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A market research published recently by Kalorama Information indicated that currently there is no clear leader in the physician EMR market.   With a market size estimated at $13.8 billion in 2009, it is one of huge interest to all the technology companies.

Here is some key points:

large IT companies such as McKesson, Cerner, Eclypsis and MediTech which had previous service relationships with hospitals is doing fairly well.

Allscripts, Epic, eClinicalworks, athenahealth and NextGen are among the leaders but none of them hold 1/5 of the market share.

This is nascent industry is definitely in need of consolidation.  Don’t be surprise to see mergers start to occur in the next couple years as the  health care technology industry matures.

I saw this article called background: US policy for EHR that attempts to give a background on how the EHR landscape took shape starting from the stimulus dollar to the new standard that is currently being created.

The standards adopted in the IFR cover four main areas: Vocabulary- promotes the creation of a common language and codes to be applied in clinical problems and procedures; Content Exchange- setting guidelines to be followed when sharing information; Transport- for systems and processes which will transport information between healthcare systems; Privacy and Security- authentication and transmission security for safe handling of patient information.

Here is my perspective on each one:

1.  Vocabulary.  The standardization of vocabulary will be the key with the first and foremost the standardization of drug codes.  Currently the government has a generic set of drug codes called RxNorm.  However, RxNorm is rarely mapped in EHR systems.  This will have to change in order to provide better information exchange.

2.  Content Exchange – Currently one of the way to exchange data is the HL7 standard.  As someone who works closely with HL7, it doesn’t exchange data that easily.  In order to facilitate content exchange, there need to be a way to create a master data management.  How do we know one patient in one EHR system is the same as  another patient in another EHR system?

3.  Transports – nothing comment on this one.  However, if we can create an infrastructure like the one Google is currently proposing (100 gig) it will definitely help data exchange and transports.

4.  Privacy and Security – This will be a huge issue.  With the amount of data that can be stored on an external storage these days, it is very easy to get information leaked.

One of the crucial measurement of how successful a web company (e.g. Twitter) is based on service availability.  Companies were often ridiculed when their service when down.  However, if you are implementing an EHR system, think about how crucial service availability is.

Here is a paper from Stratus regarding service availability.  Be sure to check it out!

A study done by SK&A shows a 36.1% EHR adoption rate in U.S. medical offices — a 3.2% increase since the February 2009 version of the study.

I would have expected a much higher adoption rate with the amount of attention that has been put toward EHR.  Hopefully that number will start to raise once the government start releasing the stimulus funding for EHR.

A study released on Wednesday noted that the usage of EHR increased since the passage of the stimulus package.

More than 48% of the people surveyed for IT vendor Practice Fusion said their doctor or specialist stored medical records electronically as oppose to paper charts. Of those patients, more than 45% said their doctor made the switch in the last two years, and more than 14% said the switch occurred in the last six months.
It is reasonable to expect the usage to increase.  However, whether the cost of such implementation is justified is the question.  With health care IT in shortage, the wage will be bid up gradually and that will pressure the cost of running EHR system.

I just saw this article on CMIO regarding how when it comes to EHR adoption, fastest don’t always mean the best.

The push is on for healthcare providers to make the switch to EHRs but it is hard to tell how well these complex health IT systems are being implemented and used, according to a Feb. 3 commentary in the Journal of the American Medical Association.

EHR systems tend to be a lot more complex than your average software due to the fact that it is covering a lot more area.  Doctors and nurses will have to be trained on how to use the software in addition to IT support needed for maintenance.  I agree there are benefits of an EHR system but it will definitely take awhile before it is integrated into the daily health care world.

Even though the American Recovery and Reinvestment Act (ARRA) included funding allocation for the implementation of EHR systems, it is not until now the money is starting to be distributed.

According to Centers for Medicare & Medicaid Services four states have been approved for the following matching funds.

• Kentucky: $2.6 million;
• Wisconsin: $1.37 million;
• Alaska: $900,000; and
• South Carolina: $1.48 million.

This will be an exciting and turbulent year for EHR companies and hospitals.