The report classifies the ambulatory market segment as the solo/partner practice of one to two physicians, the small to medium practice of three to 10 physicians, and large practices of more than 11 physicians. The report also includes the non-physician clinician who acts as the primary care provider in certain ambulatory settings and holds an individual EHR license.
The ambulatory market is described as volatile and highly fragmented and is served by more than 300 vendors supplying a variety of basic to advanced EHRs to approximately 261,000 physicians, or 44% of physicians in an ambulatory practice for 2009.
Fabozzi, who interviewed 20 EHR vendors, health IT managers, and other stakeholders for the report, also observed that ownership of physician practices is rapidly changing and is a huge factor that is impacting the ambulatory market.
She said many physician practices are facing financial difficulties and the result is physicians are increasingly selling their practices to hospitals, entering into joint ventures with hospitals, or joining larger group practices.
"This whole reshuffling and realignment among ambulatory physicians is going to have a huge impact on the vendor market because many of these 300 vendors that we talk about are a lot of mom and pop EHR companies that have under a million dollars in sales annually," Fabozzi said.
She added that if physician practices are going to be a part of a big hospital network or a large medical practice group they are going to buy EHR products from larger vendors.
Fabozzi also noted that vendors and providers should keep the patient in mind as they adopt EHRs because the technology has the potential to be a marketing tool in the future. She said patients may get to the point where they'll say "'if my doctor doesn't have an EHR what else is he behind on?' That's a mindset that's going to be out there."