Description
The EMR Industry Standard
Kalorama has continuously examined the fast-changing market for electronic medical records (EMR) for nearly a decade, and each year we produce a comprehensive report of our findings. Our report has become the industry standard, oft-quoted by companies and industry associations as the source for market sizing and market share in healthcare.
This Kalorama Information report, EMR 2014, is a complete global analysis of the EMR market. The report includes the important trends that will affect companies offering software, hardware and services related to EMR.
Expert Global Market Sizing and Market Share
This market analysis is global, though trend analysis focuses on the US as the largest healthcare market and the most incentivized for EMR conversion. As government policy approaches the turning-point on incentives in this market, as a large shift in vendor market share occurs and new vendors play a larger role, it is an interesting time for market-watchers. How much has the market grown? How have the incentives worked? Where is physician usage now? How about hospital adoption? Where do the top vendors stand now? Kalorama answers these questions and brings sharp analysis to recent trends.
As part of its coverage, the report contains:
- 2013 Global Market Estimates for EMR, and Growth since 2011
- United States, European and Asia Pacific EMR Market Estimates
- Market Forecast to 2018
- 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
- Breakout of Hospital EMR Market and Physician/Web EMR Market
- Profiles of Major Vendors and Smaller Companies to Watch
- 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 2018. 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.
Close Examination of Industry and Regulatory Trends
There are several primary issues and trends affecting the electronic medical records (EMR) industry. New marketing strategy, new regulations, increased usage will continue to fuel growth in the future. But there are also challenges from vendor switches, usability and unexpected effects of EMR systems in hospitals. Issues and trends explored in this study include:
- Mergers and Acquisitions
- Status of Meaningful Use in 2014
- Doctor Opinion of EMR Systems
- Incentive Payments Made to Date
- EMR Alerts Overload?
- Vendor Switches Looming: Market Impact
- Blue Button
- New SGR Bill
- Virtualization Technology
- Dimensions of Interoperability
- BYOD (Bring Your Own Device) Adoption
- Epic Systems
- Stark Law Exemption Extended
- RECS and Health Information Exchange Update
- Need for Trained Personnel
- Security Breaches Update
- ICD-10
- Usability – Scores of Major Vendors
- ACOs
- Open Source EMR
- Current Return on Investment Statistics
- Google PPC adversting of EMR Companies
- Tablet Adoption and EMR
- 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.
Profiles of Important Companies in This Competitive Market
Several leading market participants are discussed in this report along with unique niche players including:
As part of its coverage, the following companies are profiled in this report:
- Abraxas Medical Solutions
- ADP AdvancedMD
- Allmeds
- Allscripts Healthcare Solutions
- Amazing Charts
- Aprima Medical Software, Inc
- athenahealth, Inc.
- BizMatics
- CareCloud
- Cerner Corporation
- ChartLogic
- Computer Programs and Systems, Inc.
- CSC
- CureMD
- Dr First/Rcop
- eClinicalworks
- Emdeon
- e-MDs
- Epic Systems, Inc.
- GE Healthcare
- Greenway Medical Technologies
- Healthland
- Kareo
- McKesson Corporation
- MedHost
- Medical Information Technology, Inc. (MEDITECH, Inc.)
- Medent Community Computer Service,
- Medsphere Systems
- MeridianEMR, Inc
- NextGen
- Nuesoft Technologies Inc
- Practice Fusion
- Quadramed Corporation
- Quest Diagnostics, Inc
- Sequel Systems, Inc
- Siemens Medical Solutions
- SoapWare, Inc
- Streamline MD
- SuiteMed
- Vitera Healthcare Solutions
- WRS Health (Waiting Room Solutions)
- WebPT
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. For the purpose of this study, Kalorama Information conducted interviews with more than 24 key industry officials, consultants, health care providers, and government personnel. These sources were the primary basis in gathering information specifically relating to revenue and market share data presented in this report. Additional interviews were completed with relevant company representatives including marketing directors, division managers, and product representatives.
Table of Contents
CHAPTER ONE: EXECUTIVE SUMMARY
Introduction
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 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-based/Ambulatory EMR Services
Physician EMR Acceptance by Type (Overall Use, Basic System, Fully Functional)
State Distribution of Office-based Physician EMR Adoption
Hospital-based EMR Services
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 by Ownership
CHAPTER THREE: EMERGING TRENDS
CHAPTER FOUR: MARKET PARTICIPANTS
Abraxas Medical Solutions
ADP AdvancedMD
Allmeds
Allscripts Healthcare Solutions
Amazing Charts
Aprima Medical Software, Inc
athenahealth, Inc.
BizMatics
CareCloud
Cerner Corporation
ChartLogic
Computer Programs and Systems, Inc.
CSC
CureMD
Dr First/Rcop
eClinicalworks
Emdeon
e-MDs
Epic Systems, Inc.
GE Healthcare
Greenway Medical Technologies
Healthland
Henry Schein
Kareo
McKesson Corporation
MedHost
Medical Information Technology, Inc. (MEDITECH, Inc.)
Medent Community Computer Service,
Medsphere Systems
MeridianEMR, Inc
NextGen Healthcare Information Systems/ Quality Systems Inc
Nightingale Infomatix
Nuesoft Technologies Inc
Practice Fusion
Quadramed Corporation
Quest Diagnostics, Inc
Sequel Systems, Inc
Siemens Medical Solutions
SoapWare, Inc
Streamline MD
SuiteMed
Vitera Healthcare Solutions
WRS Health (Waiting Room Solutions)
WebPT
CHAPTER FIVE: MARKET ANALYSIS
Market Overview
Market by Region
United States
Europe
Asia Pacific
Rest of World
Market by Segment
Hospital
Physician/Web-based
Market Segment by Type
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
Conclusion One: Physician Practices Still High Growth Area
Conclusion Two: Meaningful Use Confusion Still Plagues Industry
Conclusion Three: No Clear Leader Still, Opportunity For New Players
Conclusion Four: Mergers and Acquisitions
Conclusion Five: Interoperability A Major Hurdle
Conclusion Six: PR Effect of Breaches Downside for Industry
Conclusion Seven: Usability and Data Entry an Under the Radar Issue
Conclusion Eight: Opportunity for Telecoms
Conclusion Nine: “Stick” Will Be More Effective Than “Carrot” in Doctor Conversion
Conclusion Ten: CPOE and Other Features Sell EMR Systems
Conclusion Eleven: Hospital EMR Incentives Factor in Growing Market
Conclusion Twelve: Technology Moving Faster than EMR Technology Providers
Conclusion Thirteen: Data Storage Concerns — Top Focus
Conclusion Fourteen: User Satisfaction On Decline
Conclusion Fifteen: EMR Specialists See Gains
APPENDIX: DEFINITION OF INDUSTRY PRODUCTS
APPENDIX: DIRECTORY OF SELECT EMR COMPANIES
TABLE OF EXHIBITS
CHAPTER ONE: EXECUTIVE SUMMARY
Figure 1-1: Percentage Physician EMR Usage, 2006-2013
Figure 1-2: Analysis of CDC Physician EMR Use Numbers (Basic Use vs. Fully Functional)
Figure 1-3: Hospitals at Stage 3 or Higher
Figure 1-4: EMR Market Analysis 2011-2018
Figure 1-5: Market Share of EMR Providers 2013
CHAPTER TWO: INDUSTRY OVERVIEW
Table 2-1: Terminology Comparison Matrix
Table 2-2: Physician Adoption of EMRs 2006-2013 (Basic System and
Fully Functional System)
Figure 2-1: Physician EMR Acceptance by Type (Overall Use, Basic System,Fully Functional)
Table 2-3: State Percentage Distribution of Office-based Physicians Using EMR (US) by State 2013
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 (2014)
Figure 2-2: Comparison of Hospital Basic EHR Systems with Hospital Certified EHR Systems 2013
Table 2-6: Average Total Cost for a Three-physician Practice for EMR/PMS Installations (2012-2013)
Table 2-7: Total Cost Range for EMR/PMS Installations (2012-2013)
Table 2-8: Two-year Total Cost for EMR/PMS Installations/Subscriptions 2010-2013 Selected Products (estimates)
Table 2-9: US EMR Hospital Adoption Model 2013
Table 2-10: Canada EMR Hospital Adoption Model 2013
Table 2-11: US Ambulatory EMR Adoption Model 2013
Table 2-12: Ownership vs Non-ownership Adoption Rates 2012-2013
Table 2-13: Doctors’ Office Adoption Rates 2011-2014
CHAPTER THREE: EMERGING TRENDS
Table 3-1: HITECH ACT – Subsidy Plan
Figure 3-1: Global Healthcare Cloud Market 2010-2020
Table 3-2: Mergers and Acquisitions
Table 3-3: Number of HIEs in 2011 and 2012 by Top States
Table 3-4: 2013 Listing of Regional Extension Centers
Table 3-5: Cost of Implementing ICD-10 2008 and 2014
Table 3-6: EHR Usability Rating 2013 (Score on scale of 1-5 with 5 best)
Table 3-7: 2013 Black Book Ratings for Ambulatory Care Practices
Table 3-8: Top 20 Vendors by Popularity
Table 3-9: EHR Vendor Market Share by Practice Size
Table 3-10: Cost Break-up for a Typical One-Physician Practice (5-year period)
Figure 3-2: Distribution of Cumulative Savings
Table 3-11: EHR Incentive Select Program Payments 2011-2013
Table 3-12: Vendor Product Certifications 2006
Table 3-13: CCHIT 2007 Vendor Certifications
Table 3-14: CCHIT 2008 Vendor Certifications
Table 3-15: EMR/EHR Certifications 2010
Table 3-16: Modular System Certifications 2010
Table 3-17: System Certification in 2011
Table 3-18: System Certification in 2012
Table 3-19: Select Ambulatory EMR Certified Products 2013
Figure 3-3: By Sector Contribution to the US GDP (2012)
Figure 3-4: The US Healthcare Spending (2009-2020)
CHAPTER FOUR: MARKET PARTICIPANTS
Table 4-1: EMR Mergers and Acquisitions 2010-2013
Table 4-2: Selected Black Book Ratings
CHAPTER FIVE: MARKET ANALYSIS
Table 5-1: EMR Market Analysis, 2011-2013
Table 5-2: Forecasted EMR Market Analysis: 2014-2018
Figure 5-1: EMR Market Analysis 2011-2018
Table 5-3: United States EMR Market Analysis, 2013-2018
Table 5-4: European EMR Market Analysis, 2013-2018
Table 5-5: Asia Pacific EMR Market Analysis, 2013-2018
Table 5-6: Rest of World EMR Market Analysis, 2013-2018
Table 5-7: Hospital EMR Market Analysis 2011-2013
Table 5-8: Forecasted Hospital EMR Market Analysis: 2014-2018
Figure 5-2: Hospital EMR Market Analysis: 2011-2018
Table 5-9: Physician/Web-based EMR Market Analysis 2011-2013
Table 5-10: Forecasted Physician/Web-based EMR Market Analysis: 2014-2018
Figure 5-3: Physician/Web-based EMR Market Analysis: 2011-2018
Figure 5-4: EMR Market Breakdown, Physician/Web vs. Hospital 2013
Figure 5-5: EMR Market Breakdown, Physician/Web vs. Hospital 2018
Figure 5-6: EMR Breakdown by Type 2013
Table 5-11: Notable Companies by Healthcare Specialty Area 2013*
Table 5-12: Revenues and Market Share of EMR Providers 2013
Figure 5-8: Market Share of EMR Providers 2013