Top EHRs For Small Practices

9 Health IT Tools Patients Should Understand

IDC Health Insights has released a study that identifies 11 EHR products that analysts say offer the best features and long-term strategy to help small practices meet Meaningful Use requirements as well as prepare for healthcare reform.

The IDC MarketScape: U.S. Ambulatory EMR/EHR for Small Practices 2012 Vendor Assessment report cites that there are more than 350 vendors offering technology certified by the Office of the National Coordinator for Health IT as meeting minimum Meaningful Use criteria. However, according to IDC, the vast majority don't meet many of the 25 measures its analysts used to evaluate which EHRs are best suited for small practices.

Based on conversations with about 30 practices employing 20 or fewer physicians as well as EHR vendors and their customers, IDC gauged customer requirements and ranked EHR products based on their current capabilities and future strategies.

Analysts looked at whether an EHR can be configured to support workflows and offer clinical documentation to assess and maintain productivity, among other criteria. They also checked whether the EHR has mobility options, how well it's supported, and whether it has complementary offerings such as practice management systems and a health information exchange.

Analysts also looked at the vendors themselves, evaluating whether the companies are profitable, able to deliver new functionality to keep up with customer expectations, and able to retain the necessary talent to create market value. In addition, they assessed whether the vendors were being proactive in delivering Meaningful Use capabilities to customers.

[ The road to EHR implementation can be bumpy. For advice on how to help smooth the ride, see How To Ease EHR Frustration. ]

Vendor's future strategic plans were also evaluated, as analysts examined whether EHRs will be relevant and attractive to customers over the next four years. They also assessed the vendors on price competitiveness and looked at whether they have well-supported integration options and a portfolio of complementary tools offered by the company or its partners. Strategies for ICD-10 implementation and health information exchange were also evaluated.

The analysts found the following 11 EHRs, from 9 vendors, to be the best tools to meet their requirements:

-- ADP AdvancedMD

-- Allscripts Healthcare Solutions Professional EHR and MyWay EHR

-- athenahealth

-- athenaClinicals

-- eClinicalWorks

-- Greenway Medical Technologies PrimeSUITE

-- Lumeris's Lumeris EHR

-- MEDITECH LSS MPM

-- OptumInsight Optum Physician EMR (formerly CareTracker)

-- Optum EMR Lite (formerly Elysium)

-- Practice Fusion Practice Fusion EHR

These nine vendors and the 11 EHR products they offer have increased their client base, said IDC research director Judy Hanover in an interview with InformationWeek, citing EClinicalWorks, athenaClinicals, PrimeSUITE, Advanced MD, Lumeris EHR, and Practice Fusion EHR as having grown the fastest during the past year. While Allscripts Professional EHR is a giant in the small practice market, according to Hanover, it has lagged behind the group and market share has slowed in recent months.

"Allscripts Professional EHR still has a significant market share, but they've seen a bit of stalling in new business, and I'm not seeing growth as rapid as some of the other products in this group," Hanover said. "Obviously there's been a bit of uncertainty in Allscripts business model."

During the next four years, small practices will prove to be a very lucrative area of business. According to Hanover, EHR adoption rates among small practices are currently between 25% to 30%, and she expects them to jump to 80% by 2016.

While many small practices will be purchasing an EHR to qualify for Meaningful Use incentive payments (up to $44,000 from the Medicare program and up to $63,750 under the Medicaid program), the report urges these practices to plan for the longer term and consider how digital patient information will help them prepare for a modern, competitive healthcare environment.

That new healthcare environment will require that EHRs support new models of care, such as Accountable Care Organizations, health information exchanges, and improvements in the coordination of care through the use of mobile devices.

Given this new reality, IDC Health Insights urges small practices to buy EHRs that can be customized to support clinical workflows while maintaining productivity. It also recommends EHRs that possess strong decision support capabilities; interoperability; mobile connectivity; and clinical, financial and operational analytics. "Purchasing an EHR is an opportunity to set the stage for small practices to operate in a new healthcare reform environment that has an accountable care delivery model," Hanover said.

Small practices with limited budgets and few IT resources should focus on the price of the product, the financial stability of the vendor, and the licensing models being offered, advises Hanover. "There is very little margin for errors or workflow problems," she said. "It's important for them to really look for a product that meets their needs and a vendor who is going to support them going forward."

The report also listed barriers to EHR adoption. Not surprisingly, costs associated with licensing applications, implementation, and maintenance are the primary barriers. Small practices implementing EHRs face additional challenges, including workflow disruptions, the need to change staff behavior, and the negative impact EHR adoption can have on revenue.

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