Specialty EMR Market Still Lagging Behind

This week, I got an announcement from a specialty EMR vendor which seems to be getting decent traction in its market. The company, Health IT Services Group, announced that its Acumen nEHR system for nephrologists had just passed the 1,000-customer mark.

According to the company, Acumen is the only nephrology-specific EHR that is certified by CCHIT and ONC-ATCB.  The company also operates one of the largest CMS-qualified reporting services for doctors participating in the Physician Quality Reporting System, a benefit other specialty EMRs may not offer.

All that being said, the most recent estimate I could find concluded that there were about 8,300 nephrologists in the U.S. as of 2010. So while Acumen’s performance may be impressive — a 12 percent share of your market is always a good sign — there’s a ton of nephrologists who aren’t logged on.

Those who are using other EMRs probably aren’t getting a specialized product. My Web research suggests that most EMRs pitched to nephrologists were built for general medical needs, beefed up with a few templates addressing their clinical issues.

My guess is that most specialties are in a similar position — that they can choose from one or two specialty EMR products or go with a general EMR vendor which has arguably shoehorned a few extra functions into the mix.

Before any vendor reading this gets hot under the collar, bear in mind that I’m not suggesting that companies who don’t specialize solely in a single specialty can’t make a good specialty product.

On the other hand, in all honesty, the scuttlebutt I’ve picked up from Twitter comments, discussion forums and trade pubs (as well as my own interviews) suggests that general EMRs with extra functions/templates just don’t cut it for many specialists.

What all of this says to me is that the market for specialty EMRs has a long way to go before it matures. While most doctors have concluded that EMR adoption is inevitable, many specialists don’t seem to have a broad range of options if they want a system tailored to their needs.  (My sense is that for some reason, the psychiatry EMR market is healthier than most, but I don’t have numbers to back that up, just general observation.)

So, readers, I’m tossing this one out to you. Do you think the EMR market will grow increasingly specialized — as one might expect in other markets  — or will the products made by broad-based EMR vendors become sophisticated enough to really satisfy specialists?

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.


  • I heartily agree with you. I’m a newly graduated Rheumatology fellow, with a strong personal interest in technology and eHealth. From looking at the EHR vendors at our national conferences, the pickings for Rheumatologists is abysmal. For our speciality, our “organ” is the musculoskeletal system, with an emphasis on the joints.

    I’ve yet to find a general large commercial EHR vendor that addresses the needs of our speciality to document the standard 28 joint count without spending 5 minutes just clicking about 100 different boxes to document tenderness, swelling, and deformities.

    I will be working for a private health system that will be adopting a system wide EHR. Increasingly, many of us graduates will be joining health systems instead of going for private practice. This may give some financial stability, but it puts us at the mercy of overly generic EHR systems that are usual bought based on technologic needs from 5 years ago, and often at the lowest price.

    The future looks bleak for specialists and EHR.

  • I work for an ONC-ATCB certified nephrology focused EHR called “Falcon EHR” (www.falconehr.com); Acumen is not the only certified option out there for nephrologists (assuming you don’t care about the additional CCHIT certification; we haven’t heard any providers lamenting the lack of the extraneous CCHIT certification).

    Most Nephrologists will want to consider a nephrology specific system, as they will likely need to take their certified EHR into the dialysis clinic in order to satisfy the “50% rule.” (50% of total patient encounters must be documented in a certified EHR). As such, it is vital to support dialysis rounding activities via templates, provide a comprehensive MCP dashboard, and display pertinent patient data (labs, history, dialysis Rx) from the dialysis clinic.

  • I hope EHRs will eventually become less general and more tailored to meet the needs of specialists. I believe as the author does, that as this technology becomes more popular, specialists will not have to succumb to using general templates- this technology will mature.

  • Like those who have already commented, I believe EHRs will trend toward specialty areas. I work for EMRlogic Systems, a software firm focused solely on eye care. (Our product is activEHR.) From a marketing/sales point of view, I look to understand competitors that emanate from a general medicine background or that are spread into multiple disciplines. In my opinion, they can compete but won’t win long term. They’re either spread too thin or are missing fundamental pieces in the initial design that can’t just be bolted on. This isn’t Lego. There’s too much marketing of toys and fads, too much effort to be all things to all docs. Docs may like i-pads but in the end, I believe, won’t trade that off against content that really works for the specialty they live and breathe every day. If content seems challenging now, wait till we get seriously into Clinical Decision Support in Certification stages 2 and 3.

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