EMR 2013: The Market for Electronic Medical Records

Date: April 1, 2013
Pages: 322
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Publisher: Kalorama Information
Report type: Strategic Report
Delivery: E-mail Delivery (PDF)
ID: E253A369CF5EN
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EMR 2013: The Market for Electronic Medical Records
Electronic Medical Records (EMR) represents a growing market for a large number of companies, with customer demand, heavy competition and government incentives spurring revenues.

This Kalorama Information report, EMR 2013, is a look at the market and trends impacting electronic medical record software and related services. As government policy begins to pivot on incentives in this market, as market share adjusts and new vendors play a larger role, it is an interesting time for market-watchers. How have the incentives worked? Have reluctant physicians embraced EMR? Where does hospital adoption stand? What is the competitive situation among vendors now? Is there still opportunity for new entrants? Kalorama answers these questions and brings clarity to recent market events.


As part of its coverage, the report contains:
  • 2012 Market Estimates for EMR, and Growth since 2010
  • Market Forecast to 2017
  • Market Share of Top Vendors
  • Hospital and Physician EMR Usage Statistics
  • Pricing of Select EMR Systems and ROI for Physicians
  • Overview of EMR, EHR, CPOE and other Functions
  • Impact of Incentives and Disincentives for Paper Submission
  • Breakout of Hospital EMR Market and Physician/Web EMR Market
  • Key Trends in the Industry
  • Profiles of Major Vendors and Smaller Companies to Watch
  • Mergers and Acquisitions
  • Current Vendors with CCHIT Qualification
  • Summary of Third-Party EMR User Survey Results
  • Analyst Conclusions Regarding the EMR Market
The report estimates the size of the market for the EMR hospital and EMR physician markets and reviews usage trends among hospitals and physicians. It also forecasts the market to 2017. Included in the report are statistics influencing the industry, demographics, life expectancy, and company strategies. Market share is provided for top players in the industry. Revenues are reported based on worldwide figures with a focused view on US competitors and US trends.

The information for this report was gathered using both primary and secondary research including comprehensive research of secondary sources such as company literature, databases, investment reports, and medical and business journals. Telephone interviews and email correspondence were the primary method of gathering information.

There are several primary issues and trends affecting the electronic medical records (EMR) industry. Demographics, increasing life expectancy, and technology innovation will continue to fuel growth in the future. New developments will also positively influence growth. Issues and trends explored in this study include:
  • Meaningful Use
  • Economic Stimulus Package
  • Stimulus Guarantee
  • Information Overload
  • Patient Access – Blue Button Technology
  • Vendor Switch
  • Virtualization Technology
  • Storage Area Networks
  • Cloud Computing
  • Dashboard Modules
  • Mergers and Acquisitions
  • NFL and EMRs
  • Stark Law
  • Discreet Recordable Transcription
  • Health Information Exchanges
  • Regional Extension Centers
  • Personnel Issues
  • Security Breaches/Portable Devices
  • Tablet Adoption
  • New Network for Doctors
  • National Physician Education Program
  • ICD-10 Controversy
  • Physician Position
  • Accountable Care Organizations
  • Personal Health Record
  • Doctor’s Surveys
  • Interoperability
  • Smart Card Technology
  • Wireless Technology
  • Open Source EMR Applications
  • Adoption Issues
  • Usability and Adoption
  • Quality of Care/Malpractice
  • Cost Benefit Analysis
  • Privacy Issues
  • Technology Limitations
  • E-Prescribing
  • CCHIT
  • NHIN
  • Direct PPC Offerings
  • International Markets and Trends
The electronic medical records market in the United States is competitive, with over 400 providers; however, increasing mergers and acquisitions in the industry will result in the reduction in the number of competitors. Companies remain competitive by offering high-quality solution packages to private practices and hospitals. However, there is still ample opportunity for other companies and new entrants. There is still not a single system that is complete with true interoperability. The main drawback for smaller companies is the cost to enter the market with a certified product.
CHAPTER ONE :EXECUTIVE SUMMARY

  Industry at a Glance
  Scope and Methodology
  Physician Use of EMR
    Percentage and Increase of Physician Usage of EMR
    Analysis of CDC Physician EMR Use numbers (Basic/Some Use vs. Fully Functional)
  Hospital Use of EMR
  Size and Growth of the Market
  Key Issues and Trends Affecting the Market
  Leading Market Participants
  Conclusions

CHAPTER TWO: INDUSTRY OVERVIEW

  Introduction
  The Medical Record
  The Electronic Medical Record
  Industry Terminology
  Industry Structure
    Physician EMR Acceptance by Type (Fully Functional System, Basic System, Have Used EMR, Not Using EMR)
    Overall Physician Adoption of EMRs 2006-2012
  Advantages
    Increased Access and Efficiency
    Improved Documentation
    Quality of Care
    Increased Resources
    Quality Assurance
    Eliminates Costs
  Disadvantages
    Reliability
    Accountability
    Patient Privacy
    EMR Software
    Components of an EMR
    Administrative System Components
    Laboratory System Components
    Radiology System Components
    Pharmacy System Components
    Computerized Physician Order Entry
    Clinical Documentation
    Flow of Patient Data across Various Components
    Pricing of EMRs
    US EMR Adoption Model
    EMR Adoption Rates

CHAPTER THREE: EMERGING TRENDS

  Meaningful Use
  Economic Stimulus Package
  Stimulus Guarantee
  Information Overload
  Patient Access – Blue Button Technology
  Vendor Switches Looming
  Virtualization Technology
  Storage Area Networks
  Cloud Computing
  Dashboard modules
  Mergers and Acquisitions
  NFL Using EMRs
  Stark Law
  Discreet Recordable Transcription
  Health Information Exchange Update
  Regional Extension Centers
  Personnel Issues
  Security Breaches/Portable Devices
  Tablet Adoption
  New Network for Doctors
  National Physician Education Program
  ICD-10 controversy
  Physician Position and Usability
  Accountable Care Organizations
  The Personal Health Record System
  Doctor Opinion
  Interoperability
    Dimensions of Interoperability
    Benefits
  Smart Cards Technology
  Wireless Technologies
  Open Source EMR Applications
    Benefits of Open Source EMR Applications
  Adoption Issues
  Usability And Adoption
  Quality of Care/Malpractice/Security
  Cost-Benefit Analysis
    ROI for a Typical Physician Practice
    EHR Incentive Program
    Implementation Costs and ROI for Hospitals
    Summary
  Privacy Issues
  Technology Limitations
  Social and Organizational Barriers
  E-Prescribing
  CCHIT
  NHIN
  Direct Pay-Per-Click (PPC) Offerings
  International Markets and Trends
    Europe Asia, and Other EMR Markets
    The US Market

CHAPTER FOUR: MARKET PARTICIPANTS

  Abraxas Medical Solutions
  ADP AdvancedMD
  Allmeds
  Allscripts Healthcare Solutions
    Company Overview
    Performance Review
    Key Acquisitions, Alliances, and Partnerships
    Products and Services
    Key Competitors
    Growth Strategy
  Amazing Charts
  Aprima Medical Software, Inc
    Company Overview
    Key Acquisitions, Alliances and Partnerships
    Products and Services
    Key Competitors
    Growth Strategy
  athenahealth, Inc.
  BizMatics
  Cerner Corporation
    Company Overview
    Performance Review
    Key Acquisitions, Alliances, and Partnerships
    Products and Services
    Key Competitors
    Growth Strategy
    Locations
  ChartLogic
  Computer Programs and Systems, Inc.
    Company Overview
    Performance Review
    Products and Services
    Key Competitors
    Growth Strategy
    Locations
  CSC
  CureMD
  Dr First/Rcop
  Dr First/Rcop
  eClinicalworks
    Company Overview
    Performance Review
    Figure 4-4
    Products and Services
    Key Competitors
    Growth Strategy
  Emdeon
  e-MDs
  Epic Systems, Inc.
    Company Overview
    Performance Review
    Key Acquisitions, Alliances, and Partnerships
    Products and Services
    Key Competitors
    Growth Strategy
    Locations
  GE Healthcare
    Company Overview
    Performance Review
    Key Acquisitions, Alliances, and Partnerships
    Products and Services
    Key Competitors
    Growth Strategy
    Locations
  Greenway Medical Technologies
    Company Overview
    Performance Review
    Key Acquisitions, Alliances, and Partnerships
    Products and Services
    Key Competitors
  Healthland
  Health Management Systems
  Henry Schein
  Keane (NTT Data)
  LLS Data Systems
  McKesson Corporation
    Company Overview
    Performance Review
    Key Acquisitions, Alliances, and Partnerships
    Key Competitors
    Growth Strategy
    Locations
  Medical Information Technology, Inc. (MEDITECH, Inc.)
    Company Overview
    Performance Review
    Key Acquisitions, Alliances, and Partnerships
    Products and Services
    Key Competitors
    Growth Strategy
    Locations
  Medent Community Computer Service, Inc
  MedPlus, Inc.
    Company Overview
    Performance Review
    Key Acquisitions, Alliances, and Partnerships
    Products and Services
    Key Competitors
    Locations
  Medsphere Systems
  MeridianEMR, Inc
  NextGen Healthcare Information Systems /Quality Systems Inc
    Company Overview
    Performance Review
    Key Acquisitions, Alliances and Partnerships
    Products and Services
    Key Competitors
    Growth Strategy
  Nightingale Infomatix
  Practice fusion
    Company Overview
    Performance Review
    Private
    Key Acquisitions, Alliances and Partnerships
    Products and Services
    Key Competitors
    Growth Strategy
  Quadramed Corporation
    Company Overview
    Performance Review
    Private
    Key Acquisitions, Alliances and Partnerships
    Products and Services
    Key Competitors
    Growth Strategy
  Sequel Systems, Inc
  Siemens Medical Solutions
    Company Overview
    Performance Review
    Key Acquisitions, Alliances, and Partnerships
    Products and Service
    Key Competitors
    Growth Strategy
    Locations
  SoapWare, Inc
  Streamline MD
  SuiteMed
  Vitera Healthcare Solutions
  Waiting Room Solutions
  WebPT

CHAPTER FIVE: MARKET ANALYSIS

Market Overview
Market by Segment
Competitive Analysis
Hospitals and Health System Technology Providers
Practice Management System (PMS) Acquirers
Pharmacy Services Providers
Other Entities
Hospital
Physician Office

CHAPTER SIX: CONCLUSIONS

Overview
One: Physician Practices Still High Growth Area
Two: Meaningful Use Confusion Still Plagues Industry
Three: No Clear Leader Still, Opportunity For New Players
Four: Expect More Mergers and Acquisitions
Five: Interoperability A Major Hurdle
Six: PR Effect of Breaches Downside for Industry
Seven: Usability and Data Entry an Under the Radar Issue.
Eight: Opportunity for Telecoms
Nine: “Stick” Will Be More Effective Than “Carrot” in Doctor Conversion
TEN: CPOE and Other Features Sell EMR Systems
Eleven: Hospital EMR Incentives Factor in Growing Market
Conclusion Twelve: Technology Moving Faster than EMR Technology Providers 273
Conclusion Thirteen: Data Storage Concerns- Top Focus
Conclusion Fourteen: User Satisfaction On Decline
Conclusion Fifteen: Specialists See Gains
APPENDIX I: DEFINITION OF INDUSTRY PRODUCTS

CHAPTER ONE: EXECUTIVE SUMMARY

Figure 1-1: Percentage Physician EMR Usage, 2006-2012
Figure 1-2: Analysis of CDC Physician EMR Use Numbers (Basic/Some Use vs. Fully Functional)
Figure 1-3: Hospitals at Stage 3 or higher
Figure 1-4: EMR Market Analysis 2010-2017
Figure 1-5 Revenues and Market Share of EMR Providers

CHAPTER TWO: INDUSTRY OVERVIEW

Table 2-1: Terminology Comparison Matrix
Table 2-2: Physician Adoption of EMRs 2006-2012 (Basic System and Fully Functional System)
Figure 2-1: Physician EMR Acceptance by Type (Fully Functional System, Basic System, Have Used EMR, Not Using EMR)
Figure 2-2: Overall Physician Adoption of EMRs 2006-2012
Table 2-3: Age-wise Percentage Distribution of Office-based Physicians Using EMR (US) by State 2012
Table 2-4: Percentage Distribution of Office-based Physicians Using EMR by Age and Practice Characteristics (US, 2012)
Table 2-5: Physician Usage by US Region (2012)
Figure 2-3: Comparison of Hospital Basic EHR Systems with Hospital Certified EHR Systems 2012
Table 2-6: Average Total Cost for a Three-physician Practice for EMR/PMS Installations (2011-2012)
Table 2-7: Total Cost Range for EMR/PMS Installations (2011-2012)
Table 2-8: Two-year Total Cost for EMR/PMS Installations/Subscriptions 2010-2012 Selected Products (estimates)
Table 2-: US EMR Hospital Adoption Model 2011
Table 2-1: Ownership vs Non-ownership Adoption Rates 2012-2013
Table 2-1: Doctors Office Adoption Rates 2012-2013

CHAPTER THREE: EMERGING TRENDS

Table 3-1: HITECH ACT – Subsidy Plan
Table 3-2: Mergers and Acquisitions
Table 3-3: Number of HIEs in 2011 and 2012 by Top States
Table 3-4: Cost Break-up for a Typical One-Physician Practice (5-year period)
Figure 3-1: Distribution of Cumulative Savings
Table 3-5: EHR Incentive Select Program Payments 2011
Table 3-6: Vendor Product Certifications 2006
Table 3-7: CCHIT 2007 Vendor Certifications
Table 3-8: CCHIT 2008 Vendor Certifications
Table 3-9: EMR/EHR Certifications 2010
Table 3-10: Modular System Certifications 2010
Table 3-11: System Certification in 2011
Table 3-12: System Certification in 2012:
Figure 3-2: By Sector Contribution to the US GDP (2012)
Figure 3-3: The US Healthcare Spending (2009-2020)

CHAPTER FOUR: MARKET PARTICIPANTS

Table 4-1: EMR Mergers and Acquisitions 2010-2012
Table 4-2: Selected Black Book Ratings
Figure 4-1: Allscripts Healthcare Solutions Revenues 2010-2012 ($million)
Figure 4-2: Cerner Revenues 2010-2012
Figure 4-3: CPSI Revenues 2010-2012
Figure 4-4: eClinicalWorks Revenues, 2010-2012 (e)
Figure 4-5: Epic (estimated) Revenues 2010-2012
Figure 4-6: GE Healthcare Applications Revenues 2010-2012
Figure 4-7: Greenway Revenues 2010-2012
Figure 4-8: McKesson Revenues, 2010-2012
Figure 4-9: MEDITECH Revenues 2010-2012
Figure 4-10: MedPlus Revenues 2010-2012
Figure 4-11: NextGen Revenues, 2010-2012
Figure 4-12: Siemens Medical Solutions Revenues, 2010-2012

CHAPTER FIVE: MARKET ANALYSIS

Table 5-1: EMR Market Analysis, 2010-2012
Table 5-2: Forecasted EMR Market Analysis: 2013-2017
Figure 5-1: EMR Market Analysis 2010-2017
Table 5-3: Hospital EMR Market Analysis 2010-2012
Table 5-4: Forecasted Hospital EMR Market Analysis: 2013-2017
Figure 5-2: Hospital EMR Market Analysis: 2010-2017
Table 5-5: Physician/Web-based EMR Market Analysis 2010-2012
Table 5-6: Forecasted Physician/Web-based EMR Market Analysis: 2013-2017
Figure 5-3: Physician/Web-based EMR Market Analysis: 2010-2017
Figure 5-4: EMR Market Breakdown, Physician/Web vs. Hospital 2012
Figure 5-5: EMR Market Breakdown, Physician/Web vs. Hospital 2017
Table 5-7 Notable Companies by Healthcare Specialty Area
Table 5-8: Revenues and Market Share of EMR Providers 2012
Figure 5-6: Revenues and Market Share of EMR Providers 2012
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