12 EHR Vendors That Stand Out
With the federal incentive program for electronic health records well underway, hundreds of companies are selling EHRs. <em>InformationWeek Healthcare</em> has cut through the noise and identified a dozen vendors worth watching.
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Products: For physician offices: Allscripts Enterprise EHR, Allscripts Professional EHR, Allscripts MyWay. For hospitals: Sunrise Clinical Manager. For hospital-employed physician practices: Sunrise Ambulatory Care.
Why You Should Watch: Allscripts claims to have "the nation's #1 most utilized EHR solutions" in terms of users, with its products installed in 50,000 physician practices, 1,500 hospitals, and 10,000 post-acute care facilities--though those statistics include some who only have the company's free e-prescribing module.
Allscripts is one of the many companies selling EHRs and seeking a piece of the federal money that is available to encourage medical practices to adopt electronic health records. There are more than 1,300 products certified to help hospitals and doctors meet the "Meaningful Use" standards to qualify for their share of $27 billion in subsidies. While it is hard for any single company to stand out, Allscripts offers one of the more intriguing story lines heading into 2012.
Allscripts has a long, mostly successful history with ambulatory systems, though the company suddenly became a major player in the hospital arena thanks to its August 2010 merger with acute care and enterprise systems vendor Eclipsys. The Chicago-based company now has the product line to compete with the likes of Cerner, Epic Systems, GE Healthcare, McKesson, and Meditech, at least since Meditech completed its acquisition of LSS Data Systems in February 2011.
Around the time the merger was announced, InformationWeek Healthcare wondered whether the cost of integrating Allscripts and Eclipsys will be worth the synergies the combination will ultimately bring. The jury remains out on that question, as well as on the more telling issue of whether the two entities can successfully integrate their products and platforms. It took GE more than five years to develop a common platform for all its inpatient and outpatient clinical systems after a series of acquisitions last decade, and Allscripts itself built its ambulatory side by taking over the likes of A4 Health Systems and parts of Misys Healthcare Systems prior to the Eclipsys deal.
Products: AthenaClinicals ambulatory EHR, AthenaCollector medical billing and practice management service, AthenaCoordinator care coordination service.
Why You Should Watch: Plenty of EHR vendors have "guaranteed" that their customers will meet federal Meaningful Use requirements if they use the products as specified, but Athenahealth is about to break new ground. In November, the Watertown, Mass.-based company started talking about a malpractice guarantee of sorts.
In 2012, Athenahealth will have a plan to pay the malpractice insurance premiums of certain customers that subscribe to a trio of Athenahealth products: AthenaClinicals EHR, AthenaCollector medical billing and practice management, and AthenaCoordinator, a care coordination service formerly known as Proxsys.
Product: DrChrono EHR.
Why You Should Watch: This is a native iPad EHR, perhaps the first of its kind, and one that got a good review from InformationWeek Healthcare earlier this year. Among its standout features is the ability to take a picture or video with the tablet's camera in order to document symptoms. After all, a picture tells 1,000 words and a video might tell 10,000 words. The EHR takes advantage of other iPad capabilities with such attributes as built-in speech-to-text conversion, high-resolution video playback, and the ability to "draw" right on medical images.
While innovative, this company also seems prone to hyperbole and misstatements. In launching OnPatient, a patient check-in app for the iPad, DrChrono.com called the software "a groundbreaking app that digitizes the medical practice waiting room" by eliminating the hated clipboard patients are so often asked to fill out. The thing is, ePatientHistory.com, NoMoreClipboard.com, and Primetime Medical Software's Instant Medical History have offered something similar for years, and their software can run just fine on tablets.
DrChrono also has posted a demonstration video on which a narrator wrongly says the EHR app can help physicians qualify for "tax breaks" associated with Meaningful Use. In fact, the Meaningful Use program pays Medicare and Medicaid bonuses, and the money is considered taxable income in most cases.
Product: For small physician practices: Epocrates EHR.
Why You Should Watch: Epocrates has long been the unquestioned leader in (mostly mobile) electronic drug reference tools, with a user base that now stands above 1.4 million healthcare professionals worldwide, including 340,000 physicians in the U.S. alone. So the healthcare world was excited when the San Mateo, Calif., company announced at HIMSS10 that it was developing an EHR for both the Web and iPhone, aimed at small physician practices.
The EHR was supposed to come out in the fourth quarter of 2010, but a "core" primary care version for practices with 10 or fewer doctors didn't hit the market until July 2011. The company hasn't given much detail on how well this new product is doing, but if the EHR is anywhere near as intuitive as the free Epocrates Essentials reference guide, it could prove highly popular.
Also worth watching from this vendor: Epocrates recently added Eric Tseng, head of mobile products at Facebook, to its board of directors. Could social media be part of the company's strategy?
Products: For physician offices: 4medica Ambulatory Cloud iEHR. For hospitals: 4medica Inpatient Cloud iEHR.
Why You Should Watch: With a background in connectivity, 4medica's strength is in health information exchange. In this spirit, the Culver City, Calif.-based vendor has tightly integrated HIE with its EHR, a product fittingly called iEHR, for integrated electronic health record. The software-as-a-service iEHR, launched at HIMSS10, offers a centralized view of patient data from multiple facilities and care settings. It is available as a complete inpatient or outpatient EHR or as modular add-on that provides HIE functionality to other vendors' systems, a key piece of Meaningful Use.
Products: For physicians: MacPractice MD. For dentists: MacPractice DDS. For chiropractors: MacPractice DC. For optometrists and ophthalmologists: MacPractice 20/20.
Why You Should Watch: Though Apple has been chipping away somewhat, Windows still dominates the world of office computers. There have always been some industries that prefer the Macintosh platform--think graphic design--but healthcare is not one of them. Yet, Lincoln, Neb.-based MacPractice has bucked the trend, preferring to focus its clinical application development on Apple's desktop operating system. The company may have been the first Mac EHR to earn certification under the federal government's Meaningful Use EHR incentive program.
After branching out to another Apple product, the iPhone, to introduce a mobile component, MacPractice a year ago released an iPad interface for remote physician access. Companion iPad apps emulate clipboards when viewed in portrait mode, giving doctors a familiar view of their schedules and patients a way to enter demographic and medical history data that gets sent straight to the EHR -- without the need for transcription by office staff -- and to sign HIPAA consent and medical release forms.
Products: For small physician practices: NaviNet EMR.
Why You Should Watch: NaviNet is new to the EHR game, having introduced its first combined EHR and practice management system just a year ago. But the company, formerly known as NaviMedix, is well-known among physician practices, hospitals, payers, and other healthcare entities for its extensive healthcare communications network that provides transaction services to more than 800,000 users. That network helps form the basis for care coordination services and provides a platform for a patient portal, both of which will be integral to anyone looking to create an accountable care organization.
A December 2010 acquisition of e-prescribing and mobile clinical messaging vendor Prematics added a mobile dimension and an e-prescribing piece, since renamed NaviNet Prescribe, and provides an integration challenge for NaviNet.
Products: For pediatric practices: PhysicianXpress.
Why You Should Watch: "Just as children are not small adults, a pediatric EHR is not just an adaptation of an adult EHR," advises the American Academy of Pediatrics. Pediatric EHRs must be able to calculate medication dosing based on weight, track patient growth, and keep immunization records, among other things. There are plenty of speciality-specific EHR modules out there, but Doctor Office Management, based in Collegeville, Pa., says its PhysicianXpress was the first pediatric-only system to earn certification as a complete EHR for Meaningful Use Stage 1.
Pediatrics is different from other specialties in another way: Meaningful Use provides Medicare and/or Medicaid bonus payments for EHR adoption, and pediatricians by definition don't see Medicare patients. So the American Recovery and Reinvestment Act, which authorized the incentive program, lowered the threshold for children's doctors to qualify as "eligible providers" on the Medicaid side. While most practitioners must have 30% of their patient populations on Medicaid to be eligible for a maximum of $63,750 in extra reimbursements, pediatricians have a standard of 20%.
That still leaves a lot of physicians on the outside, so it will be interesting to see how many pediatricians will achieve Meaningful Use -- or whether they will even adopt EHRs in wide numbers.
Products: For emergency departments: ED PulseCheck. For critical care: Picis Critical Care Manager. For surgical units: various departmental systems.
Why You Should Watch: Healthcare reform is fueling demand for advanced analytics, and analytics requires data. Nobody in healthcare has more data than the insurance industry, so payers are sitting on potential gold mines. The passage of the Patient Protection and Affordable Care Act in 2010 also set off a march toward data-driven accountable care, and payers want to leverage the massive data stores they possess, which probably explains why some of the largest insurers have bought their way into health information exchanges.
A week after acquiring HIE vendor Axolotl in August 2010, the Ingenix analytics subsidiary of UnitedHealth Group went a bit deeper into health IT, buying Picis, a Wakefield, Mass.-based maker of information systems for high-acuity hospital departments. (Ingenix has since changed its name to OptumInsight.) That means that one of the two largest health insurers in the U.S. -- United and WellPoint tend to alternate in the top spot -- now owns an EHR vendor. Could this be the start of a trend?
Product: Shareable Ink Ambulatory Record
Why You Should Watch: There are now more than 1,300 EHR products certified to meet Stage 1 Meaningful Use standards, but there appears to be only one that lets doctors stick with pen and paper for documentation. That distinction belongs to Nashville, Tenn.-based startup Shareable Ink. It's not a complete EHR, but rather a module that incorporates a digital pen to capture handwriting from plain paper--not the pricey electrostatic stuff--and, in the cloud, convert handwriting to discrete, machine-readable data to populate physician encounter forms. Users also can convert data from iPads or from scanned documents.
Shareable Ink initially is certified as being capable of meeting 11 Meaningful Use measures. Company founder Stephen Hau, who also started mobile healthcare software company PatientKeeper in the 1990s, promises additional ambulatory functionality as well as modular inpatient certification in the future.
Products: For hospitals: Soarian EHR. For physician practices: Soarian EHR EP.
Why You Should Watch: Siemens Healthcare made big news this year by hiring former Partners HealthCare System CIO John Glaser to run its global health IT business. It will be interesting to see how Glaser will bring his experience in many areas of the industry to bear on a software vendor. In addition to his Partners leadership position, Glaser, who was named an InformationWeek Innovator and Influencer in 2007, was founding chairman of the College of Healthcare Information Management Executives and helped create the New England Health EDI Network, an administrative transactions consortium. He also spent a year as a special advisor to David Blumenthal, MD when Blumenthal headed the Office of the National Coordinator for Health Information Technology.
Glaser may have some tough decisions to make in the next couple of years. Data from HIMSS Analytics, presented recently by former HIMSS Analytics chief Dave Garets, show that Siemens lost 57 hospitals from its U.S. customer base between 2005 and 2011, as facilities upgraded legacy EHRs not with Siemens products but with technology from the likes of Epic Systems, Cerner, Meditech, McKesson, and others. Does German industrial conglomerate Siemens AG stay in the health IT business, or might it be time to sell this division and refocus healthcare efforts on the company's historical strength, diagnostic medical equipment?
Products: For specialty practices: SRS EHR, SRS Cloud EHR.
Why You Should Watch: For years, SRSsoft bucked the trend in EHRs, ignoring primary care in favor of serving "high-performance" physicians, mostly specialists who handle a lot of high-dollar cases and can't afford the typical revenue slowdown when implementing a clinical system. After passage of the American Recovery and Reinvestment Act in 2009, SRSsoft CEO Evan Steele blasted the Meaningful Use incentive program for being skewed toward primary care and for removing any incentive for vendors to innovate. Steele regularly asserted that plenty of his Montvale, N.J.-based company's customers would prefer not to go after the Medicare and Medicaid bonuses for Meaningful Use because the extra money wasn't worth the productivity hit from adopting a certified EHR.
But early this year, Steele relented. SRSsoft stopped calling its product a "hybrid" EHR in which physicians wouldn't necessarily have to enter their own documentation and, at the urging of doctors who did want the federal incentive money, actually got the EHR certified. Though the SRS product is one of hundreds certified to 2011 Meaningful Use standards, Steele promises that his company can innovate within the confines of the rules. And SRSsoft continues to cater to underserved specialty practices.
Products: For specialty practices: SRS EHR, SRS Cloud EHR.
Why You Should Watch: For years, SRSsoft bucked the trend in EHRs, ignoring primary care in favor of serving "high-performance" physicians, mostly specialists who handle a lot of high-dollar cases and can't afford the typical revenue slowdown when implementing a clinical system. After passage of the American Recovery and Reinvestment Act in 2009, SRSsoft CEO Evan Steele blasted the Meaningful Use incentive program for being skewed toward primary care and for removing any incentive for vendors to innovate. Steele regularly asserted that plenty of his Montvale, N.J.-based company's customers would prefer not to go after the Medicare and Medicaid bonuses for Meaningful Use because the extra money wasn't worth the productivity hit from adopting a certified EHR.
But early this year, Steele relented. SRSsoft stopped calling its product a "hybrid" EHR in which physicians wouldn't necessarily have to enter their own documentation and, at the urging of doctors who did want the federal incentive money, actually got the EHR certified. Though the SRS product is one of hundreds certified to 2011 Meaningful Use standards, Steele promises that his company can innovate within the confines of the rules. And SRSsoft continues to cater to underserved specialty practices.
Products: For physician offices: Allscripts Enterprise EHR, Allscripts Professional EHR, Allscripts MyWay. For hospitals: Sunrise Clinical Manager. For hospital-employed physician practices: Sunrise Ambulatory Care.
Why You Should Watch: Allscripts claims to have "the nation's #1 most utilized EHR solutions" in terms of users, with its products installed in 50,000 physician practices, 1,500 hospitals, and 10,000 post-acute care facilities--though those statistics include some who only have the company's free e-prescribing module.
Allscripts is one of the many companies selling EHRs and seeking a piece of the federal money that is available to encourage medical practices to adopt electronic health records. There are more than 1,300 products certified to help hospitals and doctors meet the "Meaningful Use" standards to qualify for their share of $27 billion in subsidies. While it is hard for any single company to stand out, Allscripts offers one of the more intriguing story lines heading into 2012.
Allscripts has a long, mostly successful history with ambulatory systems, though the company suddenly became a major player in the hospital arena thanks to its August 2010 merger with acute care and enterprise systems vendor Eclipsys. The Chicago-based company now has the product line to compete with the likes of Cerner, Epic Systems, GE Healthcare, McKesson, and Meditech, at least since Meditech completed its acquisition of LSS Data Systems in February 2011.
Around the time the merger was announced, InformationWeek Healthcare wondered whether the cost of integrating Allscripts and Eclipsys will be worth the synergies the combination will ultimately bring. The jury remains out on that question, as well as on the more telling issue of whether the two entities can successfully integrate their products and platforms. It took GE more than five years to develop a common platform for all its inpatient and outpatient clinical systems after a series of acquisitions last decade, and Allscripts itself built its ambulatory side by taking over the likes of A4 Health Systems and parts of Misys Healthcare Systems prior to the Eclipsys deal.
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