Comprehensive EHR market analysis now available

Posted on July 15, 2012 by Robert Rowley

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 an indispensable resource, particularly useful to health IT consultants, EHR vendors (both of hospital and of ambulatory systems), and investors wishing to get a better understanding of the EHR vendor landscape.

Both hospital systems and ambulatory systems are characterized, and differences in the nature of these two spaces are detailed. The sections of the document are as follows:

• Executive summary
• Issues around extrapolating from Medicare Meaningful Use data to the entire spectrum of EHR use by clinicians
• Vendor comparisons (including a detailing of vendors who made certified products that were not used by anyone attesting for Meaningful Use in 2011)
• Geographic distribution (market map), showing tables and maps of the regional market prominence for each vendor
• New vs. established users, examining the question of Meaningful Use benefitting those who already had EHRs vs. encouragement of new EHR adoption
• Breakdown by specialty, showing medical specialties participating in Meaningful Use on the ambulatory side, and hospital types on the inpatient side
• Discussion and conclusions
• Various appendices, with full vendor and product lists for both ambulatory and hospital products

Some of the highlights (excerpted from the Executive Summary) are as follows:

• Meaningful Use successful attestation rates represent about 7% of all physicians. It varies considerably from state to state.
• About 25% of all physicians signed up for the program. Of those who signed up, about 39% were successful attesters in 2011.
• About 53% of all hospitals signed up for the program. Of those who signed up, about 62% of hospitals were successful attesters in 2011.
• Among ambulatory EHR vendors, about 70% of all successful attestations were made using the top 12 products. The remaining 30% of successful attesters used 272 different EHR products.
• Of the 949 EHR products Certified for ambulatory use, 389 of them (41%) were not used by anyone for attestation in 2011
• Among hospital EHR vendors, about 72.5% of all successful attestations were made using products from the top 5 vendors. The remaining hospital attesters used products from 54 different EHR vendors.
• Of the 220 EHR products Certified for hospital use, 72 of them (33%) were not used by anyone for attestation in 2011
• The geographic distribution for each vendor (both ambulatory and hospital) varies widely, and offers insights into the local market strengths for each of the vendors.
• About two-thirds of attesters, both for ambulatory and also for hospital EHRs, used newer technology (versions later than 2010), whereas about one-third of attesters did so using older, established technology.
• The majority of EHR attesters on the ambulatory side were primary care physicians, though medical specialists, surgical specialists and non-MD clinical disciplines were significant.
• On the hospital side, acute care hospitals and rehab facilities were the majority of EHR attesters, though many different hospital settings were also present among successful attesters in 2011.
• Most all ambulatory attesters (95%) used Complete EHR products, whereas it was more mixed for hospitals. Only 48% of hospital attesters used a Complete EHR, whereas 52% used Modular EHR components to achieve Meaningful Use.

Notably, no EHR vendor blanketed the country in terms of its market presence. Even the largest vendor in the ambulatory space, Epic, has significant variation of use in different geographies.

These kinds of maps and detailing is carried out for each vendor, both on the ambulatory and on the hospital side.

My hope is that this analysis will be useful for those wanting a detailed understanding of the EHR vendor landscape, either for targeted consulting services (consultants), targeted marketing activity (vendors), or investment due diligence and intelligence (investors).

Tags: ambulatory EHR, by vendor, EHR market, hospital EHR, physician attestation

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