50 things to know about the EHR market’s top vendors

“To improve the quality of our healthcare while lowering its cost, we will make the immediate investments necessary to ensure that, within five years, all of America’s medical records are computerized.” — President-elect Barack Obama, Jan. 8, 2009


President Obama made this statement about six weeks before the Health Information Technology for Economic and Clinical Health Act was signed into law. Under the HITECH ACT, CMS began its EHR Incentive Program. Although that five-year benchmark has been surpassed, of April 2015, CMS paid out more than $30 billion in incentive payments to hospitals and health systems for the adoption and use of electronic health records. These incentive payments, coupled with the looming threat of financial penalties for non-adopters and a need to better coordinate care, have driven providers to rapidly adopt EHRs over the past few years. The EHR market is expected to reach $8.3 billion by 2016.

As the EHR market matured, a once-crowded field of vendors narrowed significantly. In March of 2015, 10 EHR vendors accounted for about 90 percent of the hospital EHR market, based on meaningful use attestation data from CMS: Cerner, MEDITECH, Epic, McKesson, CPSI, MEDHOST, Healthland, Allscripts, NextGen Healthcare and Indian Health Service.

According to the government’s Health IT Dashboard, three of those companies — Epic, Cerner and MEDITECH — corner nearly 60 percent of the market share combined.

Several of the big players in the EHR market are led by big personalities, from Judy Faulkner, CEO and founder of Epic, who kept the company private and is now worth an estimated $2.6 billion; to Cerner’s Neil Patterson, known for his passionate, involved leadership style; to athenahealth’s outspoken Jonathan Bush, an advocate for disruptive technologies in the healthcare industry.

Recently, the EHR market has seen an infusion of providers seeking replacements for their current systems. Surveys suggest at least one-third of physicians are dissatisfied with their current EHR, and more than half would not recommend their current EHR to colleagues. Tied with financial issues, 37 percent of physicians reported the EHR as their number one challenge.

With meaningful use stage 3 delayed until 2017, and a chorus of voices calling for an extended moratorium on the policy, the need for EHR vendors to offer providers systems capable of efficient data use and exchange has never been more pressing. The ONC has outlined the minimum criteria EHR vendors need to meet in order to achieve Health IT Certification, which ensures that that the system providers choose to adopt offers the necessary capabilities and functionalities to enable them to achieve meaningful use. To qualify to receive incentive payments, providers must successfully attest to MU by both adopting and demonstrating their meaningful use of certified health IT.

Here are 50 additional facts and insights into the EHR market and some of the most prominent players. (EHR vendors below are arranged alphabetically.)

The current EHR market

1. In March of 2015, Cerner, MEDITECH and Epic Systems comprised nearly 60 percent of the market share of primary certified EHRs for participating hospitals. Furthermore, the top 10 of 169 total EHR vendors — MEDITECH, Cerner, Epic, McKesson, CPSI, MEDHOST, Healthland, Allscripts, NextGen and Indian Health Service — provided the primary EHR for over nine out of 10 hospitals. For the remaining 169 hospital EHR vendors, 9 out of 10 of all hospitals report the vendor’s product as their secondary EHR. A secondary EHR is any additional modular EHR used within the hospital’s system.

2. According to a KLAS report, just three of these vendors expanded their market share in 2013 — Epic, Cerner and MEDITECH. The report found Epic and Cerner experienced the largest gains in both the large- and small-facility markets.

3. Allscripts, Epic, Cerner, McKesson and Quadramed are the most popular EHR systems among academic medical centers, teaching facilities and hospitals with more than 300 beds, according to a 2014 report from KLAS. Among small and rural hospitals under 100 beds and critical access hospitals, the top vendors are CPSI, Cerner, Healthland, Healthcare Management Systems and RazorInsights.

4. The following is a list of the top 10 vendors associated with the most providers who attested to meaningful use as of May 2015.

1. Epic — 185,997
2. Cerner — 120,331
3. Allscripts — 99,091
4. GE Healthcare — 55,681
5. eClinicalWorks — 52,565
6. NextGen — 50,771
7. Greenway — 30,588
8. Intermountain — 30,330
9. McKesson — 22,878
10. athenahealth — 21,442
11. Practice Fusion — 18,701
12. MEDITECH — 10,746

Here are the top seven vendors broken down by hospital attestations only.

1. Cerner — 10,044
2. MEDITECH — 5,374
3. Epic — 2,307
4. McKesson — 1,930
5. MEDHOST — 1,840
6. CPSI — 1,261
7. HCA I&T —1,223

5. Just a handful of EHR vendors dominate the market share for physician practices. Here are the top 10 vendors for those practices broken down by market share, as of February 2015, according to an SK&A report.

1. Epic — 11.6 percent
2. eClinicalWorks — 10.2 percent
3. Allscripts — 8.7 percent
4. Practice Fusion — 6.7 percent
5. NextGen Healthcare — 5.5 percent
6. GE Healthcare — 3.6 percent
7. Cerner — 3.5 percent
8. athenahealth — 3.3 percent
9. McKesson — 3.2 percent
10. Amazing Charts — 2.3 percent

6. After a months-long bidding war among finalists for the Department of Defense’s $11 billion-EHR modernization contract, three teams led by Epic, Cerner and Allscripts, respectively, remain in the running for the history-making deal. The Pentagon wants seamlessly interoperable health data exchange for its nearly 10 million employees, service members, retirees and their families. The transition to the new system will be the largest of the decade and the winning team is expected to be awarded the contract in fall 2015.

7. HIMSS’ EHR Developer Code of Conduct outlines expectations for developers in the areas of general business practices, patient safety, interoperability and data portability, clinical and billing documentation, privacy and security and patient engagement. Its 32 signatories include:

· AllMeds
· Allscripts
· Amazing Charts
· Aprima
· Cerner
· CureMD

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