Meaningful Use EHR Breakout by Percentage

I’ve seen a bunch of different websites listing the top 10 EHR vendors based on physicians who attested to meaningful use using their EHR software. This list is certainly interesting and worthy of a discussion. However, I think it’s also important to put these numbers in some context. Remember that these numbers are just for the ambulatory EHR space. The Hospital EHR numbers are a different story which I’ll probably cover on Hospital EMR and EHR.

Here are the EHR incentive numbers by EHR vendor and also the percentage of meaningful use attestations they had (Thanks to Dr. Rowley for the numbers):

EHR Vendor MU Attestations Percentage
Epic 11075 23%
Allscripts 5743 12%
eCW 4057 8%
NextGen 2237 5%
GE 2002 4%
Athena 1733 4%
Greenway 1650 3%
Cerner 1375 3%
MEDENT (Previously Community Computer Service) 1264 3%
e-MDs 1235 3%
Practice Fusion 1156 2%
Sage 1140 2%
Other EHRs (272) 14358 29%

As Dr. Rowley points out in his post, Epic is the largest vendor on the list, but they don’t market or sale their product to independent clinics or even independent physician groups. Epic’s ambulatory EHR is found in owned or affiliated clinics who use the ambulatory piece of the EHR an Epic hospital buys. So, the above Epic number actually provides an insight into how many ambulatory practices are associated with Epic using hospitals.

The numbers tell an interesting story if you take Epic out of the mix:

EHR Vendor MU Attestations Percentage
Allscripts 5743 15%
eCW 4057 11%
NextGen 2237 6%
GE 2002 5%
Athena 1733 5%
Greenway 1650 4%
Cerner 1375 4%
MEDENT (Previously Community Computer Service) 1264 3%
e-MDs 1235 3%
Practice Fusion 1156 3%
Sage 1140 3%
Other EHRs (272) 14358 38%

Once you take out the hospital dominance in the ambulatory market, the EHR market share for any one EHR vendor is quite small. In fact, the other EHR vendor category has 38% of the EHR market. The long tail of EHR software is definitely at play right now.

Plus, we have to be really careful using meaningful use attestation as a proxy for the EHR market. I recently saw a figure that only 20% of the ambulatory EHR market had attested to meaningful use. That’s right, the above numbers only represent 20% of the ambulatory market.

If my math is correct, that still leaves almost 200,000 providers that aren’t represented in the above analysis of 50k providers. Imagine an EHR vendor comes along that’s so great that they quickly capture only 20% of the 200,000 uncounted providers (no small feat). That would give them about 40,000 providers and using the above numbers they would have 45% of the EHR market (including Epic).

Of course, the current EHR vendors will continue to sale EHR software and many will switch EHR software vendors during that time as well. Plus, no doubt many of those who haven’t attested to meaningful use already have an EHR, but aren’t represented in the numbers above. They just either don’t care about meaningful use and EHR incentive money or they’re still working to get to the point where they can attest to meaningful use. However, I still think the above numbers illustrate that there’s plenty of opportunity available for an upstart EHR company to get plenty of EHR market share.

It’s going to be an exciting next couple years as we watch all of this shake out. We’ll take a look back at this post in a few years to see how far we’ve come.

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.

12 Comments

  • Here’s another observation on the ambulatory EHR market. If you look at all the Certified complete EHRs on the CMS CHPL list, and compare that to the HHS Meaningful Use list from data.gov, you will see that 284 vendors had products that were used (at least once) for MU attestion; however 295 additional vendors had NO usage of their products for MU attestation in 2011. More argument to a very crowded field, and lots of products in the market with perhaps no usage (or, at least, no Meaningful Usage).

  • Great observation. That’s quite astounding. I’m going to highlight your comment on my other blog. Add in those that aren’t even complete EHR certified yet and we’re definitely in for EHR consolidation. Although, I still don’t think it will be consolidated as narrow as many suggest.

  • John,

    This breakdown is by vendor, not by individual EHR product. If we break the numbers down by product, we see that eCW is the actual leader (if we omit Epic), with Allscripts Professional EHR coming in second, followed by NextGen Ambulatory EHR. I am an eCW user and an avid supporter, which makes these numbers even more exciting.

  • Let me suggest another view if you are capable of providing it; by region. My reason is simple; I’m one of many preparing to enter the field. I know there are pile of vendors, and I realize that no matter how well I know the concepts, if I don’t know a given vendor then I won’t get onto a project for it. So it seems to me – from a purely selfish view, that I need to know which systems to try for training in. Rumor has it that where I live – Long Island, that Epic is king in hospitals, and hospitals here tend to have very large affiliated practices, so that if I want to be employable, I might need to know Epic. But that’s just a rumor.

  • Sidney,
    If you look at the numbers certain ways you could say that this is the list of top EHR non-innovators. It’s not a perfect match, but one could make an argument for it being a possibility.

    R Troy,
    I’d love to do it by region. As I’ve learned more about the health IT software market I realize that it’s very regionalized.

    I expect in Long Island every EHR vendor is represented. You have such a high density of people and doctors. I bet Epic just gets a large portion of the coverage. You might ask the people at the New York e-Health collaborative. They work in NY and would likely have a good idea of the dominant players.

  • One of our instructors in the HealthIT program plans to get EPIC instructor certification, though I don’t know how that will translate to us getting trained in it. But my guess is that without being certified in a product like EPIC that we won’t get work implementing it, which would make the whole HealthIT training and cert process nearly worthless. So it is important that somehow I learn EPIC.

    As to other vendors, I’m also interested in doctor’s offices, especially small to medium size. LIke an allergist I know; one doctor, few if any Medicare or Medicade patients, no legal need to do EHR except maybe eprescribe. She’s worried about privacy, cost and difficulty, does not want to have to worry about servers, backups, etc. Fed law making the clinician responsible for backups and security may be a huge problem for such practices (indemnity clauses not withstanding). She MIGHT do well with a product like PracticeFusion (paying for it might get her some indemnity clauses).

    I’m also interested in large practices attached to hospitals. It would be good if they had a system closely connected to their hospitals, which might mean EPIC.

  • R Troy,
    You’re right that if you want to work on Epic, you need Epic experience/certification. Although, I don’t know why you’d want to pidgeon hole yourself into Epic. Reminds me of a guy I know quite well who is still doing some Epic work but hates it. He says, “I just get paid so well to do it that I don’t know how to get out.”

    Considering the size of NY, I can’t imagine that epic is the only game in town.

  • I don’t want to be locked into something, its just that once I finish the HealthIT training I’d really like to work in it; I haven’t worked in over 2 years. I’ve got this expectation that I’ll get through all this and still hear the old; we can’t hire you either because you have not been working, you haven’t worked on our xyz system and have not been certified in it, etc.

  • You’re right. So, why not go now to your dream job and ask if you can volunteer for them while you’re taking the classes? You’ll get some experience you can add to a resume and they’ll see first hand that they should hire you.

    It’s definitely worth the effort to kick, scratch and claw until you can find a way for them to let you get some experience.

  • My dream job? Right now being employed doing something useful. I have no idea who is doing what around me, no industry contacts, nothing. And from what people are telling me (ones who’ve gone through the same exact training) even getting some unnamed certification doesn’t actually lead to anything.

  • Well, then start going to every healthcare provider you know asking if you can work and get experience even for free.

    The sad thing is that you shouldn’t have to do it. The community colleges should have a bunch of programs like that in place so you could get experience, but I digress.

  • No disagreement.

    BTW, I had gone to a couple job fairs where the biggest hospital group in the area was recruiting. Every recruiter was a nurse, and they would not even look at someone’s resume, let alone pass it on. The only way to apply is via their web site, but they automatically reject any resume that doesn’t have exactly what they are looking for. Of course, it takes them a long time to find someone whose resume fully fits – and is not lying.

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