Market consolidation is leading to provider headaches
by Melissa Adams VanHouten and Kate Braschayko
August 14, 2017

For nearly a decade, the $28 billion Electronic Medical Record (EMR) market was on a foreseeable path with roughly 20 similarly-sized competitors and many smaller participants offering software systems and support services. A new report from Kalorama Information says the EMR market is confronting changes that will determine how health care providers operate moving forward. Per the report, the market is consolidating, leading to a decrease in EMR support services and creating issues for providers. To illustrate, here are 11 ways the EMR market is changing:

  1. The EMR systems market has been consolidating for years. While there are hundreds of EMR vendors today, consolidation in the industry has accelerated in recent years. In a meaningful use (MU) attestation in 2012, the top 15 EMR vendors of 336 hospitals surveyed represented 75 percent of all providers attesting. On the inpatient side, this concentration was even more pronounced with the top six representing 75 percent of total hospital attestations.
  2. More recent data reveals further consolidations. Based on the most recent Kalorama report, less than five EMR companies account for more than half of the market share. While the market is still ripe for disruption, this lack of competition can create a vacuum in terms of available EMR support and process integration solutions for institutions.
  3. EMR implementation and usage can impact a provider’s workforce, as noted by the North Carolina Medical Journal. EMR systems include a variety of information technologies that impact workflow, data and personnel. Effective EMR usage often requires the creation of entirely new roles—or the implementation of a shared-services model where core medical personnel perform their work, and other support personnel from a document and information management company such as Novitex, handle the peripheral EMR work.
  4. Consolidation creates an IT support shortage for health care providers. As competition deteriorates, the motivation for EMR vendors to provide end-to-end support does as well. This doesn’t mean that hospitals or clinics are left unsupported—they may just need to look beyond the EMR industry to obtain everything they need. According to HIT Consultant, 82 percent of hospitals surveyed enlist comprehensive outsourced tech support.
  5. Document management and data warehousing isn’t the only EMR process that can be unsupported by vendors. Data entry, document conversion, scanning and adjusting to regulatory conditions all fall outside EMR provider scope. This is where document outsourcers such as Novitex can help address these unattended document management needs.
  6. End-to-End EMR processes support top ad-hoc suppliers. Hospitals are realizing that there are business process support and document outsourcing organizations that can plug these operational gaps for them—often in an end-to-end fashion. This way, one vendor provides the EMR system and another provides all other related support.
  7. One disruptive event on the horizon of the EMR market is blockchain technology. While moving patient data between disparate EMR systems has historically been difficult, blockchain, an innovative transaction ledger tracking technology, can make it easier.
  8. When properly supported, EMR emerges as a workflow enabling partnership with both an EMR provider and an outsourcing support partner; this can unlock new levels of efficiency for providers. By doing so, the EMR workflow is supported by proven processes and procedures that can improve the practice by filling operational gaps in what EMR providers supply.
  9. Value-based policy changes and purchasing are impacting EMR usage. Health care professionals should expect to see value-based care policies increasingly influencing EMR-use standards, and an administration that is likely to reduce EMR regulation and oversight.

  10. The Trump administration has introduced new policy goals. Since the HITECH Act passed in 2009, billions in incentives have been paid to put a national EMR backbone in place. The 2016 ONC report points out the progress so far: 96 percent of hospitals and 78 percent of physicians are using certified EMR technology. This implies the administration is less likely to dismantle this, but more likely to bring in changes that leverage a digital infrastructure.
  11. Dashboarding and other product-related trends are impacting the EMR market, and for many of the reasons described above, the market is coming up short for many end users. As such, vendors are busy implementing user-friendly dashboards, blockchain connectivity and other changes that should give net positive results for providers.

By proactively managing these fundamental EMR market changes and bringing in external help where the market comes up short, hospitals and other providers can successfully navigate market evolutions and create effective, sustainable EMR systems.