EHR Market

EHR Market To Reach $6.5 Billion By 2012

pejman — Sat, 22 Oct 2011 12:39:23 +0000

The total market revenue for electronic health records (EHRs) is expected to hit $6.5 billion in 2012, which is more than a sixfold increase from the $973.2 million posted in 2009, a study from Frost & Sullivan predicts. The rise in EHR revenues is primarily due to new licensing and upgrades as hospitals get their EHR systems ready to meet Meaningful Use requirements.

IT staff shortages is affecting EHR adoption

pejman — Mon, 11 Oct 2010 22:58:46 +0000

According to a survey conducted by CHIME in early September IT staffing shortages is putting projects at risk and negatively impact healthcare organizations’ EHR implementation. The survey included responses from 182 member CIOs of CHIME.

According to the survey, more than 70% of CIOs said their organizations had inadequate IT staff to implement clinical application software, while 51% said that such staffing issues may affect their ability to implement electronic health record systems and qualify for "meaningful use" incentive payments through Medicare and Medicaid.

The survey also found that 76% of respondents have concerns about retaining existing health IT staff.

The most glaring need for healthcare organizations is for trained personnel who can implement clinical records software. More than 70 percent of respondents reported that their organizations lack staff to implement clinical applications.

To meet immediate needs, CIOs reported that they were planning to use various strategies, and the use of third-party consultants was the most frequently mentioned strategy, listed by more than a third of respondents.

EHR Products Certified For Meaningful Use

pejman — Sat, 02 Oct 2010 17:47:22 +0000

CCHIT just published a list of EHR products that are certified and meet the ONC-ATCB 2011/2012 requirements of Meaningful Use.

The certifications include 19 Complete EHRs, which meet all of the 2011/2012 criteria for either eligible provider (e.g. doctor practices and other clinicians in ambulatory settings) or hospital technology, and 14 EHR Modules, which meet one or more – but not all – of the criteria.

The complete EHR products (as of October 1, 2010) are:

ABEL Medical Software Inc. ABELMed EHR – EMR / PM 11 (Eligible Provider)
Allscripts Allscripts Professional EHR 9.2 (Eligible Provider)
Aprima Medical Software Inc. Aprima 2011 (Eligible Provider)
Athenahealth Inc. AthenaClinicals 10.10 (Eligible Provider)
CureMD Corp. CureMD EHR 10 (Eligible Provider)
The DocPatientNetwork.com Doctations 2.0 (Eligible Provider)
Epic Systems Corporation EpicCare Inpatient – Core EMR Spring 2008 (Hospital)
Epic Systems Corporation EpicCare Ambulatory – Core EMR Spring 2008 (Eligible Provider)
GE Healthcare Centricity Advance 10.1 (Eligible Provider)
GloStream, Inc. GloEMR 6.0 (Eligible Provider)
Intuitive Medical Software UroChartEHR 4.0 (Eligible Provider)
MCS – Medical Communication Systems, Inc. iPatientCare 10.8 (Eligible Provider)
Medical Informatics Engineering WebChart EHR 5.1 (Eligible Provider)
Meditab Software Inc. IMS v. 14.0 (Eligible Provider)
NeoDeck Software’s NeoMed EHR 3.0 (Eligible Provider)
NextGen Healthcare NextGen Ambulatory EHR 5.6 (Eligible Provider)
Nortec Software Inc. Nortec EHR 7.0 (Eligible Provider)
Pulse Systems 2011 Pulse Complete EHR 2011 (Eligible Provider)
SuccessEHS SuccessEHS 6.0 (Eligible Provider)

And here are the modules/products which meet one or more – but not all – of the criteria.:

Allscripts Allscripts ED 6.3 Service Release 4 (Hospital)
Allscripts Allscripts PeakPractice 5.5 (Eligible Provider)
EClinicalWorks LLC eClinicalWorks 8.0.48 (Eligible Provider)
Health Care Systems, Inc. HCS eMR 4.0 (Hospital)
NexTech Systems Inc. NexTech Practice 2011 9.7 (Eligible Provider)
nextEMR, LLC nextEMR, LLC 1.5.0.0 (Eligible Provider)
PeriGen PeriBirth 4.3.50 (Hospital)
Prognosis Health Information Systems ChartAccess 4 (Hospital)
Sammy Systems SammyEHR 1.1.248 (Eligible Provider)
T-System Technologies, Ltd. T SystemEV 2.7 (Hospital)
Universal EMR Solutions Physician’s Solution 5.0 (Eligible Provider)
Vision Infonet Inc. MDCare EMR 4.2 (Eligible Provider)
WellCentive WellCentive Registry Version 2.0 (Eligible Provider)
Wellsoft Corp. Wellsoft EDIS v11 (Hospital)

Source: http://www.cchit.org/media/news/2010/10/commission-announces-first-onc-atcb-20112012-certifications

Is CCHIT Dead?

pejman — Sun, 20 Jun 2010 18:45:21 +0000

In early March 2010 the Office of the National Coordinator of Health IT (ONC) and the Center for Medicare & Medicaid Services (CMS) announced that they would name more than one organization to certify EHR software. This implies that CCHIT might become less relevant in EHR market.

Chris Thorman, who blogs about electronic health records, has captured the potential impacts in his article and is running a poll on that topic.

ePrescription

pejman — Fri, 19 Mar 2010 04:32:45 +0000

ePrescription is an important element in improving the quality of patient care and as such it is also part of requirements for CCHIT qualifications and MIPPA incentive payment.

The data interchange standards for ePrescriptions are maintained by NCPDP (National Council for Prescription Drug Programs) for the pharmacy services sector of the healthcare industry.

There are few companies offering transmission networks for electronic connection between Physicians and Pharmacies nationwide. They mostly use and enable communication between HL7 and NCPDP SCRIPT Standards.

Among the leaders are SureScripts, RxHub and ProxyMed, with SureScripts currently dominating the market with about 90% market share.

Following is the list of Companies providing solutions or gateway for Prescription transmissions:

Healthcare Costs Around the World

pejman — Tue, 02 Mar 2010 05:46:10 +0000

Good information on Healthcare Costs Around the World from VisualEconomics

Open Source and Free EMR Systems

pejman — Sat, 12 Dec 2009 22:50:11 +0000

The commercial EMR systems cost physicians somewhere between $20 to $50 thousands, depending on vendor and different revenue models (subscription, lease, upfront, …)

That motivates some Physicians to look into alternative, free or open sources, options.

(Intentionally separating free vs. open source, as those are necessarily not the same)

Recently I researched available open source options that includes more than 40 products!!!

Among those I found the following three to be the best:

OpenEMR, ClearHealth and OpenVista.

New Jersey’s Hoboken University Medical Center , Blue Mountain Hospital in Utah and Kern Medical Center of Bakersfield, Calif. are among organizations that have recently decided to go with Open Source EMR Systems.

Of course one pending question on Open Source EHR solutions is about CCHIT certifications.

On June 18, the Certification Commission unveiled new options for CCHIT certifications to support self-developed and open source community in an effort to better position itself as the certification agency required under the HITECH provisions of the American Recovery and Reinvestment Act (ARRA).

At the same time some organizations and consulting firms are taking matters in their own hands, by applying for CCHIT certificate for a "modified" or "commercialized" branch of Open Source code. WorldVista is a good example.

Product Review: eClinicalWorks

pejman — Thu, 03 Dec 2009 02:32:40 +0000

As part of my continuous EHR product review I recently evaluated AllScript, NextGen and eClinicalWorks.

This post is covering eClinicalWorks. (See my previous post on NextGen)

To summarize among the three, I like eClinical the best. It is technically solid, and

provides a fully integrated platform, including PM, EMR and Billing.

However I think the User Interfaces are not as intuitive as they could be. I hope

the product manager will put some effort in optimizing the user experience.

That would motivate eClinical users in utilizing all the power under the hood.

The system provides customizable templates per spatiality and provides a good

Clinical Decision Support System (CDSS).

The company started with smaller physician groups before targeting hospitals

and larger clinics. As such the product design is well suited for small offices.

In larger environments the community module allows patient records to

be shared between physicians (e.g. referrals).

My favorite feature is eCliniForms, which allows to scan in or create office forms

in the system (such as consent or hospital admission forms).

eCliniForms can be used to input data and integrate directly with patients’ chart.

Following you can see a demo of eCliniForms:

In terms of pricing eClinicalWorks has 3 offerings:

- Traditional client server (you purchase the software license outright and data lives on a server in your office). The pricing is around $10,000 for the first physician, $5,000 for each subsequent provider. An annual support & maintenance license fee of 18% could apply, translating to about $200/month.

- Hosted model or ASP (monthly fee, data lives on a server at the vendor’s facility). The pricing is around $500/month for the first provider, with discounts for subsequent providers.

- Lease or Subscription (monthly fee, data lives on your server in your office). $400/month for the first provider. It goes down around 10% per additional doc on the contract.

The above fees are for the combined EHR-PM product. More details can be found on their website:

http://www.eclinicalworks.com/cost.php

They charge an additional $250/month for billing and scheduling and $25/month for e-prescribing. Training is between $500 to $750 per day plus travel expenses at $250/day.

Here is a Flash Demo of the product:

http://www.eclinicalworks.com/indexFLASH_popup.php

They recently partnered with Sam Club to sell eClinical EMR, in a packaged deal along with Dell computers to cover both software and hardware. More info here: http://www.samsclub.com/health/

eClinicalWorks is opening an office in Pleasanton California before end of the year.

Product Review: NextGen

pejman — Wed, 25 Nov 2009 18:17:08 +0000

Just recently I evaluated 3 EHR systems (AllScript, NextGen and eClinical) and will gradually dump my notes into individual reports for each one.

NextGen (by Quality Systems (NASDAQ: QSII)) provides an all-in-one solution, including PM, EMR and Billing.

Among the three, NextGen has the best user interface. It is intuitive and easy to use.

The visual aid helps physicians to point and click their way through an entire exam.

NextGen EMR is completely integrated system and supports different specialties. It has a large selection of pre-built templates to help automate the workflow.

Having said that, the product philosophy is that you will like the pre-built templates as they are. Adjustments are possible but that is relatively hard and would require engineering support.

For example on HPI screen symptoms are listed as check-boxes in comparison to decision-tree-style selection lists that are used by many other vendors.

This is presented by NextGen sales as a competitive differentiator that removes the restrictions of sequential questioning needed in decision-tree pick lists.

NextGen EMR integrates with NextMD, which is the company’s patient-provider portal that facilitates effective electronic interactions between the patient and the practice.

The NextGen product is written in Visual Basic and Visual C++ and uses MS SQL database and Active Domain. This implies an open architecture for custom developed extensions, such as integration adaptors and complex reports. NextGen has its own integrated word processing for creating/customizing letters and communication materials. The company is currently working on optional interface with Microsoft office.

Product Review: PracticeFusion

pejman — Sun, 08 Nov 2009 21:17:31 +0000

I have been recently exposed to PracticeFusion, a three years old player in EMR market. They offer a fully hosted (SaaS) PM and EMR system at no charge! (more about it below)

The product is very easy to setup and use. The user interface is self-explanatory and intuitive. Each top category of functionality has a short video tutorial that helps getting started.

Adding Patients, scheduling visits and dealing with charts is very simple.

The only thing I didn’t like must was document handling, which is not as easy to work with, specially if you are dealing with lots of scanned materials.

They have partnered with Digital Island to offer conversion of paper charts into electronic charts.

As for billing, they offer own integrated billing system that charges about 6% of receipts that are received and deposited. Alternatively they offer secure email system for working with existing internal and external billers. I am not sure how well this will work!

The Web interface takes advantage of Flex 3, Adobe’s rich Internet application interface and the system backend is cloud-based and ensure scalability.

However as many other SaaS solutions there are few points to keep in mind:

Switching to another solution provider is going to be a nightmare. There is no easy way to get the data (which you own!) and move it to other hosted solution.

So basically you are stuck with one SaaS provider as soon as you start.

Furthermore there is a question on what happens when Internet goes down; how would you access schedules and patients’ records during that time?

And finally, there is always challenge of integration in SaaS environment, in this case,

for example, integration with medical devices and instruments.

In terms of functionality E-Prescription is the most important missing piece, which seems to be a priority items on their roadmap.

As for business model PracticeFusion plans to make money on free software by connecting advertisers with doctors while they are working on the system. Apparently they have already signed up advertisers such as Johnson & Johnson, AstraZeneca LP and Ortho-McNeil-Janssen Pharmaceuticals, Inc.

Given how difficult it is for a drug salesperson to get a doctor’s attention, the CEO, Ryan Howard, is convinced this business model will work.

For Physicians who don’t like to see ADs on their screen, an AD-free version of the solution is available at $100/month/provider.

For more info here is an interview with Ryan:

http://www.viddler.com/explore/scobleizer/videos/6/

In August 2009 Practice Fusion received an investment from SaleForce.com

The investment is reportedly between $5 to $10 million.

As a side note, to me this was an excellent strategic move by SalesForce, which is heavily focused in promoting its cloud platform.