Another Example Why Small EHR Companies Face Tough Challenges

No doubt many small EHR companies have been looking at themselves in the mirror long and hard and asking themselves how they’re going to survive this rough market. Not only did the HITECH act slow purchasing of EHR systems, but between “certified EHR” and “meaningful use” many are questioning where the small EHR vendor will fit into the EHR market.

I could (and probably will at some point) expound on each of the topics above, but I think that EHR vendors have an even more difficult challenge on their hands. The challenge comes in the form of incredibly large number of marketing dollars and splashy partnerships.

Here’s just one simple example of what I’m talking about. It was just announced that HEALTHeLINK, The Western New York Clinical Information Exchange, now has formal agreements in place with Allscripts, eClinicalWorks, McKesson, MedAppz, NextGen Healthcare Information Systems and Pulse Systems. [Hailing out of Buffalo, I’d love to meet up with the people at HEALTHeLINK sometime when I’m visiting family in the area.]

I’m not sure how much of an impact this particular partnership will have on EHR adoption in upstate New York. However, that’s not really my point. My point is that this is just one small example of a partnership that the “big boy” EHR companies are going to use to market their product. Consider that the marketing budget for these large EHR companies is quite possibly larger than some smaller EHR companies entire budgets. That’s pretty formidable.

I’m not saying that small EHR companies should close their doors and stop competing. In fact, I hope just the opposite happens. I’m all for innovation and the most innovative products usually come from small companies who have to be innovative to survive. I’m just saying that these small EHR companies better come ready to fight. It’s not going to be a pretty couple months in the EHR industry. Only the strong will survive.

Of course, all is not lost for small EHR vendors that survive. Assuming EHR implementation failure rates continue at their current dismal rates, then there will be a tremendous opportunity for a number of companies to take care of those who fail to implement unusable EHR systems.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference,, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • Hey John, I can appreciate your point that the “Big Box” solutions form strategic alliances that exclude smaller players, but I suggest that in several key areas there really is no difference between Big and Small Vendors.
    1) Physicians buy the systems they “like” – And many smaller vendors have sold and continue to sell systems. If there were difference between Big and Small Vendors, then you would not see sales split across the groups. To your point the mega bucks spent on splashy marketing will generate more sales but at what cost?
    2) Competition, Consolidation and Survival – Both Big and Small companies have been and will be consolidated. Both Big and Small vendors are competing for the same business. Both Big and Small companies are struggling to survive. It’s all the same, just at a different scale.

    There are differences that are significant here are a few:
    1) Speed of Change – Small companies can change fast, Big companies can’t instead they divest like GE Divested the Advantage program. This is a HUGE benefit to survival where the small companies have an advantage.
    2) Customization – Small companies are more like to accommodate customization request more quickly than larger companies.

    The Real issue is that physicians have lost control of their practices because their EHR now controls their workflow and their cash flow and they don’t like it one little bit. Ultimately the surviving EHR systems are going to be much more simple solutions that actually restore the control of the practice back to the Physician.

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