EHRs and Data Exchange

The health care marketplace has changed dramatically over the past few years, and EMR systems are evolving to keep up with current industry needs. Policy changes and competition have driven significant consolidation, and many hospital systems own practices now.

The outpatient clinic has become the pipeline for patients. Much of the payment model innovations center around the outpatient care, and thus the clinic has become a center of attention. This has worked well for electronic health records vendors that support a integration record of care spanning inpatient and ambulatory environments, as well as enabling sharing within the community of providers and other health care partners.

The single, longitudinal record has been a major selling point for systems like Epic, and have helped these integrated systems dominate in competitive sales situations. This raises the question of viability of ambulatory-only systems like athenahealth and GE Centricity EMR. Also, it has driven companies like Meditech to work fast on an ambulatory product to bundle with their HIS system. Health care is an evolving industry and it can be a lot of work to be a vendor in this marketplace. Constantly changing requirements and new policies ensure a lot of work for vendors to stay relevant and viable for current and future customers.

CIOs and CMIOs have a different set of criteria than they did coming to the table 10 years ago. Now, interoperability and integration are key needs and often the very drivers for the system changing technology in the first place. Interfaces can be put in place for some data exchange, but this isn’t always the solution. While data can be transferred, it doesn’t ensure the type of real-time information that an integrated record provides.
The EHR and HIS markets have boomed over the past five years, and a clear winner is Epic of Wisconsin. The owner is now reportedly a billionaire, and the company continues to win hospitals across the nation away from their top competitors.

There’s no sign that their growth is slowing soon. Even while HIS adaption may slow, Epic still has many hospitals to win away from competitors, and many mechanisms to do this. One of the major selling points is an integrated system that works across the outpatient clinics and inpatient hospital departments. While they don’t have every module perfect or ideal, they have become the safe choice for hospital systems looking to carefully move to an integrated system. While the database technology is ancient by IT standards, it continues to be the choice for hospitals that can afford it. Affordability is a key concern; hospitals have frequently ran into cost increases during the Epic implementation. The health care system purchasing Epic has to be prepared for a cost that will run far above the initial investment.

Leading competitors are looking for niches that they can win and protect against Epic. This would most apparently be the small hospital market, where Epic will not allow them to purchase their software through the vendor. Instead, these hospitals can be purchase through area health systems that are larger and would then operate the environment and offer it’s use out to the small hospital. This isn’t always appealing, as many small facilities may prefer to keep some control of their system, and not align so closely with a system that may even be a competitor.