Doc EHR market remains competitive

Epic Systems Corp. has more physicians and other eligible professionals who have attested as meaningful users of complete electronic health records systems in the ambulatory-care setting than any other vendor in a still-crowded and intensely competitive field, an analysis of federal data shows.

The Verona, Wis.-based developer has 27,694 or 20.9% of eligible professionals or EPs with complete EHRs in ambulatory care who met federal meaningful-use criteria under the Medicare portion of the EHR incentive payment program. The program was created and funded under the American Recovery and Reinvestment Act of 2009.

The other top five vendors in the EP, complete EHR, ambulatory category by customer count and share of the market are: Allscripts Healthcare Solutions, 15,997 and 12.1%; eClinicalWorks, 10,855, 8.2%; NextGen Healthcare Information Systems, 8,753, 6.6%; and GE Healthcare, 7,543, 5.7%.

Combined, the top five vendors have 53.4% of this market niche, or 70,842 meaningful users; the top 10 vendors, 65.5%, or 86,963 users; and the top 25 vendors, 80.3%, or 106,609 users. A total of 132,470 EPs met the meaningful use standard.

Subtracting out the top 25, that leaves 353 vendors capturing the remaining 26,131 customers in the EP/complete EHR, ambulatory category, by far the largest in the EHR incentive payment program, based on the number of payment recipients.

The database of meaningful users and the EHR systems they use on which this analysis is based is a mashup of two databases. One, compiled by the CMS, covers hospitals, physicians and other meaningful users that have attested to compliance with the meaningful-use criteria of the EHR incentive payment program under Medicare. The other database is kept by the Office of the National Coordinator for Health Information Technology at HHS and comprises EHR systems that have been tested and certified as meeting ONC functional criteria for use in the EHR incentive payment programs.

The mashup of the two does not include data from state-run Medicaid EHR incentive payment programs. Under Medicare, eligible professionals can be physicians, dentists and dental surgeons, podiatrists, optometrists and chiropractors. Thus far, about 90% are physicians, according to the CMS.

The mashup database is current for attestations through Dec. 31, 2012, according to an ONC spokesman. It includes nearly 151,200 records.

Cerner Corp., North Kansas City, Mo., leads all EHR vendors of systems used by physicians and other eligible professionals that have attested as meaningful users of “modular” EHRs in an ambulatory-care setting with 3,704 customers and 29.9% of the 12,370 participants in this program category. The others in the top five in the EP, modular EHR, ambulatory-care category are Allscripts, 2,364, 19.1%; Jardogs (which Allscripts acquired earlier this month), 1,405, 11.4%; HealthPort, 713, 5.8%; and Dr. First, 542, 4.4%. There are 73 vendors with at least one customer who has successfully attested as a meaningful user in the EP, modular EHR, ambulatory care market niche.

Fewer than 1,500 physicians and other professionals have qualified for EHR incentive payments while practicing in the inpatient environment, according to the CMS/ONC database.

Epic Systems had the most physicians and EPs using a complete EHR in an inpatient setting, with 403, or 40.6% of some 992 physicians and EPs who qualified for EHR incentive payments using complete EHRs for inpatient work; followed by Cerner, 309, 31.1%; and Allscripts, 150, 15.1%. There were 22 vendors that had at least one customer successfully become a meaningful user in this category.

An even smaller number—465 physicians and EPs—used a modular EHR to qualify for EHR incentive payments practicing in an inpatient setting. Allscripts, 155, 33.3%, led these, followed by Cerner, 108, 23.1%, and Meditech, 102, 21.9%. There were 17 vendors in this category.