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Why the electronic health record (EHR) market is poised for disruption

Brian Eastwood | Feb. 11, 2014
Simply put, 2014 is a big year for electronic health record vendors. They must adhere to stricter standards under the federal government's meaningful use program while convincing healthcare providers that they can meet future needs for information exchange, patient engagement and data analytics. Not everyone will make the cut.

The healthcare industry has known for years that the electronic health record (EHR) market, dominated by a handful of EHR vendors but also populated with literally thousands of disparate systems, can't maintain status quo forever. Mergers, acquisitions, consolidations and bankruptcies, though seldom mentioned, are nonetheless inevitable.

This belief exists in spite of the government's meaningful use incentive program, which gives hospitals and eligible healthcare providers money if they can demonstrate that they are using an EHR system - and which, some say, has created artificial demand for EHR software and thrown less-than-stellar systems a much-needed life preserver.

Stage 1 of meaningful use, which began in 2011, was a "low hurdle to get across" for EHR vendors and healthcare providers alike, says John Moore, managing partner of healthcare IT analyst firm Chilmark Research.

Stage 2, which began this year, is much harder, Moore says. There are more clinical quality measures to track and more patient matching and data mapping requirements; vendors must demonstrate interoperability (both creating and pushing records as well as consuming and populating them) with at least one other EHR system built by another vendor, and systems must let patients view, download and transmit their own electronic records.

As a result, EHR vendors are struggling with stage 2 - to the point that only 13 percent of physicians have an EHR that meets stage 2 criteria, according to the Centers for Disease Control and Prevention. Not surprisingly, then, half of physicians think EHR costs outweigh their benefits, according to a survey by cloud EHR vendor Athenahealth, while a RAND Health report says that, "for many physicians, the current state of EHR technology significantly worsens professional satisfaction in multiple ways."

The remedy, RAND Health concludes, is better EHR usability. That, experts say, is where the wheat in the EHR market will be separated from the chaff.

In Most EHR Systems, the Workflow's the Problem
Reports on the tumultuous state of the EHR market have come hard and fast in the last several months. Black Book, which surveyed close to 900 consultants, analysts and managers last summer, suggested that half of EHR vendors won't make it to meaningful use stage 3; those that placed meeting meaningful use criteria before usability will likely suffer the most, Black Book found.

Meanwhile, multiple surveys also released last summer said more than one-third of healthcare providers aren't happy with their EHR systems and want to switch, even if it will cost time, money and efficiency.

Part of the problem, says Dr. Heather Haugen, managing director of The Breakaway Group within Xerox, is that there's a difference between EHR implementation and EHR adoption.


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