Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and EHR for FREE!

EMR Vendors Buying Physician Market Share

Posted on January 9, 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.

Here at EMRandEHR.com, as well as in blogs across the web, we’ve been predicting that this will be the time when the EMR vendor market will begin to consolidate.  I stand by that prediction. But I have to admit that the first couple of deals I’ve tracked have turned out differently than I had expected.

Consider the acquisition of Amazing Charts by Pri-Med, a provider of professional medical education to more than 260,000 clinicians. I would have assumed that Amazing Charts would be acquired by a larger EMR vendor to fill out its offering physicians, but instead, Amazing sold to a publishing company with a huge physician base.  In retrospect, it makes plenty of sense, but for some reason I didn’t see it coming.

EMR vendor athenahealth pursued a similar strategy recently when it signed a definitive agreement to buy Epocrates, perhaps the most popular mobile application used by physicians today. athenahealth agreed to pay almost $300 million in cash for Epocrates, 22 percent more than what the mobile app vendor’s’ stock was worth on the day in question, in a move that the EMR company concedes tapped out its credit line.

But costly though the deal might have been, athena is getting a lot for its money. Buying Epocrates adds another one million physicians to its comparatively small provider base of 38,000.  If you consider the app itself plus the physician users, athenahealth’s investment seems pretty reasonable. When you consider how costly it is to acquire physicians as customers, a deal valuing them at $300 a physician doesn’t sound astronomical to me.

What I’m getting at, bottom line, is that other EMR players are likely to follow the model established by the Amazing Charts and athenahealth deals. I think this approach — buying, rather than begging for, new physician relationships — makes a great deal of sense.  What about you?

Are Large EHR Vendors More Likely to Shut Down an EHR Than Small EHR?

Posted on May 9, 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.

As most people who have read this blog for a while, you know that I try to bring you raw perspectives on things that a lot of people don’t want to talk about. Plus, I don’t mind arguing the other side of topics in order to provide a more well rounded view of an important topic. One of my main goals is to provide the information necessary for doctors to make great decisions.

I recently got into a lengthy discussion with someone about EHR vendor selection. They suggested that doctors should look to the 5 EHR market leaders in their EHR selection process (I believe he sold one of those EHR market leaders). He made some very good points about the market leaders ability to support all stages of meaningful use, that they have a solid business model that will support doctors for the long term, and that they have the resources to support an EHR software for the long run. He also provided some reasonable cautions around small EHR vendors with skeptical business models that might not be around a few years from now.

Certainly the points he makes have merit and are worthy of consideration. Although, unlike this person, I’m not so ready to throw the rest of the non-top 5 EHR vendors out and I think it’s a mistake for a doctor or practice manager to do so as well.

As I considered on this discussion, I realized that over the past 5-7 years, it’s many of the big EHR vendors that have closed up their EHR software. Possibly even more than the various startup EHR companies. Here are just a few examples of large companies shuttering their EHR: Misys (billion dollar company if I remember right), Epocrates and GE Centricity Advance (one of GE’s suite of EHR). Of course, Misys merged with Allscripts (if you call it a merger since they were going bankrupt), but I know a lot of unhappy Misys users that don’t know what to do now. GE has many other Centricity products as well and seems to have made a smoother transition for their Centricity Advance users. At least that’s within the same company. Epocrates is a large company, but didn’t have many EHR users.

My point of course is that even EHR software from large EHR vendors aren’t safe from possible future issues. In fact, I could make a reasonable case for why a smaller EHR vendor that’s grown in a sustainable way over a long period of time is in a better financial position than a HUGE company with a lot of overhead. Plus, I know personally A LOT of these small EHR vendor CEOs. They love what they’re doing and they’re in this for the long haul.

Now with 600+ EHR vendors out there, I’m certainly not saying that all of them have great business models. I was blown away when I met one at MGMA who had 1 doctor using their system. I hope whoever they sign up second is aware of the situation and is going in with both eyes open. There are certainly risks associated with being the second doctor on an EHR software, but there are also plenty of benefits as well. When you suggest something be changed, there’s a good chance you’ll get that change.

Conclusion
There are good small EHR companies.
There are good large EHR companies.
There are bad small EHR companies.
There are bad large EHR companies.

I guess what I’m saying is that size doesn’t matter in EHR selection. There are much more important factors to consider.

Epocrates EMR Killed Immediately After Launch

Posted on March 15, 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. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Back in 2010, Epocrates had its EMR ducks in a row. The company, known best for a very popular smartphone-based drug interaction database for physicians, announced plans to release a mobile SaaS EMR.  While Epocrates was jumping into a market more crowded than a barrel full of monkeys, one could see where leaders might see an EMR as an extension of the relationship it already had with physicians.

Now, Epocrates leaders have said “oops” and announced that they were killing the product,  telling investors and the public that building the darned thing was distracting it from its core business.  It does seem that the company was struggling with the EMR rollout process:  it didn’t roll out its first-phase product until August 2011 and didn’t get its Meaningful Use certification until February of this year. But this is the first time I’ve seen a company kill a product at this stage of development, particularly in such a high-profile manner.

It must have been more than a bit embarrassing to make the announcement during HIMSS12 when, of course, companies traditionally kick off products they’re planning to sell vigorously. As Epocrates was making plans to dump or sell their EMR, the company’s CMIO, Tom Giannulli, MD, was pitching the company’s new iPad EMR to editors.

As Epocrates itself pointed out, there aren’t too many dedicated iPad EMR offerings out there. So in theory, this should not have been a waste of the company’s time.  On the other hand, with the iPad still a new frontier for EMRs, we still don’t know whether it will ultimately work as a platform of choice for physicians.  As we’ve previously discussed on this blog, the iPad seems to be a pretty good medium for reading data but a very awkward one for entering data. Whether that’s a fatal flaw remains to be seen.

Truthfully, this looks like a failure of execution from start to finish, rather than a product that couldn’t possibly work. But these are tough times. Even the best execution may not work; and if so, Epocrates was probably wise to fold its cards before further damage was done.

Mobile Makes the Difference in Emergencies … or on Vacation

Posted on August 3, 2011 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

My family and I have escaped this week to our favorite vacation destination, Pensacola Beach. And so I sit here writing in the cozy confines of the condo that we call home for close to a week nearly every summer. I gave barely a thought to how I was going to transmit this blog to the HealthcareScene.com servers while here. As it turns out, there is no WiFi, which means I’m relying on my iPhone to do a bit of online research, my laptop for Word, and the hotel across the street’s business center with which to cobble it all together.

My connectivity issues pale, of course, in comparison to those of providers working outside of their hospital’s four walls – be it in emergency situations such as the aftermath of a hurricanes like Ivan and Dennis, which hit Pensacola back in 2004 and 2005, respectively, or as part of a routine provider/patient encounter in telehealth programs. I wonder how providers at Pensacola’s Sacred Heart Hospital, where I was born (and no, I’m not telling you what year), handled patient care in the aftermath of Ivan, which devastated the town and outlying beach communities, and how mobile health solutions might better enable them should Mother Nature pay the same sort of visit today.

Well timed for this blog was the recent news that Epocrates has released the first phase of its EHR system, including an iPhone app, targeted to primary care practices with 10 physicians or less. The EHR, according to a recent report at MobiHealthNews.com, “is initially available as a Web-based SaaS product, includes patient encounter notes, electronic lab integration, e-prescribing and Epocrates’ flagship drug database.”

The iPhone version should be available in a few weeks, and is likely to include remote patient record look-up and schedule access, and e-prescribing. The iPad version, which is in development, will focus on point-of-care data capture. MobiHealthNews.com also reports that an Android app is in the works, but will be rolled out in later versions of the EHR.

It will be interesting to see if later versions also target larger physician practices, which would surely also benefit from mobile technology like this. Perhaps most interesting, at least to providers in places like Pensacola that see their fair share of hurricane-induced on-site emergency care, is that the Epocrates mobile EHR app will “be a native app and it will store patient data on the device,” according to the company, which means that “the device will not need a signal to access the EHR. Any new data will be synched with the record once the phone finds a signal.”

Hopefully that signal will not be as elusive in a community’s time of need as the WiFi seems to be at my vacation destination.

iPad EMR Demo in Apple Store

Posted on June 16, 2010 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 find this completely fascinating. Yes, the Apple Store is demoing various medical applications like EMR on the iPad. Here’s an excerpt from blogger Iltifat Husain walking into an Apple Store:

When I recently walked into my local Apple store to buy an iPad accessory, I saw a group of about 20 people huddled around a large LCD screen while an Apple employee was giving a workshop.

When I saw the LCD screen full of medical applications, I was shocked. This wasn’t your run of the mill “how to use your iPhone” workshop.

The people gathered for the workshop consisted of healthcare professionals in medicine, dentistry, and other fields. About a third of the group consisted of physicians.

The workshop was focused on how the iPhone and iPad can be useful for their practices and as reference tools for day to day work.

The workshop was led by an Apple employee who went through a slideshow presentation of useful medical applications, such as Epocrates, iMurmur, Airstrips OB, and many of the other useful applications we’ve featured on iMedicalApps before.

Along with the presentation given by the Apple employee, a MacPractice representative was on hand to demonstrate their electronic health record and how it worked from the desktop to the iPhone and to the iPad.

Pretty interesting to see Apple committing that type of resource to marketing the clinical applications.

iPad EHR or Not

Posted on April 6, 2010 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 first wrote about the possibility of an iPad EMR back in February when the iPad was first announced. At the time my speculation was that we wouldn’t see an iPad EMR developed, but that the iPad would have a significant impact on the EMR input methods.

Well, I guess I was wrong on one account. MangoMed has developed what their website calls an “iPad based EMR EHR.” I wonder if this was just a quick shift from being an EMR like all the rest and the company quickly just decided to capitalize on the PR that an iPad EMR would have. They’ll be interesting to watch. If I had an iPad I’d try out their EMR and give you a full recap. MangoMED EMR, want to buy me an iPad and I’ll review your EMR and post it on my site as payment?

I must admit that it’s not a bad initial move. I’m actually quite surprised how many people are searching for iPad EHR or iPad EMR or some variation on those terms. The other company that I think is likely to benefit from the iPad is the Epocrates EHR that was announced at HIMSS. Epocrates has been all about this type of form factor for a while and so they should definitely capitalize on that skill.

With all of this said, I still don’t see the iPad being a revolutionary device in the EMR world. Outside of my initial assertion that it will change EMR input methods that will then be implemented by other companies as well.

Matthew Holt’s Impressions from HIMSS

Posted on March 14, 2010 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 still working through some of the various wrap ups from HIMSS that I’ve found. Matthew Holt is always an interesting blogger. Turns out that he’s even more interesting in person. Here’s a few of his thoughts that I think are worth sharing:

Busiest booth?: I think Cisco wins. Maybe it was HealthPresence, maybe the magician—but it was always packed. What I think it means is that mainstream Internet tools are now coming into health care (with some little tweeks). But as MrHISTalk says, putting all the big guys in the A hall was a mite unfair on the C side—although I got to both a little.

Most intruiging announcement?: Epocrates will release a hand-held and web-base EMR app for the iPhone and other handhelds. Why is that interesting? Because they already have 275,000 docs actively using their tool on a handheld, most on iPhones. If their tool’s any good you have to assume they have a great marketing advantage. If this succeeds there’s no way they remain independent in 18 months.

Most interesting niche company you’ve never heard of whose CEO you randomly met at a party?: LiveProcess is a SaaS-based emergency preparedness tool. (I think CEO Nathaniel Weiss said) it has 500 hospitals paying $10K a year each with no customization.

Other interesting niche company?: CPM does CRM outbound marketing for hospitals and as nearly doubled in size during the downturn (video of them to come).

Most interesting philosophical chat?: Andy Weisenthal of Kaiser Permanente discussing how specialists are going to change entirely what they do now that everything in KP is online. One Hawaii endocrenologist is on a jihad to prevent diabetics ending up on dialysis—he’s completely reorganized how primary care docs treat their patients. It’s almost like his goal is to put himself out of a job. Andy said about Healthconnect’s finalization of the $6bn (?) implementation—”It’s not the end, it’s the start”.

It’s also worth linking to Matthew Holt’s interview with Epocrates about the Epocrates EHR. Although, I also just remembered I could embed it below: