other.
Observations from this data are analyzed in detail in this document. Some salient observations from this data are:
The implications seen from this data for health policy, for EHR vendors, and for investors in the EHR space are reviewed in this document. The landscape has changed, and the market is beginning to show saturation, so that most physicians and hospitals now have some sort of EHR system at their disposal. That means that new entries into the field must address the reality that their market adoption will be at the expense of someone else, and vendor switching will become important.
There is room for consolidation and vendor failure, especially among vendors with little or no market adoption. Those that have good technology might find that their technology is purchased by someone else in order to improve someone else’s product and user satisfaction. There might be some consolidation due to purchase of someone else’s market footprint, but this is probably less likely than consolidation based on purchasing someone’s technology.
There is still ample room for innovation. No large vendor is immune from market share loss, and even though the EHR market is approaching maturity, there is plenty of room for competition based on product value. No one is truly “locked in.”
New data from CMS allows comparison of EHRs used for Meaningful Use. Shifts in market footprint by EHR vendors from 2011 to 2012 can now be analyzed.
Next-generation Personal Health Records (PHRs) are starting to emerge. We review the evolution of these and look at different ways to build PHR adoption.
Electronic Health Records (EHR) systems come with the vision of eliminating paper in a medical practice. “No more paper” is the rallying cry of many an EHR company. But is this the case? As it turns out, not really. Stacks of legible, computer-generated paper still pile up on a medical practitioner’s desk, despite having an …Continue Reading
The term “population management” has become one of the buzzwords of modern health care. Medical practices as well as larger delivery organizations, such as medical groups, IPAs, ACOs, and PCMHs, are being asked to report on their performance around managing the health of assigned populations. Performance-based compensation, in fact, hinges on measuring and comparing groups …Continue Reading
With the beginning of 2013, health IT is facing a new set of challenges. Electronic Health Record (EHR) vendors are gearing up for Stage 2 Meaningful Use certification, which includes more emphasis on interoperability – the sharing of health data about a patient across different health settings – and on patient engagement. Health care is …Continue Reading
Medication Reconciliation, keeping track of all a patient’s medications from all soruces, is a big challenge. Universal PHRs can be very significant here.
In the upcoming year, Electronic Health Record companies will be challenged to enhance their products in anticipation of Stage 2 Meaningful Use. Stage 2 is right around the corner, and will begin in 2014 for those who have already started their EHR usage in 2011 or 2012 (for those who start Meaningful Use later, Stage …Continue Reading
Health technology tools are rapidly emerging, a swirling rising tide of products (web and mobile applications) addressing countless niche issues in the very complex healthcare ecosystem. Two countervailing sources of such efforts characterize the modern landscape – products that come from the consumer Internet side, and products that come from the healthcare provider (and payer) …Continue Reading
“Patient engagement” is one of the buzzwords in health policy these days, and substantial data exist to show that when patients are actively engaged with the health care system, particularly if they have a chronic medical condition, their resulting health outcomes are better. Clearly, it’s a good thing for people to be involved in their …Continue Reading
Health Information Exchanges (HIEs) are hubs where different parts of the healthcare system can exchange information with each other. Doctors can communicate with other doctors, with hospitals, with labs, etc. Funding that encouraged the creation and maturation of HIEs were part of the 2009 American Reinvestment and Recovery Act (ARRA), just like Meaningful Use was …Continue Reading
Patient-facing health IT has come a long way, but is also poised to make another significant leap forward. Last week, the final rules for Stage 2 Meaningful Use were released, and even though these rules address what physicians and hospitals must do to receive incentive payments for demonstrating “meaningful use of certified healthcare technology,” some …Continue Reading
Health care is changing. It is doing so in a profound, organizational way. I’m not talking about the advent of new technologies – diagnostics, therapeutics and information technology – I’m talking about how doctors and hospitals are organized. The tradition in this country is that health care has been delivered mainly by individual, self-employed physicians …Continue Reading
The federal EHR Incentive Program (Meaningful Use) is based on the presumption that once a medical practitioner has adopted an Electronic Health Record (EHR) system, that system will remain in use for subsequent years. More specifically, the presumption is that once a clinician attests to Meaningful Use (the first year of attestation only needs a …Continue Reading
The mid-year data on the Electronic Health Record (EHR) Incentive Program (Meaningful Use) has been released, allowing further insight into adoption of EHRs. The current year-to-date Meaningful Use attestation figures can be compared to 2011 data, and can illustrate vendor-specific trends in adoption. A few points about Meaningful Use need to be made here. All …Continue Reading
Health Information Technology (health IT) has been a burgeoning space in the past several years. Partly spurred by federal incentives to clinicians to adopt Electronic Health Records (EHR), investment in companies in this field has flourished. In addition to EHR companies, which are numerous, and which will very likely experience significant shake-out over the next …Continue Reading
Accountable Care Organizations (ACOs) are gaining momentum. These efforts, part of the 2010 Affordable Care Act (recently upheld by the Supreme Court), aim at building voluntary groups of doctors, hospitals and other healthcare providers in order to improve the quality and reduce the cost of health care (at least, to Medicare fee-for-service beneficiaries). In December, …Continue Reading
We are at a time of dramatic change in health care. Not only is the question of health care finance on the table as a hot area of debate, but also the issue of health care delivery is (perhaps more quietly) undergoing big change. And the kinds of health Information Technology needed by the delivery …Continue Reading
The number of vendors of Electronic Health Records products seems unsustainable. Stimulated by federal Meaningful Use incentives, plus the irresistible tide of pressures and encouragement from all sides (specialty societies, peers, licensing boards, insurance payers), the uptake of EHRs has been steadily increasing. As a result, large established EHR companies, some of whom have been …Continue Reading
In response to requests for a thorough analysis of the Electronic Health Record industry, I have spent some time putting together a comprehensive EHR market analysis reference document, based on actual Meaningful Use experience in 2011. This document is now available for purchase and download in a newly-created bookstore. This document is designed to be …Continue Reading
The promise of using “Big Data” from health care has been the focus of many in the health IT community, particularly from academia, as witnessed in the recent Health IT Connect conference. As we move from a paper legacy for healthcare data to a new electronic one, huge amounts of clinical data are being amassed …Continue Reading
Who has benefitted from the federal EHR Incentive Program (Meaningful Use) so far? Has it been simply a reward to those clinics and medical practices who already had an EHR (as some have argued), or has the system actually encouraged new users who never had an EHR before to adopt? Prior to the beginning of …Continue Reading
EHR Usability is a very important aspect influencing the utility of, and adoption of, Electronic Health Records (EHR). The use of EHR systems is moving out of the “early adopters” phase, and is reaching the tipping point where it is becoming mainstream. More often than not, some form of Health IT is being used in medical offices …Continue Reading
The question of “usability” of Electronic Health Records (EHR) systems continues to be a topic of discussion. A recent report in iHealthBeat gathers comments from a number of influential expert opinions on the topic. There are many aspects to the issue of EHR “usability” – not the least of which is a consensus on what …Continue Reading
The Patient Centered Medical Home (PCMH) is a team-based health care delivery model focused on comprehensive and continuous care, sort of a coordinated one-stop-shopping approach to health care. It has been supported as a policy goal over the past several years, and is often mentioned along with Accountable Care Organizations (ACOs) as a way of …Continue Reading
A recent article in The Health Care Blog about how some Electronic Health Records (EHR) systems are poorly enough designed to where they present bad information, and thus can lead to potential patient harm, got me to thinking. What motivates an EHR to make changes? Are hospital and ambulatory EHRs to be thought of in …Continue Reading
The finalized numbers for the federal Electronic Health Record (EHR) incentive program (Meaningful Use) allow for some insights into the state of the EHR vendor industry. A table of successful Stage 1 Meaningful Use attesters for 2011, including which EHR was used by each individual attester, is available at data.gov, and can be downloaded here. …Continue Reading