Table of Contents
1: 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
Table 1-1: Total Worldwide Market for EMR Technologies Revenues, 2015-2022
KEY ISSUES AND TRENDS AFFECTING THE MARKET
COMPETITIVE OUTLOOK
CONCLUSION HIGHLIGHTS
2: INTRODUCTION AND OVERVIEW
OVERVIEW
THE MEDICAL RECORD
THE ELECTRONIC MEDICAL RECORD
INDUSTRY TERMINOLOGY
Table 2-1: Terminology Comparison Matrix
INDUSTRY STRUCTURE
Physician-based/Ambulatory EMR Services
Table 2-2: Physician Adoption of EMRs 2006-2017, Basic System and Fully Functional System
Table 2-3: Percentage of Physicians Reporting Fully Functional EMR 2017
Age-based and Practice Distribution of Office-based Physician EMR Adoption
Table 2-4: Percentage Distribution of Office-based Physicians Using EMR by Age and Practice Characteristics (US)
Table 2-5: Percentage of Office-based Physicians with Certified EMR by State
Hospital-based EMR Services
Table 2-6: State Percentage Distribution of Non-Federal Acute Care Hospitals Using EHR (US) by State
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
Table 2-7: Average Total Cost for a Three-Physician Practice for EMR/PMS Installations
Table 2-8: Total Cost Range for EMR/PMS Installations
US EMR Adoption Model
Table 2-9: U.S. Adoption Stage % by Year, 2014-2017
Table 2-10: New EMRAM Criteria Update 2018
Table 2-11: Canada EMR Hospital Adoption Model 2017
Table 2-12: US Ambulatory EMR Adoption Model 2017
Table 2-13: Doctors Office Adoption Rates 2013-2017 (%)
3: EMERGING TRENDS
PATIENT ENGAGEMENT/PATIENT-CENTERED HEALTHCARE
MEANINGFUL USE
Table 3-1: Attestation Details
Modified Stage 2
Table 3-2: Modified Stage of Meaningful Use 2015-2019 and beyond
ECONOMIC STIMULUS PACKAGE
Table 3-3: Medicare EHR Incentive Payment Schedule
Table 3-4: Medicaid EHR Incentive Payment Schedule (thousands $)
STIMULUS GUARANTEE
INFORMATION OVERLOAD
PATIENT ACCESS – BLUE BUTTON TECHNOLOGY
VENDOR SWITCHES
BLOCKCHAIN
HEALTHCARE ANALYTICS
MEDICAL ACCESS AND CHIP REAUTHORIZATION ACT (MACRA)
Merit Based Incentive Payment System
Alternative Payment Models (APM)
Vendor Readiness
VIRTUALIZATION TECHNOLOGY
STORAGE AREA NETWORKS
INTEROPERABILITY
Types of Interoperability
Table 3-5: Three Types of Interoperability
Dimensions of Interoperability
Benefits
CommonWell Alliance
Sequoia Project
The Interoperability Pledge
FHIR
Argonaut Project
21st Century Cures Act and Trusted Exchange Framework
CLOUD COMPUTING
Types of Clouds
ARTIFICIAL INTELLIGENCE AND HEALTHCARE
BIG TECH INVASION
Amazon
Apple
Goggle
Facebook
Microsoft
INTEROPERABLE DEVICES
BYOD ACCELERATES
DASHBOARD MODELS
BIG DATA
INTERNET OF HEALTH THINGS
RISE OF EPIC
ONC INTEROPERABILITY GUIDELINES DRAFT FRAMEWORK
MERGERS AND ACQUISITIONS
Table 3-6: Mergers and Acquisitions
PROFESSIONAL SPORTS ORGANIZATIONS USING EMRS
STARK LAW
DISCREET RECORDABLE TRANSCRIPTION
REGIONAL EXTENSION CENTERS
Table 3-7: 2017 List of Regional Extension Centers
PERSONNEL ISSUES
HEALTHCARE CYBERSECURITY
SECURITY BREACHES/PORTABLE DEVICES
Table 3-8: 2015 Data Breaches
RANSOMWARE
FRAUD AND SECURITY SURVEILLANCE INCREASES
MEDICAL DEVICE CONNECTIVITY MARKET IN EMR
Table 3-9: Ways to Improve Connectivity of Medical Devices
Drivers
Restraints
Market Revenues and Competitors
Table 3-10: Market Size and Growth for Medical Device Connectivity Market, 2017-2022 ($millions)
MOBILE HEALTH AND APPS
EpicCare Mobile Apps: Haiku and Canto and Limerick
Allscripts Mobile App: TouchWorks Mobile
Cerner Mobile App: PowerChart Touch
NETWORK FOR DOCTORS
PHYSICIAN POSITION AND USABILITY
ACCOUNTABLE CARE ORGANIZATIONS
Table 3-11: Top Accountable Care Organizations 2017
THE PERSONAL HEALTH RECORD SYSTEM
Differences in Access to PHR
SMART CARDS TECHNOLOGY
WIRELESS TECHNOLOGIES
OPEN SOURCE EMR APPLICATIONS
Benefits of Open Source EMR Applications
Table 3- 12: Select Free or Open Source EMR Products
ADOPTION ISSUES
Table 3- 13: Physician Office National Level Adoption by Vendor 2017
Table 3-14: Regional Physician Adoption by Vendor
USABILITY AND ADOPTION
QUALITY OF CARE/MALPRACTICE
COST-BENEFIT ANALYSIS
ROI for a Typical Physician Practice
EHR Incentive Program
Table 3-15: EHR Incentive Payments
Implementation Costs and ROI for Hospitals
Summary
PRIVACY ISSUES
TECHNOLOGY LIMITATIONS
SOCIAL AND ORGANIZATIONAL BARRIERS
E-PRESCRIBING
CCHIT
Certifications 2010
Table 3-16: EMR/EHR Certifications 2010
Certifications in 2011
Table 3-17: EMR/EHR Certifications 2011
Certifications in 2012
Table 3- 18: System Certifications in 2012
Certifications in 2013
Table 3-19: Select Ambulatory EMR Certified Products 2013
Certifications in 2014
Table 3-20: Select EMR Certified Products 2014
Table 3-21: Select Ambulatory EMR Certified Products 2014
Certifications in 2015
Table 3-22: Select Ambulatory EMR Certified Products 2015
Certifications in 2016
Table 3-23: Select EHR Certifications 2016
Certifications in 2017
Table 3-24: Select EHR Certifications 2017
NHIN (EHEALTH EXCHANGE)
GLOBAL HEALTHCARE SPENDING TRENDS
Europe
Table 3-25: EU Healthcare Expenditures as Percent of GDP by Select Countries
Asia Pacific
The US Market
4: MARKET PARTICIPANTS
Table 4-1: EMR Mergers and Acquisitions
4MEDICA
Table 4-2: 4Medica Corporate Summary
Company Overview
ADVANCEMD
Table 4-3: AdvanceMD Corporate Summary
Company Overview
ALERT LIFE SCIENCES COMPUTING S.A.
Table 4-4: Alert Life Sciences Computing S.A. Corporate Summary
Company Overview
ALLMEDS
Table 4-5: Allmeds Corporate Summary
Company Overview
ALLSCRIPTS HEALTHCARE SOLUTIONS
Table 4-6: Allscripts Healthcare Solutions Corporate Summary
Company Overview
Company Financials
Table 4-7: Allscripts (2014-2017) ($ millions)
AMAZING CHARTS
Table 4-8: Amazing Charts Corporate Summary
Company Overview
APRIMA MEDICAL SOFTWARE, INC
Table 4-9: Aprima Medical Software, Inc. Corporate Summary
Company Overview
ATHENAHEALTH, INC
Table 4-10: athenahealth, Inc. Corporate Summary
Company Overview
Company Financials
Table 4-11: athenahealth Revenue (2014-2017) ($ millions)
BERNOULLI ENTERPRISE, INC
Table 4-12: Bernoulli Enterprise Inc Corporate Summary
Company Overview
BIZMATICS, INC.
Table 4-13: Bizmatics, Inc. Corporate Summary
Company Overview
CAMBIO HEALTHCARE SYSTEMS
Table 4-14: Cambio Healthcare Systems Corporate Summary
Company Overview
CARECLOUD
Table 4-15: CareCloud Corporate Summary
Company Overview
CERNER CORPORATION
Table 4-16: Cerner Corporation Corporate Summary
Company Overview
Company Financials
Table 4-17: Cerner Revenue (2014-2017) ($ millions)
CHANGE HEALTHCARE
Table 4-18: Change Healthcare Corporate Summary
Company Overview
CHARTLOGIC, INC
Table 4-19: ChartLogic, Inc. Corporate Summary
Company Overview
COMPUGROUP MEDICAL AG
Table 4-20: CompuGroup Medical AG Corporate Summary
Company Overview
Company Financials
Table 4-21: CompuGroup Revenue (2014-2017) ($ millions)
COMPUTER PROGRAMS AND SYSTEMS, INC
Table 4-22: Computer Programs and Systems, Inc. Corporate Summary
Company Overview
Company Financials
Table 4-23: CPSI Revenue (2014-2017) ($ millions)
COMPUTER SCIENCES CORPORATION (CSC)
Table 4-24: CSC Corporate Summary
Company Overview
Company Financials
Table 4-25: CSC Revenue (2014-2017) ($ millions)
CUREMD
Table 4-26: CureMD Corporate Summary
Company Overview
DR FIRST/RCOP
Table 4-27: Dr First/ Rcop Corporate Summary
Company Overview
ECLINICALWORKS
Table 4-28: eClinicalWorks Corporate Summary
Company Overview
Company Financials
Table 4-29: eClinicalWorks Estimated Revenue (2014-2017) ($ millions)
EMDS
Table 4-30: eMDs Corporate Summary
Company Overview
EMIS HEALTH
Table 4-31: EMIS Corporate Summary
Company Overview
Performance Review
Table 4-32: EMIS Estimated Revenue (2014-2017) ($ millions)
EPIC SYSTEMS CORPORATION
Table 4-33: Epic Systems Corporation Corporate Summary
Company Overview
Company Financials
Table 4-34: Epic Systems Corporation Estimated Revenue (2014-2017) ($ millions)
GE HEALTHCARE
Table 4-35: GE Healthcare Corporate Summary
Company Overview
Company Financials
Table 4-36: GE Healthcare Revenue (2014-2017) ($ millions)
GREENWAY HEALTH, LLC
Table 4-37: Greenway Health Corporate Summary
Company Overview
HEALTHLAND
Table 4-38: Healthland Corporate Summary
Company Overview
HENRY SCHEIN MICROMD
Table 4-39: Henry Schein MicroMD Corporate Summary
Company Overview
IBM HEALTHCARE
Table 4-40: IBM Healthcare Corporate Summary
Company Overview
IMS MAXIMS
Table 4-41: IMS MAXIMS Corporate Summary
Company Overview
INTERSYSTEMS CORPORATION
Table 4-42: InterSystems Corporate Summary
Company Overview
KAREO
Table 4-43: Kareo Corporate Summary
Company Overview
KONINKLIJKE PHILIPS N.V.
Table 4-44: Koninklijke Philips Corporate Summary
Company Overview
KRONOS INCORPORATED
Table 4-45: Kronos Corporate Summary
Company Overview
MCKESSON CORPORATION
Table 4-46: McKesson Corporate Summary
Company Overview
Company Financials
Table 4-47: McKesson Revenue (2014-2017) ($ millions)
MEDENT COMMUNITY COMPUTER SERVICE, INC.
Table 4-48: MEDENT Community Computer Service Corporate Summary
Company Overview
MEDHOST
Table 4-49: MEDHOST Corporate Summary
Company Overview
MEDICAL INFORMATION TECHNOLOGY, INC (MEDITECH)
Table 4-50: MEDITECH Corporate Summary
Company Overview
Company Financials
Table 4-51: MEDITECH Revenue (2014-2017) ($ millions)
MEDITAB SOFTWARE, INC
Table 4-52: Meditab Software Corporate Summary
Company Overview
MEDSPHERE SYSTEMS CORPORATION
Table 4-53: Medsphere Systems Corporate Summary
Company Overview
MICROTEST LTD.
Table 4-54: Microtest Corporate Summary
Company Overview
NANTHEALTH
Table 4-55: NantHealth Corporate Summary
Company Overview
NEXTGEN HEALTHCARE INFORMATION SYSTEMS
Table 4-56: NextGen Healthcare Corporate Summary
Company Overview
Company Financials
Table 4-57: NextGen Revenue (2014-2017 ($ millions)
NEXTECH
Table 4-58: Nextech Medical Corporate Summary
Company Overview
NIGHTINGALE INFORMATIX CORPORATION (NOW TELUS HEALTH)
Table 4-59: Nightingale Informatix Corporate Summary
Company Overview
NOEMALIFE S.P.A. (NOW DEDALUS HEALTHCARE GROUP)
Table 4-60: NoemaLife Corporate Summary
Company Overview
NUESOFT TECHNOLOGIES, INC
Table 4-61: Nuesoft Corporate Summary
Company Overview
PRACTICE FUSION
Table 4-62: Practice Fusion Corporate Summary
Company Overview
PRAXIS
Table 4-63: Praxis Corporate Summary
Company Overview
QUALCOMM LIFE, INC
Table 4-64: Qualcomm Life Corporate Summary
Company Overview
QUALITY SYSTEMS, INC
Table 4-65: Quality Systems Corporate Summary
Company Overview
Company Financials
Table 4-66: Quality Systems Inc (2014-2017) ($ millions)
QUEST DIAGNOSTICS, INC.
Table 4-67: Quest Diagnostics Corporate Summary
Company Overview
Company Financials
Table 4-68: Quest Diagnostics (2014-2017) ($ millions)
SAP SE
Table 4-69: SAP SE Corporate Summary
Company Overview
Company Financials
Table 4-70: SAP SE (2014-2017) ($ millions)
SEQUELMED
Table 4-71: SequelMed Corporate Summary
Company Overview
STREAMLINE MD
Table 4-72: StreamlineMD Corporate Summary
Company Overview
TIETO
Table 4-73: Tieto Corporate Summary
Company Overview
Company Financials
Table 4-74: Tieto (2014-2017) ($ millions)
WEBPT
Table 4-75: WebPT Corporate Summary
Company Overview
WRS HEALTH
Table 4-76: WRS Health Corporate Summary
Company Overview
5: MARKET ANALYSIS
MARKET OVERVIEW
Table 5-1: EMR Market Analysis 2015-2022 ($ millions)
MARKET BY REGION
United States
Table 5-2: Market Size and Growth for US EMR Market, 2017-2022 ($millions)
EMEA
Table 5-3: Market Size and Growth for EMEA EMR Market, 2017-2022 ($millions)
Table 5-4: Market Size and Growth for UK EMR Market, 2017-2022 ($millions)
Table 5-5: Market Size and Growth for Germany EMR Market, 2017-2022 ($millions)
Table 5-6 : Market Size and Growth for France EMR Market, 2017-2022 ($millions)
Table 5-7: Market Size and Growth for Spain EMR Market, 2017-2022 ($millions)
Table 5-8: Market Size and Growth for Nordic Countries EMR Market, 2017-2022 ($millions)
Table 5-9: Market Size and Growth for Middle East EMR Market, 2017-2022 ($millions)
Table 5-10: Market Size and Growth for Israel EMR Market, 2017-2022 ($millions)
Table 5-11: Market Size and Growth for Africa EMR Market, 2017-2022 ($millions)
Table 5-12: Market Size and Growth for Other EMEA Countries EMR Market, 2017-2022 ($millions)
APAC
Table 5-13: Market Size and Growth for APAC EMR Market, 2017-2022 ($millions)
Table 5-14: Market Size and Growth for Japan EMR Market, 2017-2022 ($millions)
Table 5-15: Market Size and Growth for China EMR Market, 2017-2022 ($millions)
Table 5-16: Market Size and Growth for India EMR Market, 2017-2022 ($millions)
Table 5-17: Market Size and Growth for Australia EMR Market, 2017-2022 ($millions)
Table 5-18: Market Size and Growth for Other APAC Countries EMR Market, 2017-2022 ($millions)
Rest of World
Table 5-19: Market Size and Growth for Rest of World EMR Market, 2017-2022 ($millions)
Table 5-20: Market Size and Growth for Brazil EMR Market, 2017-2022 ($millions)
Table 5-21: Market Size and Growth for Canada EMR Market, 2017-2022 ($millions)
Table 5-22: Market Size and Growth for Mexico EMR Market, 2017-2022 ($millions)
Table 5-23: Market Size and Growth for Other ROW Countries EMR Market, 2017-2022 ($millions)
MARKET BY SEGMENT
Hospital
Table 5-24: EMR Hospital Market Analysis 2015-2022 ($ millions)
Figure 5-1: EMR Large Hospitals vs Small Hospitals by Percent 2017
U.S. Large vs Small Hospital
Table 5-25: US Market Size and Growth for Large Hospital EMR Market, 2017-2022 ($millions)
Table 5-26: US Market Size and Growth for Small Hospital EMR Market, 2017-2022 ($millions)
Physician/Web-based
Table 5-27: Market Size and Growth for Physician/Web-based EMR Market, 2017-2022 ($millions)
Figure 5-2: Hospital vs Physician/Web Breakdown 2017 (%)
Figure 5-3: Hospital vs Physician/Web Breakdown 2022 (%)
MARKET SEGMENT BY TYPE
Figure 5-4: EMR Breakdown by Type 2017 (%)
COMPETITIVE ANALYSIS
Hospitals and Health System Technology Providers
Small Hospitals 1-200 beds
Practice Management System (PMS) Acquirers
Pharmacy Services Providers
Other Entities
Large Practices (20+ Practitioners)
Small Practitioners (1-20 Practitioners)
Web-based Users
Meaningful Use Attestations
Market Leaders
Table 5-28: Revenues and Market Share of EMR Providers 2017 (in millions $)
Figure 5-5: EMR Top Seven Providers Market Share % 2017
Hospital
Physician Office
6: CONCLUSIONS
OVERVIEW
ONE
TWO
THREE
FOUR
FIVE
SIX
SEVEN
EIGHT
NINE
TEN
ELEVEN
TWELVE
THIRTEEN
FOURTEEN
FIFTEEN
SIXTEEN
SEVENTEEN
EIGHTEEN
NINETEEN
TWENTY
TWENTY-ONE
TWENTY-TWO
TWENTY-THREEY
TWENTY-FOUR
