EMR Key Differentiators

I’m really interested in trying to differentiate between the 300+ EMR vendors lately. Not to mention understanding what innovations will shape the EMR markets going forward. More on the second subject later. The first one has become even more important to me since tomorrow I plan on launching an e-book on EMR selection. Thus, I was really intrigued by a blog post by Didier Thizy from macadamian entitled, “Electronic Medical Records – 3 Key Differentiators

In the post, he says that he’d stump EMR vendors at HIMSS 10 the following questions:
“With so many major EMR competitors out there, what is your product’s differentiator?” “What makes you stand out from the crowd?”

It’s interesting, because I asked a number of EMR vendors similar questions. Didier offers the following three answers which are NOT EMR differentiators:

  • “Our EMR has been an industry standard for 20 years”
  • “Our EMR is SaaS-based”
  • “Our EMR is CCHIT certified”

He then offers 3 “Real” EMR differentiators:

  • “Our EMR has excellent UI and usability”
  • “Our EMR is designed for a particular specialty”
  • “Our EMR’s technology makes the user’s life easier”

I like his 3 differentiators. I’m going to think about this and allow people to comment and then add some differentiators of my own. However, I think one problem with this list is that you need to also provide a method for measuring these differentiators. It’s easy for every EMR vendor to say that they have great usability. It’s a much harder thing to really make it usable.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, 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, EXPO.health, 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.


  • You are spot-on with your comment about the requirement that they be measurable. Otherwise everyone will be arguing something as nonsensical as how wet is the water.

    Even with the second group of differentiators, one can argue that they are too easily qualified. “Excellence” and “easier” are difficult terms to measure. Stating that an EHR was designed for a specialty may be of no more value than stating a Yugo was designed for the sports car enthusiast.

    I’d look for differentiators along the lines of the following, and then see if they result in business improvements:

    • Our system requires 25 % fewer clicks per process than systems A, B, and C
    • Our system uses 1/3 less screens to enter X than systems A, B, and C
    • Productivity at hospitals H1, H2, and H3, as measured by factors E, F, and G, is up 12%
    • We are able to see an average of 12% more patients since we started using XYZ
    • Rework and errors by our clerical staff is down 8% since we started using XYZ

    These differentiators each translate to measurable increased revenues and decreased costs.

    But, for how long will this matter? The business driver towards EHR seems to be to ameliorate today’s problems. I believe the future of healthcare is not the EHR, HIE & NHIN. The future of healthcare is post-EHR, electronic medical records will be in a cloud, and will be here before the paint on the NHIN has dried.

  • John,
    Interesting to put the attention to the differentiators. However, what about first to have the list of what they all (EMR) should minimally provide?
    The reason? Well I am of the opinion that at the current stage of the EMR developments and public talks, speaking simply on differentiators will possibly support the focus toward the creation of proprietary systems, while the important is to develop “open access” or “interoperable systems” with safe and proved interoperability. Once in place this should allow the creation of differentiations/differentiators on top of that for every new product.

    John I have a question to your note: you said 300 + EMR. Where is this 300+ number coming from?


  • Paul,
    I think that’s an interesting idea. I wonder if we could create some standard measures as you describe, measure them across a number of EMR companies and then provide some interesting feedback on the results. Would be an interesting research project.

  • Marco,
    It’s an interesting concept. However, there are a few problems with that line of thinking. First, is that often you can live without features in an EMR and continue with a paper process while your EMR vendor develops that feature. Certainly there are exceptions to this, but generally you will find this out in a reasonable selection process.

    Plus, from what I’ve found most EMR vendors with any sort of implementation footprint have some way to achieve all of the necessary functions. So, I’d much rather go with an EMR vendor that does my 10 core elements really effectively and may be even missing 1 or 2 things than an EMR vendor that does everything under the sun poorly. I say that because once the EMR vendor who’s done the core well will also do the other things well when they get to them also.

    Then, you make sure you have a good contract in case your EMR selection might have missed something.

  • Differentiators describe how solutions differ in the eyes of the beholder 🙂

    As an example, if your beholder is a clinician, then your differentiators need to address how they improve that person’s efficiency, effectiveness, and / or effort. In my view, a differentiator might sound like, My EMR has an interface that is organized around the clinical interview – this enables clinicians to complete more interviews more thoroughly and more accurately.

  • Interesting thoughts, Paul. To continue your response John, would such a framework tie-in to all the reporting mechanicism described in Stage 1 meaningful use? That would seem to to be a giant pool of information that will (hopefully, eventually) provide an insight into the EHR market.

    This conversation reminds me of the old writer’s adage, “Show, don’t tell.” I expanded a little more on my thoughts over at the blog (http://www.occampm.com/blog/hitech/an-ehr-in-the-hit-haystack/).

  • This is a great blog subject. One challenge I see with the differentiating factors that they don’t usually last that long. We are coming from a very dynamic market where in the past not many EHR packages offered document management as part of their package, and now also everyone supports bar coding or some sort of OCR ability to capture unstructured data to enable data mining from paper based form.
    The keep here is to have a proven comprehensive solution. There has to be some type of baseline functionality/features available. For example: E N/M coding, support for LIONC/SNOMED vocabulary, CPOE, web portal, data interoperability, and few other ones. Once the baseline features are met, then you start reviewing the specific differentiators that will in fact matter to your organization. Some products have features and benefits that are crucial to a community health centers while others might have relevant items for a hospital or a cardiologist.
    My approach is start with a matrix that checks off the MUST Haves, then have a section that will compare products based on what the organization requires, then a final piece would be history of the company, financial health, support models, cost and so forth..
    This is a great subject John!!!

  • My approach is start with a matrix that checks off the MUST Haves,

    Wouldn’t that be what the NPRM does with its meaningful use matrix?

  • Glad you guys like the subject. It’s definitely an art not a science to select the right EMR.

    Your point about differentiating factors constantly evolving is a good one. However, that’s why I think it’s important to select an EMR organization that will continue to innovate and does a good job using the technologies available.

    I agree that Must Haves are important, but after you do that baseline analysis you want to make sure the EMR organization will keep up with the changing technology.

  • Michelle,
    I’d say that the meaningful use matrix gives a baseline of what the government wants from your EMR. That’s very different from what a doctor wants from an EMR.

    For example, I don’t see increased productivity and reimbursement on the NPRM for meaningful use, but every doctor I talk to wants that.

  • An important distinction, true. We all have examples where what Uncle Sam wants doesn’t line up with personal expectations. I suppose, as all have indicated, it really depends on what you want. If your goal is to get HITECH incentives and/or line-up with that mandate, I’d say the MU matix is a good baseline. Even if that’s not your goal, it gives a good reference point for those simply needing a place to start or a comparison for those who already have their own criteria outlined.

  • You need to also take into account when choosing the EMR what all the hardware requirements are, because sometimes those can be hidden costs to the practice. Also, just because the UI mayhave a nice flow to it, doesn’t mean the backend does so when you may request simple changes to the UI it maynot be something the EMR vendor can do with a major rework of the software that can take forever or never happen at all. That is why I think it is important to understand the DB structure behind the EMR software.

  • An excellent point, Kara

    I would like to add another view to the discussion: that of the specialist practices. Their eyes see things specific to their specialty (just as a gp would see to hers). Not only are there differentiators between EMRs, but there are further differentiators between the applied area for the EMR.

    A smooth UI for a GP may not even be relevant to an oncology office (and usually isnt).

  • In the 2009 AAFP EHR User Satisfaction Survey, Praxis EMR was rated Number One in the following categories:

    •Number One in Practicing Higher Quality Medicine

    •Number One in Disease Management

    •Number One in Health Maintenance

    •Number One for Excellence in Training and Support

    In addition, Praxis EMR scored first place among physicians indicating that their EMR had a positive effect on determining their salary.

    Would you consider these “Key Differentiators?”
    See the Praxis EMR demo @ http://www.PRAXISEMR.com
    The only non-template EMR on the market.

  • Thomas,
    Well, if it’s the AAFP survey that I saw, the number of responses was too low to be all that meaningful. However, for sake of argument, let’s say a doctor was looking at an EMR that offered:
    -Higher Quality Medicine
    -Disease Management
    -Health Maintenance
    -Excellence in Training and Supoort
    -Positive Impact on Salary

    I’d say that’s a pretty good differentiator. Of course, most doctors are likely to care most about the last one. The other ones are mostly nice add on benefits.

    Of course, the real challenge is finding a credible way to show that your EMR can meet the above list. If I new a good way to do that, I’d be putting together my own EHR certification to do just that. It’s just much harder than it looks.

    P.S. Praxis isn’t the “only non-template EMR on the market.” There’s a whole variety of new EMR documentation methods coming out that aren’t template based. Plus, I think your process engine (I think that’s what it’s called) could be classified as a template EMR also. Certainly it’s a very interesting variation on templates, but still a derivation of sorts. I’m also not saying if Praxis’ documentation method is good or bad. Just that I don’t agree that it’s “the only non-template EMR on the market.”

  • Notice that we are back speaking in terms of ‘excellence’. I believe my EMR software is excellent and I’m sure other vendors thing highly of their own work. But, like Paul said, we’re just arguing about whose water is the wettest without actual usability/productivity numbers.

    A good number for Praxis might be ‘notes eliminated’. This is a real, measurable scalar that is directly verified by the MD himself… he is literally determining this value by training the neural net.

    But then we’ll be asking which doctors were the laziest. 🙂

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