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EMR, HIE Use Up Sharply In U.S.

Posted on May 10, 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. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new survey by Accenture has concluded that the number of U.S. doctors using EMRs — either in their practice or at a hospital — has climbed to over 90 percent, and that almost half are using HIEs. More than half of doctors surveyed (60%) report using an EMR in their own medical practice.

The Accenture survey reached out to 3,700 doctors in eight countries, including Australia, Canada, England, France, Germany, Singapore, Spain and the U.S.  Data showed a spike in healthcare IT usage across all of the countries surveyed.

In the U.S., doctors had the biggest increase in adoption demonstrated in the survey, up 32 percent in routine use of health IT capabilities, as opposed to an average increase of 15 percent among non-U.S. clinicians, reports HealthcareIT News.

Other standout activities were e-prescribing (65 percent using) and entering patient notes into EMRs (78 percent), a 34 percent annual increase between 2011 and 2012. Forty-five percent of physicians also use IT for basic clinical tasks such as getting alerts while seeing patients (45 percent), according to Healthcare IT News.

Healthcare IT News also caught an interesting detail around lab orders. The magazine notes that 57 percent of U.S. doctors said they regularly use electronic lab orders  (a 21 percent annual increase) the volume of physicians doing so internationally dropped 6 percent.

Globally, the number of doctors who “routinely” access clinical data on patients seen by different health organizations has climbed by 42 percent, from 33 percent of doctors in 2011 to 47 percent in 2012. Spain was the leader by a significant margin, with 69 percent of doctors routinely accessing such data.

The study also concluded that internationally, almost 60 percent of doctors customarily enter patient notes electronically either during or after consults.

On the other hand, so-called “digital doctors” are still unlikely to connect or transact electronically with outside organizations. Accenture found that only 10 percent of physicians communicate electronically to support remote consults/diagnostics, and that roughly 20 percent e-prescribe, receive notifications of patients’ interactions with other health organizations and communicate electronically with clinicians in other organizations.

Medical Apps, $21 Billion EMR Market, and Sick of EMR

Posted on April 21, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


This is a pretty interesting idea and another way to talk about subjects we’ve talked about many times here. The idea of an app in this case is an app on top of EMR software. I call this making the Smart EMR. It will likely come from these apps. The article is right that many of the data warehouses are clunky and don’t serve the doctors. In fact, there are very few data warehouses focused on the doctors needs at all.


The last EMR incentive numbers I saw were at $10 billion. Does that mean the government has funded half of the market? These numbers are always a little fishy, but it’s interesting to consider how big the EMR market is.


I actually know a lot of doctors who love their EMR and wouldn’t practice medicine without one. What I think most doctors are tired of is all the government regulations. We shouldn’t confuse government regulations with EMR.

March Madness and the EHR Vendor Shakeout

Posted on March 29, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m not sure how many of my readers love March Madness as much as I do. I just love the emotion and the all day experience of March Madness. Unfortunately there haven’t been quite as many last minute buzzer beaters for the win as there have been in years past, but I still love the emotions of the games. These young kids have worked almost their entire life for this moment. I love to see the raw emotions from both teams.

As I think about March Madness, I couldn’t help but think about the EHR Madness we’re experiencing right now. We don’t have 68 teams in the EHR tournament. Instead, there are more like 300+ EHR vendors. In fact, in just the last week or two I’ve had two EHR vendors I’d never heard of contact me. Yes, we’ve seen some EHR software put out to pasture, but we still have a long ways to go before the EHR market really shakes itself out.

The nice thing for EHR vendors is that unlike the NCAA tournament which only has one winner, the EHR world is likely going to have many many successful companies. First, because many EHR vendors will likely get acquired by larger EHR vendors. Second, because it’s fair to say that the EHR world is going to be a heterogeneous environment. There won’t be one EHR to rule them all (although some EHR vendors still think they might get there).

Which type of vendors am I putting my money on in the EHR battle?

While many EHR vendors might win some short term battles, I think the big EHR winners are going to be those who end up battling through the mess of regulation while still having a laser focus on the impact to doctors. The most expensive employee in every healthcare institution is the doctors. EHR software that takes these high paid doctors away from seeing patients is going to have a real challenge long term.

I’ve written about the EHR Backlash a number of times before. I think productivity is going to be at the core of the EHR backlash. I’m hopeful that EHR vendors are taking this idea to heart, but I also still see a very long road in front of us to reach EHR nirvana.

I’ve been digging into the idea of a Smart EMR lately. At the core of the idea is how to make a doctor more efficient at what they do while increasing the quality of care provided. That certainly stands in stark contrast to many of the other EHR initiatives we see out there today.

The Fast EHR Companies and the 37Signals EHR Companies

Posted on September 4, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I was recently reading this fascinating interview with Jason Fried, Founder of 37signals. It’s a fascinating read, as was his book Rework. I must admit that I have a similar model for tech entrepreneurship to Jason Fried and it is quite different than what’s written about by most tech websites. Jason is much less about the flash and cash part of entrepreneurship and much more about building something of value in a long term sustainable way.

As I consider on these ideas, I started to wonder about the various EHR companies and which companies fall into the various entrepreneurship buckets.

Fast EMR
The fast EMR company is usually one that’s gone out and gotten a ton of funding from venture capital firms. If you’re an EHR company that’s gone out and raised millions and millions in funding, then you have no choice but to attack the market aggressively so that you can provide a return to your investors. There are actually a number of EHR companies that fit this profile, but the first one that will likely come into everyone’s mind is Practice Fusion. There $64 million in EHR funding means that they have to get a large portion of the EHR market. They no longer have the option of staying small but successful.

Let me be clear that there’s nothing wrong with being a Fast EMR. In fact, there are a lot of good things that come out of fast EMR companies that are trying to push the envelope when it comes to EHR adoption and how EHR should be done. It is entrepreneurship at work.

Slow and Steady EMR
On the opposite end of the spectrum are what I call the slow and steady EMR companies. These companies are often self funded or took in a much smaller investment and then used revenues to grow the company much like 37signals founder described. They slowly and steadily built their product, acquired customers and generated revenue.

I believe that SOAPware and Amazing Charts are the epitome of this type of company. They were both physician founded EMR companies that have built their user base slowly over time. They’ve never gone out and gotten the millions in funding. Instead they’ve grown organically over time.

Why Does This Matter?
In my e-Book on EHR selection, I talk about why it is important for you to understand the type of EHR company you are choosing. Would you rather “marry” the EMR tortoise or the EMR hare? The choice could change your EHR experience dramatically.

Disclosure: Practice Fusion, Amazing Charts and SOAPware are all advertisers on this site, but I didn’t discuss this post with them before posting it. Although, since they’re advertisers they were likely top of mind for me when I was writing this post.

EHR Vendor Consolidation

Posted on June 15, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Katherine Rourke recently did a post on EMR and HIPAA entitled, “Major EMR Vendor Consolidation On The Verge.” This is an incredibly important topic, and so I’m glad that she’s writing about it. However, I have a number of differing views on EHR consolidation.

Probably the two biggest differences of opinion is how quickly she believes we’re going to see EHR consolidation and how much EHR consolidation will happen. Sure, we all know that the current mass of EHR companies isn’t sustainable (I personally put us at about 600 EHR vendors, versus her 1000+ EHR company projection).

In my EHR Company Funding Risks series I looked at all the various type of EHR companies. In that analysis, I realized that each type of company seems to be really well funded through at least the next stage of meaningful use stage 2. Sure, there might not be a few that make it that far, but I believe that most of them will. So, yes EHR consolidation has got to happen, but I don’t see EHR companies falling like flies until at least after meaningful use stage 2 and possibly after meaningful use completely.

I also don’t believe that we’ll ever see the MASS EHR consolidation that many predict. The reason I believe this is that healthcare is very regionalized and so I think there could be many regional EHR companies that are quite successful. Plus, there are such a wide variety of practices including things like: specialty, practice size, billing method, etc on top of local that I believe each of these factors are likely to make it that each factor could have its on EMR market.

Plus, the other challenge I see is that there are a large number of EHR vendors that I know that have no interest in consolidation. In many cases they’re what I call Cash Flow Positive EHR companies and so they are in a good position to last for a long time to come and don’t have any need to sell their company to someone else. I believe they’re in a very good position to be around for a long time.

I imagine some would make the argument that there could be some market forces that could come into play that would change this situation. The most likely argument I’ve heard is the new ACO (accountable care organization) model requiring a large EHR company that can support the entire ACO. This is an important change that should be considered, but I personally don’t think this will drive EHR consolidation. We’re going to have a heterogeneous EHR environment and so ACOs will have to be possible across EHR companies. I don’t see a small set of EHR companies creating a virtually ACO monopoly and shutting out certain EHR companies from that ACO. Although we’ll see how that plays out.

I am interested to hear what other forces people see that could cause EHR market consolidation to happen faster.

I also concur with Katherine’s suggestion that practices have a plan if (and in many cases when) something happens to their EHR company. Maybe I should start seeking out and publishing experiences of practice who’ve gone through this and can share what they learned.

US EMR Market to Exceed $8 Billion in 2016

Posted on January 2, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In case you missed it, I’ve moved a lot of my discussion of the EMR and Health IT markets to my site: EMR Thoughts. I’ve done a lot of posts on that site that look at the EMR market, the health IT investments, the Health IT incubators (or accelerators if you prefer), and other movement in the EMR, EHR and Health IT markets. If you like that type of content, you should definitely subscribe to the EMR Thoughts email list.

Even though, I’ve moved a lot of my EMR market discussion to the other site, every once in a while I’ll drop in some EMR market stuff on here as well. In the article linked in my Costco EMR post, they discussed the size of the EMR market:

Millennium Research Group said in its November report, “U.S. Markets for Electronic Medical Records 2012,” that the U.S. market for EMRs will exceed $8 billion by 2016, with the fastest-growing segment occurring in the small-practice market. Web-based EMRs that don’t require an expensive information technology infrastructure are contributing to the growth, the report said, because they are an affordable option for small practices on tight budgets.

I always hate when they don’t split the EHR market into ambulatory EHR and hospital EHR. I also still haven’t figure out a good way to reconcile that the EMR market in the US will be $8 billion in 2016, but we’ll have spent a good portion of the $36 billion of EHR stimulus money by 2016. Those two numbers don’t jive very well.

I also find it interesting that the fastest-growing segment of the EMR market is the small-practices. I’m not sure I agree with this. I think the larger sales and hospital EHR sales are brisker than the small practice EMR market. Much of the small practice market is still “waiting and seeing.”

Job Growth in Healthcare and the EHR Bubble

Posted on August 11, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It’s a crazy world that we’re living in today. The market is on a roller coaster. The riots in London. A lot of other crazy things happening. Not the least of which is the high unemployment in the US. Despite the challenging times, I’m not seeing as many of the same challenges in healthcare IT.

This was higlighted in some recent tweets I saw that talked about the job growth that’s happened in healthcare. That’s right, healthcare has actually had job growth. It’s quite amazing to consider, no?

Healthcare IT is especially interesting thanks to the $36 billion in EHR stimulus money. It’s a frother EMR and EHR market out there and I expect the froth is going to continue for another couple years. Is it fair to say that we’re in an EMR and healthcare IT bubble? I think so.

The question I’m starting to consider is what’s going to happen when the bubble pops? I’m not sure that we’re going to see one big pop in the EMR market. Maybe I’m wrong, but I think that we’re going to see a long protracted fall out of EMR and EHR companies. I guess this type of slow failing EMR companies is better than a major pop, but it still doesn’t sound good.

Well, at least it doesn’t sound good for those clinics who are using the EMR software from the EMR companies that fail. However, it’s going to present some interesting opportunities for EMR companies that can clean up the mess that’s left. Of course, most of us won’t know the details of the mess. We’ll just see flowery announcements about EMR companies selling off to larger EHR companies. However, those acquisitions will be a great customer acquisition buy for the EHR companies who have the cash and can transition users effectively to their EHR software.

How far off is this? I’d say at least 2 years. So, the next 2 years are going to be an interesting time for EHR vendors that are trying to position themselves for these types of acquisitions.