EMR 2015: The Market for Electronic Medical Records, Forecasts to 2019

Table of Contents

EXECUTIVE SUMMARY

INTRODUCTION

INDUSTRY AT A GLANCE

SCOPE AND METHODOLOGY

USE OF EMR

Percentage and Increase of Physician Usage of EMR

HOSPITAL USE OF EMR

SIZE AND GROWTH OF THE MARKET

KEY ISSUES AND TRENDS AFFECTING THE MARKET

LEADING MARKET PARTICIPANTS

CONCLUSIONS HIGHLIGHTS

INDUSTRY OVERVIEW

Introduction

The Medical Record

The Electronic Medical Record

Industry Terminology

Industry Structure

Physician-based/Ambulatory EMR Services

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

EMERGING TRENDS

Meaningful Use

Economic Stimulus Package

Stimulus Guarantee

Information Overload

Patient Access – Blue Button Technology

Vendor Switches Looming

Merit Based Incentive Payment System

Virtualization Technology

Storage Area Networks

Interoperability

Types of Interoperability

Dimensions of Interoperability

Benefits

Cloud Computing

Hybrid Healthcare Clouds

Interoperable Devices

BYOD Accelerates

Dashboard modules

Big Data

Rise of Epic

ONC Interoperability Guidelines Draft

Mergers and Acquisitions

Professional Sports Organizations Using EMRs

Stark Law

Discreet Recordable Transcription

Health Information Exchange Update

Regional Extension Centers

Personnel Issues

Security Breaches/Portable Devices

Fraud and Security Surveillance Increases

Mobile Adoption

Network for Doctors

National Physician Education Program

ICD-10 controversy

Physician Position and Usability

Accountable Care Organizations

The Personal Health Record System

Industry Survey Results

Medscape

Black Book Ratings

KLAS Survey

Captera Survey

SK&A Survey

Smart Cards Technology

Wireless Technologies

Open Source EMR Applications

Benefits of Open Source EMR Applications

Adoption Issues

Usability And Adoption

Quality of Care/Malpractice

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

Certifications 2006

Certifications 2007

Certifications 2008

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Certifications 2010

Certifications in 2011

Certifications in 2012

Certifications in 2013

Certifications in 2014

NHIN (eHealth Exchange)

Direct Pay-Per-Click (PPC) Offerings

Global Healthcare Spending Trends

Europe

Asia Pacific

The US Market

MARKET PARTICIPANTS

4Medica

ADP AdvancedMD

ALERT LIFE SCIENCES COMPUTING S.A

Allmeds

Allscripts Healthcare Solutions

Amazing Charts

Aprima Medical Software, Inc

athenahealth, Inc.

BizMatics, Inc.

CAMBIO HEALTHCARE SYSTEMS

CARECLOUD

Cerner Corporation

ChartLogic

COMPUGROUP MEDICAL AG

Computer Programs and Systems, Inc.

CSC

CureMD

Dr First/Rcop

Dr First/Rcop

eClinicalworks

EGTON MEDICAL INFORMATION SYSTEMS LIMITED

e-MDs

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existence or hereafter developed, in whole or in any part, is strictly prohibited

Epic Systems Corporation

GE Healthcare

Greenway Medical Technologies

HealthFusion, Inc

Healthland

Henry Schein

IMS MAXIMS

INTERSYSTEMS CORPORATION

KAREO

McKesson Corporation

MedHost

Meditab Software Inc

Medical Information Technology, Inc. (MEDITECH, Inc.)

Medent Community Computer Service, Inc

Medsphere Systems

MeridianEMR, Inc

Microtest LTD.

NextGen Healthcare Information Systems /Quality Systems Inc

Nextech

Nightingale Infomatix Corporation

NOEMALIFE S.P. A.

Nuesoft Technologies Inc

Practice fusion

Quadramed Corporation

Quality Systems, Inc.

PRAXIS

Quest diagnostics, Inc

SAP AG

Sequel Systems, Inc

Siemens Medical Solutions

Streamline MD

Tieto

WRS Health (Waiting Room solutions)

WebPT

MARKET ANALYSIS

Market Overview

Market by Region

United States

EMEA

APAC

Rest of World

Market by Segment

Market Segment by Type

Competitive Analysis

Market Leaders

Hospital

Physician Office

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: 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

Twelve: Technology Moving Faster than EMR Technology Providers

Thirteen: Data Storage Concerns- Top Focus

Fourteen: User Satisfaction On Decline

Fifteen: Specialists See Gains

Sixteen: EHRs More Personalized

DEFINITION OF INDUSTRY PRODUCTS

Table of Figures

CHAPTER ONE: EXECUTIVE SUMMARY

Figure 1-1 Percentage Physician EMR Usage, 2006-2014

Figure 1-2 EMR Market Analysis 2012-2019

Figure 1-3 Revenues and Market Share (%) of EMR Providers

CHAPTER TWO: TRENDS

Table 2-1 Terminology Comparison Matrix

Table 2-2 Physician Adoption of EMRs 2006-2014 (Basic System and Fully Functional System)

Figure 2-2 Overall Physician Adoption of EMRs 2006-2014

Table 2-3 State Percentage Distribution of Office-based Physicians Using EMR by State 2013-2014

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)

Table 2-6 State Percentage Distribution of Non-federal Acute Care Hospitals Using EMR (US) by State 2013

Table 2-7 Average Total Cost for a Three-physician Practice for EMR/PMS Installations (2013-2014)

Table 2-8 Total Cost Range for EMR/PMS Installations (2013-2014)

Table 2-9 Estimated Two-year Total Cost for EMR/PMS Installations 2010-2014 Selected Products (estimates)

Table 2-10 US EMR Hospital Adoption Model 2014

Table 2-11 Canada EMR Hospital Adoption Model 2014

Table 2-12 US Ambulatory EMR Adoption Model 2014

Table 2-13 Ownership vs. Non-ownership Adoption Rates 2012-2014

Table 2-14 Doctors Office Adoption Rates 2011-2014 (%)

CHAPTER THREE: TRENDS

Table 3-1 Attestation Details in 2014

Table 3-2 Medicare EHR Incentive Payment Schedule

Table 3-3 Medicaid EHR Incentive Payment Schedule

Table 3-4 Three Types of Interoperability

Figure 3-1 Global Healthcare Cloud Market 2010-2020

Table 3-5 Mergers and Acquisitions

Table 3-6 Number of HIEs in 2011 and 2012 by Top States

Table 3-7 HIE Grants by State

Table 3-8 2014 Listing of Regional Extension Centers

Table 3-9 Cost of Implementing ICD-10 2008 and 2014

Table 3-10 EHR Patient Portal Usability Rating 2014 (Score on scale of 1-10 with 10 best)

Table 3-11 Top 5 Most Widely Used Physician EHRs 2012, 2014

Table 3-12 Top Rated Physician EHRs Overall 2012, 2014

Table 3-13 Physician Satisfaction with EHR Vendor

Table 3-14 Switch or Keep EHR 2014

Table 3-14a Privacy Concerns 2014

Table 3-15 Meaningful Use Survey 2014

Table 3-16 Type of EHR System by Practice Size 1-9 Physicians

Table 3-17 Type of EHR System by Practice Size 10-24 Physicians

Table 3-18 Type of EHR System by Practice Size 25+ Physicians

Table 3-19 Cost per Physician to Purchase and Install EMR 2014

Table 3-20 Monthly Fees per Physician Web-based System

Table 3-21 2013 Black Book Ratings for Ambulatory Care Practices

Table 3-22 2014 Best in KLAS Award Ambulatory EMR (1-10 Physicians)

Table 3-23 Top 20 Vendors by Popularity

Table 3-24 EHR Vendor Market Share by Practice Size 2014

Table 3-25 Adoption by Selected Practice Specialties 2014

Table 3-26 Top Free or Open Source EMR Products 2014

Table 3-27 Physician Office National Level Adoption by Vendor

Table 3-28 Regional Adoption by Vendor

Table 3-29 Cost Break-up for a Typical One-Physician Practice (5-year period)

Figure 3-2 Distribution of Cumulative Savings

Table 3-30 EHR Incentive Select Program Payments 2012-2014 ($)

Table 3-31 Percent of Physicians e-Prescribing Using EHR December 2008 and April 2014

Table 3-32 Vendor Product Certifications 2006

Table 3-33 CCHIT 2007 Vendor Certifications

Table 3-34 CCHIT 2008 Vendor Certifications

Table 3-35 EMR/EHR Certifications 2010

Table 3-36 Modular System Certifications 2010

Table 3-37 System Certification in 2011

Table 3-38 System Certification in 2012

Table 3-39 Select Ambulatory EMR Certified Products 2013

Table 3-40 Select Ambulatory EMR Certified Products 2014

Table 3-41 EU Healthcare Expenditure as % of GDP by Top Countries

Figure 3-3 The US Healthcare Spending (2009-2020)

CHAPTER FOUR: COMPETITIVE ANALYSIS

Table 4-1 EMR Mergers and Acquisitions 2010-2015

Table 4-2 Selected Black Book Ratings

Figure 4-1 Allscripts Healthcare Solutions Revenues 2012-2014

Figure 4-2 athenahealth Revenues 2012-2014

Figure 4-3 Cerner Revenues 2012-2014

Figure 4-4 CompuGroup Revenues 2012-2014

Figure 4-5 CPSI Revenues 2012-2014

Figure 4-6 EMIS Group Revenues 2012-2014

Figure 4-8 Epic (estimated) Revenues 2012-2014

Figure 4-9 GE Healthcare IT Applications Revenues 2012-2014

Figure 4-10 Greenway Revenues 2012-2014 (E)

Figure 4-11 McKesson Revenues, 2012-2014

Figure 4-12 MEDITECH Revenues 2012-2014

Figure 4-13 NextGen Revenues, 2012-2014

Figure 4-14 Nightingale Infomatix Revenues, 2012-2014

Figure 4-15 NoemaLife Revenues 2012-2014

Figure 4-16 QSI Revenues, 2012-2014

Figure 4-17 Quest Diagnostics Revenues 2012-2014

Figure 4-20 Revenues 2012-2014

CHAPTER FIVE: MARKET ANALYSIS

Table 5-1 EMR Market Analysis, 2012-2014

Table 5-2 Forecasted EMR Market Analysis: 2015-2019

Figure 5-1 EMR Market Analysis 2012-2019

Table 5-3 United States EMR Market Analysis, 2014-2019

Table 5-4 EMEA EMR Market Analysis, 2014-2019

Table 5-5 United Kingdom EMR Market Analysis, 2014-2019

Table 5-6 Germany EMR Market Analysis, 2014-2019

Table 5-7 France EMR Market Analysis, 2014-2019

Table 5-8 Spain EMR Market Analysis, 2014-2019

Table 5-9 Nordic Countries EMR Market Analysis, 2014-2019

Table 5-10 Middle East EMR Market Analysis, 2014-2019

Table 5-11 Africa EMR Market Analysis, 2014-2019

Table 5-12 Other EMEA EMR Market Analysis, 2014-2019

Table 5-13 APAC EMR Market Analysis, 2014-2019

Table 5-14 Japan EMR Market Analysis, 2014-2019

Table 5-15 China EMR Market Analysis, 2014-2019

Table 5-16 India EMR Market Analysis, 2014-2019

Table 5-17 Australia EMR Market Analysis, 2014-2019

Table 5-18| Other APAC EMR Market Analysis, 2014-2019

Table 5-19 Rest of World EMR Market Analysis, 2014-2019

Table 5-20 Rest of World EMR Market Analysis, 2014-2019

Table 5-21 Canada EMR Market Analysis, 2014-2019

Table 5-22 Hospital EMR Market Analysis 2012-2014

Table 5-23 Forecasted Hospital EMR Market Analysis: 2015-2019

Figure 5-2 Hospital EMR Market Analysis: 2012-2019

Table 5-24 Physician/Web-based EMR Market Analysis 2012-2014

Table 5-25 Forecasted Physician/Web-based EMR Market Analysis: 2015-2019

Figure 5-3 Physician/Web-based EMR Market Analysis: 2012-2019

Figure 5-4 EMR Market Breakdown, Physician/Web vs. Hospital 2014

Figure 5-5 EMR Market Breakdown, Physician/Web vs. Hospital 2019

Figure 5-6 EMR Breakdown by Type 2014

Table 5-26| Notable Companies by Healthcare Specialty Area 2014*

Table 3-27 2014 Top Vendor by State’s Meaningful Use Attestations

Table 5-28 Revenues and Market Share of EMR Providers 2014

Figure 5-7 Revenues and Market Share of EMR Providers 2014