Expect an Upcoming Shake-up of Health IT Vendors in the Marketplace

Medical Economics just published their report listing the "The Top 100 EHR Companies in 2013".  It makes for very interesting reading. According to the report, best estimates by the government currently show over 700 companies that now offer 'certified' electronic health record (EHR) systems to healthcare providers. These companies range from publically-traded software companies to start-up enterprises - and everything in between.

The future viability of these vendors and their EHR systems has become an issue of increasing importance to large healthcare provider organizations, as well as family practices and small physician offices. Many industry experts believe the next phase of the EHR evolution will result in consolidation of the market, with many of these vendors going away as they go under or are acquired by larger companies.

The editors of Medical Economics thought it necessary to take a closer look at the financial health of companies operating in this sector, especially as we move towards 2014 and Stage 2 of the government’s EHR Meaningful Use program. That's when we should start to see consolidation in the market. Industry experts are starting to advise that physicians should have contingency plans in place, especially related to migrating patient data, in case their current HIT vendor goes away.

The Medical Economics list of "Top 100 EHR Companies" is sorted principally by company revenue. It is generally understood that over the next 5 years the HIT marketplace will see significant consolidations and/or closure amongst many of the weaker EHR companies. Thus, it is felt that monitoring the financial health of these companies is of ever greater importance to healthcare provider.

Medical Economics editorial staff pulled together data on over 700 vendors of EHR systems using a variety of sources, including data from the U.S. Department of Health and Human Services (HHS). This was then supplemented by a survey, interviews, follow-up calls and reviews of annual revenue reports and other publically available data sources. They then produced their list of "Top 100 EHR Companies" in 2013.

The following is a table showing the top 20 companies based on revenue. These top 20 companies have revenue levels in excess of $200 million.

1. Cerner
2. Epic
3. Allscripts
4. NextGen
5. Athenahealth
6. GE Healthcare
7. eClinicalWorks
8. McKesson
9. Abraxas
10. Vitera Healthcare
11. CPSI Systems
12. Practice Fusion
13. Greenway
14. Patinum Systems
15. Optum (Picis)
16. CompuGroup
17. T-System
18. Meditab
19. CureMD
20. Praxis EMR

In the meantime, in the non-proprietary or 'open source' health IT space, groups of companies have emerged around several major EHR solutions, e.g. VistA, OpenEMR, OpenMRS, OSCAR. The VistA System, or one of its variants, is ideal for hospitals or large organizations with composed of hospitals, nursing homes, outpatient clinics, and small practices. It is being used by over 2000 healthcare facilities across the U.S. and around the world.  See VistA rivals Epic and Cerner in major deployments of EHR systems

In addition, it has been estimated that there are more than 5,000 installations of OpenEMR in physician offices and other small healthcare facilities across the U.S. serving more than 30 million patients. As of 2012, OpenMRS was in use at over 100 facilities in more than 30 countries and had been used to record over 2 million patient records around the world.

As usual, these 'open source' EHR alternatives were not mentioned. One of the strengths of these EHR systems is that a growing number of companies support these products. If one of the companies goes away, there are usually several others waiting in the wings ready to step in and provide support. In addition, a robust global community collaborates on continually enhancing the systems.