I’ve been thinking a lot about the EMR implementation market lately. Looking at the market, you see a lot of mixed signals about what’s happening. Take for example a comment that was recently shared on the HIStalk blog:
“Re: KLAS doing research on consulting firms. We had been ranked by KLAS for multiple years, but we’re no longer ranked in our category and KLAS can’t get us back up to the minimum number. Our category used to have 35-40 consulting firms ranked and now there are only 11.”
We’ll leave the specific comments about KLAS alone for now, but know that we’ve talked about how you do well in KLAS rankings and how you ensure you get a high number of ratings so you’re ranked in our healthcare marketing community. This piece aside, it’s kind of astounding to think that where they’re used to be 35-40 EHR consulting firms there are now only 11. That’s quite amazing attrition for a section of the market that was so hot for many years.
Certainly there are a lot of obvious reasons why we’ve seen the EHR consulting market contract in such a big way. The most obvious is the end of the $36 billion of EHR stimulus money which created a false market. Now that the money has run out, the market has contracted back to what it probably should be. The second is that there’s been quite a bit of consolidation in the EHR consulting marketplace. That said, I think we’ve seen more consulting companies dwindle than we have seen them get snatched up.
If you go to any of the major conferences, you see the same contraction by EHR consulting companies. Many that have massive booths now have 10x10s with no one in them. Some of this contraction has happened because they’re spending their money elsewhere. However, no doubt much of the contraction is due to a decrease in EHR implementation business.
Going back to the original comment about so many consulting companies not being listed by KLAS anymore. Some of this also has to do with how KLAS ranks vendors. They’ll only rank you if they can talk to enough of your customers. This was easy when you were doing 50 implementations. If you’re only doing 5 implementations, it’s much harder to get your customers to review you. Along with the other reasons mentioned, this has likely caused KLAS’ list to decrease as.
In a recent tweet, David Chou offered this alternative perspective to the EHR implementation market:
I am working with many health systems that are replacing their @Cerner systems with Epic. Looks like the EMR implementation is still going.
— David Chou (@dchou1107) June 24, 2019
I think the point David Chou is making is that most of the EHR market has shifted to a replacement market. This still presents an opportunity for EHR consultants, but it’s quite a different experience. This is particularly true since many of the replacements I see happening are when a Cerner organization acquires an Epic organization and vice versa. In this type of acquisition, the acquiring organization already has expertise in the replacement EHR and so there’s less need for outside services. Plus, just because replacements are happening doesn’t mean it’s anything like the volume of EHR implementation we had during what I called the Golden Age of EHR (ie. Government Funded adoption).
I do see some interesting pockets of replacement. For example, it seems like there are quite a few MEDITECH users that are upgrading to the new MEDITECH Expanse platform. While this is technically an upgrade from one MEDITECH EHR to another, from a practical standpoint it’s closer to a replacement EHR than a real upgrade since it’s a move to all new software. I see a number of MEDITECH consultants capitalizing on this opportunity.
I guess the moral of the story here is that EHR implementations are still happening but largely in a replacement market as opposed to a new EHR implementation market. That’s a very big difference and explains at least some of the contraction in the EHR consulting market. However, there are still pockets of opportunities out there. It also explains why most EHR consulting companies have looked at doing some type of other service including: analytics, help desk, etc.
What’s your take on the EHR implementation market? What are you seeing happening? Are there still opportunities or is that area of the market dead?