Of the 35 vendors HIEs named as product and services providers, no vendor has a majority foothold yet, according to a new report released by the eHealth Initiative, which recently surveyed 196 of the 255 HIEs currently operating in the United States. The HIEs surveyed ranged from state-run initiatives to community-based organizations, including for-profit and non-profit efforts.
Leading the pack is Axolotl, which provides products and services to 22 of the 196 (about 11%) surveyed HIEs. Axolotl was recently renamed OptumInsight, and is part of UnitedHealth Group's health IT services business. The next most prevalent HIE vendor is Medicity, being used in 14 initiatives, followed by a tie between Cerner and Mirth, with each providing products and services to nine HIEs.
Also among the nearly three dozen vendors providing products and services to small handfuls of HIEs are GE Healthcare, IBM, ICA, Microsoft, and eClinicalWorks. Homegrown products are used by at least eight HIEs surveyed. More than a dozen vendors are serving just one or two HIEs so far.
Nearly a quarter of the HIE respondents said they're planning to reevaluate vendors within the next 12 months, so there's plenty of opportunity for a shakeout and for other dominant players to emerge. Reasons given by HIEs planning to reevaluate their vendors include poor customer service, configuration, cost, and implementation issues.
The eHI study found that 66% of HIE initiatives consider four to 10 vendors when selecting their primary HIE vendor. Also, most HIEs reported outsourcing the technical work and some or all of the project management responsibilities to their HIE vendor.
When asked to describe the architecture that the HIE initiative is using, 85 HIEs responded. More than half (or 44) of these HIEs reported using a hybrid architecture model, while federated models are being used by 23 HIEs, and centralized models by 18.
Finally, when it comes to cost, the price HIEs pay for IT products and services also varies widely. Approximately a quarter of all respondents (55) spent under $100,000 on their vendors in the last fiscal year, while 14 initiatives indicated they spent more than $1 million on their vendors in the last fiscal year.
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