EHR Company Funding Risks – Positive Cash Flow EHR Companies

This is the third post in my EHR Company Funding Risks series that was started in response to my original post about the The Current Health IT & EHR Bubble. In this series, we’re looking at the following EHR company categories: Seed Funded, Well Funded, Positive Cash Flow, Large EHR Company, and Large Company Backed EHR. Next up is Cash Flow Positive EHR companies.

Positive Cash Flow EHR Companies
This type of EHR company is usually a conservatively funded EHR company (often through non traditional funding mechanisms, or through a private buy out) that have grown large enough that their current user base provides enough cash flow to cover the EHR company’s ongoing expenses. The majority of these EHR companies have been around for a long time. In most cases they started out as EHR only companies (since everyone already had a PM system) and over time were able to grow a large EHR user base.

Instead of going after a large funding round, these EHR companies stayed small and chose to grow slow and steady over time. At this point, most of these companies have a large enough user base and enough cash flow that they’re in it for the long haul. While a sale could happen, most are content to continue growing the way they’ve done for a long time.

The users of these systems are usually happy with the software. Plus, they’ve often been using it so long that the idea of switching is something they wouldn’t even entertain. Even if the EHR software has some issues, the practices know the problems and have found ways to work around them. Plus, I’ve heard from many about the kinship they have with the EHR software that they’ve had for so long.

The real question for these EHR companies is how well they’ll be able to retain their existing EHR user base and/or how well can they acquire new EHR users. At some point if they aren’t maintaining or growing their EHR user base, they won’t have the cash flow needed to continually improve the EHR system with changing technology and clinical requirements. Plus, considering the fast pace of technology, time and their legacy software creation starts to catch up with them.

Many of the best specialty specific EHR companies have been able to reach this category. Some are still in the seed funded or well funded categories, but most of the specialty specific EHR companies I’ve seen have reached the cash flow positive category or are really close to getting there. Most of them realized that they had a very specific EHR market and so they had to grow it slow, steady and focus on revenues early.

Next up, we’ll look at Large EHR Companies. Read all the posts in the EHR Company Funding Risks series.

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.


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