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Best Of Breed Systems Lead In Battle For Meaningful Use Dollars

This week, Modern Healthcare published a very interesting analysis of ONC and CMS data on which vendors were used for Meaningful Use attestation.  The results suggest that the battle for market dominance may be closer than it looks when it comes to producing results that count. Perhaps more importantly, the data suggests that best-of-breed systems may have a stronger foothold than unified systems (see more below).

According to Modern Healthcare, four vendors stood out as leader in the complete inpatient EMR market:

* Epic Systems, with 370 hospitals customers, or 17.9 percent of 2,071 hospitals which have attested using one of the four

* Meditech, with 323 hospitals, or 15.6 percent

* CPSI, with 313 hospitals, or 15.1 percent

* Cerner Corp., with 208 hospitals, or 10  percent

All told, these top four players have sold 1,214 hospitals a complete inpatient EMR system. That’s represents 58.6 percent of all systems sold to hospitals that have gotten a Medicare incentive check using a complete inpatient EMR. The top 10 vendors swelling such systems, meanwhile, have sold them to 1,902 hospitals, owning almost 92 percent of this niche, Modern Healthcare notes.

It’s important to note, however, that best-of-breed implementations have won even more Meaningful Use dollars, the analysis suggests.  In fact, 2,438 hospitals using modular inpatient EMRs have achieved Meaningful Use. According to Modern Healthcare research, three developers lead the modular inpatient EMRs hospitals have used for this purpose:

* Meditech, with 637 hospitals, or 26.1 percent

* Cerner, with 530 hospitals, or 21.7 percent

* HCA Information & Technology Services, with 274 hospitals, or 11.2 percent

Collectively these vendors account for 59.1 percent of modular inpatient EMR market, the analysis shows.

I thought it was quite noteworthy that a larger share of hospitals are using best-of-breed inpatient systems to achieve Meaningful Use than complete inpatient systems. It would be interesting to find out if interoperability was one of the reasons hospitals are making this choice — since we know that the big vendors are shaky on the concept at best.

April 1, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Top Inpatient EHR Vendors – 2013 Black Book Rankings

I think that most of you know how I feel about the various EHR ranking systems. They all have their issues, but they are another interesting data point in the search for the right EHR. Plus, the EHR ranking trends over time can be interesting. Not to mention, it’s hard not to look at a post that has rankings. It’s almost un-American not to look.

So, I figured I’d post some of the Black Book Rankings over the next week. The following are the Top Ranked EHR Vendors for Inpatient Hospital Systems, Chains and IDN (in alphabetical order).

4MEDICA
ALLSCRIPTS
CPSI
EPIC
GE HEALTHCARE
HCS EMR
HEALTH MANAGEMENT SYSTEMS
HEALTHLAND
INFOMEDIKA
KEANE
MCKESSON
MEDITECH
NEXTGEN
PROGNOSIS HIT
QUADRAMED
SEQUEL
SIEMENS
UNI/CARE
VERSASUITE

Not too many surprises on the list. Was their any Hospital EHR vendor that you think should have made it on this list? I think this list would be more interesting if it just ranked the top 5 Hospital EHR vendors.

February 22, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Top 10 Hospital EHR Vendors By Installed Systems

I came across this list of Top 10 Hospital EHR vendors by installed systems on Dark Daily (a great resource, particularly if you’re into Labs). The data is a little dated, but I thought it would be interesting to consider the numbers in 2011 and how they might look different today. Here’s the list:

Vendor Name Total Installations Percent of Installations
• Meditech 1212 25.50%
• Cerner 606 12.80%
• McKesson 573 12.10%
• Epic Systems 413 8.70%
• Siemens Healthcare 397 8.40%
• CPSI 392 8.30%
• Healthcare Management Systems 347 7.30%
• Self-developed 273 5.80%
• Healthland 223 4.70%
• Eclipsys (Bought by Allscripts) 185 3.90%

This list was taken from the HIMSS Analytics database. I wish I had access so I could compare these numbers for 2012. The interesting thing is that I’m not sure the Hospital EHR vendor numbers would be all that much different. Epic is the media darling, but its focus is squarely on the large hospital systems so they often lag behind when it comes to total installations.

December 21, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Oops! Community Hospitals Unhappy With EMR Purchase

A new report from KLAS seems to confirm what we all know already — that buying an EMR is a tricky business that can easily end in failure.  The new KLAS report found that increasingly, community hospitals are questioning whether they bought the right EMR, and that a substantial number are already ripping out and replacing their system.

The authors of the report found that about 200 hospitals with less than 200 beds said they were planning to replace their EMR. And in an even more dramatic turn, KLAS found that one in three community hospitals who’d gone live with their EMR in the past 12 months felt they’d made the wrong decision.

Epic had the most overall community hospital wins for 2011, followed by Healthland, Cerner and CPSI. Looked at another, by market share, Meditech came in first with 20 percent, followed by Epic and Cerner, both with 12 percent.

This ferment comes against a backdrop of bigger institutional changes, in which smaller hospitals are joining integrated delivery networks, and as a result, are being shoehorned into using enterprise systems like Epic and Cerner already in place within the IDNs.

This level of disappointment in technical investments would be pretty remarkable in just about any industry. Given the pressure to get on the Meaningful Use train, it’s perhaps a bit less surprising, since pressure to invest can lead to fatal flaws in just about any decision-making process. Still, as an observer, it alarms me to see just how common EMR dissatisfaction is in smaller community hospitals.

As we’ve noted here before, giant institutions making giant investments seem a lot less prone to expressing dissatisfaction with their EMR.  Maybe it’s because those hospitals really are getting more for their money — who knows? But my guess is that they’ve as prone as smaller hospitals to wish they’d gone another way, given how hard it is to make an enterprise software buy that pleases everybody.

In any event, let’s hope that community hospitals largely make their peace with the EMR they’ve got. Rip and replace can’t be good for morale, finances or patient care.

December 18, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Gap Between Small/Rural and Large/Urban Hospitals Closing

As readers know, we’ve been tracking the progress of Meaningful Use uptake, and data has repeatedly suggested that small and rural hospitals were lagging behind. Now, courtesy of Modern Healthcare, comes an analysis suggesting that the EMR gap between small/rural and large/urban hospitals may be closing.

The magazine, which drew this conclusion after analyzing a CMS/ONC database of meaningful users of EMR systems, found that small hospital-oriented vendor CPSI has moved to the number one position among vendors “whose hospital clients have achieved Meaningful Use with systems certified as ‘complete EHRs.’ ”

According to Modern Healthcare’s analysis, CPSI’s 266 hospital clients account for 19 percent of the 1,381 hospitals that have become meaningful users with complete EMRs.

CPSI, which typically serves hospitals of 100 beds or less, can now boast more hospitals with so-called complete EMRs than larger vendors like Epic and Meditech.  Epic has 251 clients which met Meaningful Use criteria for a complete EMR, and Meditech came in third with 173 hospital clients who were meaningful users of complete EMRs.

That being said, this doesn’t mean that the small and rural hospitals don’t face significant barriers when it comes to acquiring — and more significantly, developing sophisticated uses for — robust EMRs.

As the Modern Healthcare piece notes, far more large hospitals adopted an EMR in 2011 (25.4 percent) than did small hospitals (14.7 percent).  There was also a big gap between the percentage of rural hospitals who adopted EMRs (19.4 percent) versus urban hospitals (19.1 percent), according to Mathematica Policy Research.

It’s also worth noting that when last we checked, smaller hospitals were generally far lower on the HIMSS EMR Adoption Model scale.  Smaller hospitals and rural facilities were on average below 2 on the seven point scale, while urban and academic institutions scored much higher.

That being said, I like how Modern Healthcare used vendor data as a proxy for looking at the status of small/rural hospital EMR adoption. Good idea. Any data we have on how hospitals are faring is good data.

November 7, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Differences Between ROI, Ease of Meaningful Use Vary Between Vendors

New research by KLAS seems to have uncovered important differences between the way EMR vendors perform when organizations are mounting them for Meaningful Use compliance.

According to the research firm, which interviewed 104 MU-compliant providers, both large and small hospitals successfully passed through Meaningful Use attestation.  However, the choice of vendor did seem to make a difference — one which, if KLAS is right, hospitals would be ill-advised to ignore.

KLAS concluded that hospitals using Allscripts, Healthland, HMS, McKesson had a harder time moving ahead on MU than organizations that went with MEDITECH, Cerner, CPSI and Epic. (It should be noted that while MEDITECH had the highest number of successful attesters, most of those came from a single large IDN, which makes it a bit hard to tell whether the IDN’s execution strategy or the product deserves the credit.)

One surprising bit of data, for me at least, that community hospitals were having an easier time covering their costs than larger IDNs.  KLAS notes that this varied from vendor to vendor, but didn’t name which were the higher performers.

Why the difference? My guess is that the bigger IDNs bought “Extormity” software (such as Epic and Cerner) and are having a hard time paying for it; that they have higher integration costs; and that they’re dealing with larger piles of smoking heaps of machinery (oh, excuse me, I meant very outdated mainframes and what have you).

As for problems, providers obviously had plenty to share.  Reporting and problem list functions were the most commonly reported challenges, KLAS said. In these areas, it seems, all vendors performed poorly, including the ever-popular Epic Systems.

March 21, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Which Hospital Vendor Solutions Are a Fit for the Community and Mid-Size Hospital Space?

The following are some of the vendors often under consideration:

  • Allscripts: The Eclipsys Sunrise platform has proven clinical functionality. Strong outpatient strategy via Allscripts.
  • Cerner: Has been among the most aggressive in adapting a large hospital solution for the community space. A proven clinical platform which is made more consumable by the introduction of the remote-hosted version.
  • Epic: Has dominated the large hospital market. Not accustomed to selling to hospitals with less than 300 beds (unless it is a children’s hospital). Some community hospitals are piggybacking on a larger organization’s investment in Epic, making these larger hospitals act as solutions providers to other hospitals – i.e. acting as vendors.
  • McKesson: Paragon has a lot of momentum in the community and mid-size hospital space. They are rolling out CPOE functionality.
  • Meditech: The most successful (and affordable) integrated platform in the community hospital market. Huge number of legacy installs. The go-forward is Version 6.
  • QuadraMed: Has a sizable client base in the middle of the market. Proven clinical adoption. Clients wonder where the core clinical product is going in terms of development.
  • Siemens: Soarian has several installs in community and mid-size hospitals. Has gained CPOE adoption. Little clinical enhancement with MedSeries4 and still working out which is the preferred solution for this market – Soarian or MS4.

CPSI, Healthland, HMS, and NextGen are pushing up into the small end.

What is on the horizon?

Large hospital vendors are redoubling their efforts to win business in the community hospital space, which, in turn, causes vendors with small hospital solutions to reinvest in their products in order to prove clinical functionality and adoption. These two groups of vendors are coming at the market from different places, but providers benefit all the same.


Guest Post: Jeremy Bikman is Chairman at KATALUS Advisors, a strategic consulting firm focused on the healthcare vertical. We help vendors grow, guide hospitals into the future, and advise private equity groups on their investments. Our clients are found in North America, Europe, and Asia. www.KATALUSadvisors.com

The principals of KATALUS Advisors have worked with hundreds of healthcare organizations, vendors, and other consulting firms across the globe. The opinions expressed here are our own and are not intended to promote any specific vendor and do not reflect those of any other organization or individual.

December 29, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Which Health IT and EHR Vendors Should Critical Access Hospitals Consider?

The number of health IT and EHR enterprise options available to critical access hospitals is increasing as competition for new hospital contracts moves downstream to smaller facilities. The following is a brief (not all-inclusive) list of health IT and EHR vendors that could be ideal fits for critical access and small, rural hospitals:

  • CPSI: Has done a good job of proving clinical adoption and leads with the most critical access hospital clients doing CPOE.
  • Healthland: Solid system with proven operational capability. Clients give the EMR high marks for usability.
  • HMS: Reinvesting heavily in improving clinical functionality and UI, including a partnership with MEDHOST for strong ED capability.
  • McKesson: Paragon is being considered more often in the critical access space. Has significant sales momentum in larger community hospitals, with some IDN wins.
  • Meditech: Already has a huge client base in larger community hospitals. Small organizations with resources are considering v.6.
  • NextGen: Gets little notice despite having an inpatient offering that is completely integrated with their successful outpatient EMR. Already have a number of clients. Has solid functionality.
  • Prognosis: Exciting new entrant. Applies remote-hosting technology to a single-database inpatient solution for small, rural facilities and critical access hospitals. Already has several clients.

These health IT and EMR vendors represent a mix of those who have caught the attention of smaller facilities, those who represent a new and intriguing competitive advantage, and those who have proven able to deliver products in a small hospital environment.

See also our list of hospital EMR and EHR vendors.

Chris O’Neal is Managing Partner at KATALUS Advisors. KATALUS Advisors is a strategic consulting firm focused on the healthcare vertical. We serve healthcare technology vendors, hospitals, and private equity groups in North America, Europe, and the Middle East. Our services span growth strategies in new and existing markets, M&A due diligence, market analysis, and advisory services. www.KATALUSadvisors.com

September 27, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.