By 2016, more than 80% of healthcare providers will put an electronic health record (EHR) in place, according to an IDC Health Insights report; right now the figure stands at less than 25%. That said, EHR vendors face a very competitive marketplace, and will have to do a better job of designing products that are more user-friendly, have broader functionality and features, and are compatible with mobile devices.

The report, "IDC MarketScape: U.S.A. Ambulatory EMR/EHR for Midsize and Large Practices 2011 Vendor Assessment," evaluates EHR systems that support practices comprised of 20 providers or more. The study also examines eight of the largest EHR vendors, each of which serve at least 15,000 providers, and relied on interviews with vendors as well as IT managers at healthcare delivery organizations.

"The magnitude of the commitment that these EHR vendors need to make to produce functionality that both supports the operations of a practice and allows them to participate in Meaningful Use projects is fairly great and I think I saw some vendors struggle under that burden while others seem to thrive," Judy Hanover, research director at IDC Health Insights, told InformationWeek Healthcare.

[For background on e-prescribing tools, see 6 E-Prescribing Vendors To Watch.]

Hanover, the lead author of the report, noted that while some providers have embraced EHRs and are more receptive to the technology, others have difficulty using interfaces that don't meet their requirements.

"The principal of a good user interface is the ability to customize the tool at the user level. It has to be a visually pleasing display that calls your attention to the important things first," Hanover said.

Hanover said that providing better functionality that positively impacts a provider's workflow will drive vendors who hope their EHR products will survive in the marketplace for years to come.

"We're talking about chart capture, we're talking about being able to manage data, document phone calls, document communications, prepare a medical history, have easy access to a patient's medical history, generate alerts to help with order entry and with e-prescribing to protect patient safety--that's what I'm talking about when I talk about functionality in the mid-to-large size practice EHR," Hanover said.

Among the eight vendors highlighted in the report, four received special mention--eClinicalWorks, Cerner, NextGen Healthcare, and Sage Healthcare Division--as companies that have designed their EHRs with enhanced functionality.

The report said eClinicalWorks' competitive advantage lies in its early commitment to the software-as-a-service (SaaS) delivery model, which customers in the mid-to-large ambulatory market find is secure and reliable enough to satisfy their needs. eClinicalWorks' EHR integrates with numerous third-party hospital systems via XML, IHE, or HL7 data transfer, and can be used on mobile devices.

The report also commended Cerner for its PowerChart EHR tool, a SaaS application that supports more than 30 medical specialties. Providers can install the PowerChart EHR along with other applications such as a practice management tool, patient portal, and reporting modules in a packaged bundle under a subscription application service provider (ASP) model. The PowerChart EHR user interface offers user customization and can function with PDAs, smartphones, and tablet PCs, the report said.

The IDC report also mentioned NextGen because its EHR includes highly customizable workflows and templates and offers particularly strong decision support and reporting capabilities.

Sage Healthcare Division's Intergy EHR offers strong clinical functionality and integrates practice management tools using a single database. Intergy allows physicians and others to use features such as charge capture, billing and reimbursement, financial reporting, and other associated practice management capabilities. The report highlighted Intergy's reporting and decision support functionality, which lets clinicians track internal performance metrics and participate in pay-for-performance programs. These decision support tools allow physicians to integrate clinical best practice metrics into their workflow.

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