Researching software? Our FastStart Consultation will get you started quickly and save you weeks of research.EHR Software Market Share Analysis
Market Analyst, Software Advice
on 5/14/2010
Calculating market share for the electronic health record (EHR) market is no easy task. There are over 300 software vendors, many market segments (consider: size of practice served, specialties services, inpatient/outpatient) and very “fuzzy” sources of data.
Nevertheless, the team at Software Advice set out to see what numbers we could pull together. We limited our analysis to the outpatient EHR software market. Moreover, we decided to measure market share based on the number of physicians users, rather than vendor revenue or other metrics. We tried to keep it simple. It’s not.
Number of Doctors Using EHR Software
First, let’s define the total size of the market we are analyzing. Of the approximately 788,000 physicians in the United States, 65% of them work in an outpatient facility or physician’s practice, according to the Bureau of Labor & Statistics. That’s 512,000 possible physicians who are in the outpatient EHR software market.
According to a recent study of office-based physicians released by the Center for Disease Control and Prevention (CDC), 44% of those of 512,000 office-based doctors had adopted either a partial, basic, or fully functional EHR system. That’s 225,000 outpatient doctors using an EHR to some extent. Here’s how EHR adoption breaks down among the total number (512,000) of outpatient physicians in the United States:
Outpatient EHR software adoption, 2009
The CDC defines “partial” EHR systems as those not exclusively used for billing. “Basic” systems include the following functionalities: patient demographic information, patient problem lists, clinical notes, orders for prescriptions, and viewing laboratory and imaging results.
Systems defined by the CDC as “fully functional” include all functionalities of a basic system plus these functionalities: medical history and follow-up, orders for tests, prescription and test orders sent electronically, warnings of drug interactions or contraindications, highlighting of out-of-range test levels, electronic images returned, and reminders for guideline-based interventions.
Outpatient EHR Market Share
So, what EHR software are the 225,000 physicians using? Based on number of physician users, here’s how the market breaks down:
Outpatient EHR software market share by vendor, 2010
Software Advice’s analysis showed that a handful of vendors – Allscripts, Epic, eClinicalWorks, NextGen, and GE Centricity – own more than three-quarters of the ambulatory EHR software market. This is a similar trend that other EHR market reports and analysis have noted.
Here is the data Software Advice was able to gather on the top EHR vendors, based on volume of physician users:
Vendor Physician Users Practices Served
Epic 45,000 N.A.
Allscripts 40,000 N.A.
eClinicalWorks 40,000 6,500
GE Centricity 35,000 2,500
NextGen 35,000 2,000
SOAPWare 30,000 8,000
Practice Fusion 18,500 10,000
Eclipsys 11,000 N.A.
Sage Health 10,000 N.A.
Greenway Medical 6,000 1,400
Clarifications, Disclaimers, Footnotes, Contradictions, etc.
As mentioned in the introduction, the EHR software market has many “fuzzy” sources of data. In fact, when all of the physician users are calculated in the table above, the number of physicians using EHRs in the United States is more than 40,000 over what the CDC reported. Clearly, we need to dig into these numbers a bit more.
In most cases, the information was gathered directly from the EHR software vendors. For those vendors that weren’t able to be contacted, publicly reported information was used. In some cases, exact numbers of physicians and practices were available. In some cases, approximations were used by Software Advice and the software vendors (In the case of a discrepancy, please contact us).
Here are a few questions that came up during the research process whose answers would help refine our market share numbers:
- Sage Health. How many of Sage Health’s users are using their Intergy EHR product in conjunction with their practice management software versus those using just Sage’s practice management software, in particular, Medical Manager?
- Allscripts. How many of Allscripts users are still using Misys practice management systems? Like Sage, they have a huge practice management installed base, but not all of those customers are using their advanced EHR systems.
- Epic and NextGen. How many of their users are exclusively outpatient customers? Both of these EHR vendors are meaningful players in the inpatient EHR market. We need to exclude those physicians from our analysis.
- GE Centricity. General Electric didn’t distinguish between physician (MD) users and mid-level providers in their count of users. This would be a helpful distinction to have in this analysis.
- Practice Fusion. Being a free EHR system, it would be important to see how many of Practice Fusion’s EHR users are actively using their software, instead of just kicking the tires on a cool new web-based EHR and “freemium” business model.
Feedback (We Need Your Help)
Software Advice knows many of you are just as, if not more, intimately plugged into the EHR software market than we are. That’s why we’d like your feedback to help figure out these numbers.
Which vendors’ numbers are higher? Lower? Who are the up and coming players that will earn significant market share in the coming years?
Excellent piece, and worthy of participation.
This is an exceptionally challenging space for technology. At it’s simplest, information technology is competing with a pen and a piece of paper, in regard to cost, portability and ease-of-use, it’s hard to beat.
In addition, the costs, both explicit (cost of the system) and implicit (training and adoption) are incurred by the practice, but not always the benefits, they fall to insurance companies and patients.
Add to this that medical practices are professional corporations who can not keep retained earnings. This means that funds remaining at the end of the year have to be distributed as ordinary income. The cost of an information system comes directly out of the income of the practitioner. Ouch!
Everyone believes that there are benefits to the process of care and to the patient, but those benefits lie well beyond the cost of bringing on the system, often in the future.
To understand the strategy going forward consider this: the future of healthcare medical practice will look a lot more like the 1950′s than the 1990′s. That is an increasing amount of income will be coming from patients paying cash. With that in mind, what should a practice do?
As a trained economist, my bias is that it changes the nature of the relationship between practice and patient to where the patient is also a customer. This means that practices need to work on building close relationships with their patients, develop communication strategies to share information with them, and provide them the ability to create their own appointments at their convenience.
All the sophistication of an EHR is irrelevant until the patient shows up, and the longer they stay around, the more valuable the information in that system is to the practice. This is why I’ve focused on tools for practices to better communicate with their patient/customers along with the ability for those patient/customers to create their own appointments when it is convenient to them. It wasn’t easy, but it’s done. And better yet, it’s a revenue story, not just an expense reduction story.
Good luck,
Tom
May 14, 2010 @ 6:02 pm