IDC: EMRs/EHR market to hit 80% saturation in U.S. by 2016
Written by Luke Gale, November 28, 2011
The market for EHRs/EMRs will presumably expand as more healthcare organizations, encouraged by financial incentives included in American Recovery and Reinvestment Act (ARRA), adopt the technology. Research from IDC Health Insights estimates an adoption rate of more than 80 percent by 2016, up from less than 25 percent in 2009, and predicts a competitive EHR/EMR market that values vendors’ responses to providers’ needs.
“With over 150 vendors currently offering Office of the National Coordinator for Health IT (ONC)-certified technologies for meaningful use, EMR/EHR buyers face an overabundance of options,” said research director Judy Hanover, of Framingham, Mass.-based IDC Health Insights.
The market researcher’s recent report, "IDC MarketScape: U.S. Ambulatory EMR/EHR for Midsize and Large Practices 2011 Vendor Assessment," predicted that successful EMR/EHR vendors will be defined by their ability to provide quality customer support services, create products with a wide range of functionality perceivable to users, demonstrate financial sustainability and build devices interoperable with other technology.
The report identified midsize and large ambulatory practices, or those with more than 20 providers, as healthcare organizations that are particularly poised to benefit from EMR/EHR adoption.
“Large practices also see economies of scale that accrue with process efficiencies upon EMR/EHR introduction as improvements to charge capture, documentation and billing practices enhance revenue for the practice, driving return on investment,” researchers wrote.
IDC researchers cautioned EMR/EHR buyers against rushed purchasing decisions, suggesting that they consider barriers to EMR/EHR implementation that include cost, clinician acceptance, potential workflow disruption and incompatibility with technologies currently in use.
Additionally, the report advised EMR/EHR buyers to consider usability when selecting a product, but concluded that healthcare organizations also implement staff-wide planning and training processes to ease the transition. http://www.cmio.net/index.php?option=com_articles&view=article&id=30649
In our last two posts, we have discussed the first five important questions to ask your current or potential EHR vendor. Today, we wrap up the series with the last few questions to consider.
6. How do you balance innovation, client needs and regulatory changes in your product?
Purchasing a software solution can be a substantial investment for any organization. Looking at the software provider’s ability to continue meeting organizational needs into the future will help ensure the investment has long-term value. Looking at the details behind the percent of staff or resources a software provider allocates to product development is an ideal way to gauge the likelihood the solution will keep the value. Further delving into exactly how a vendor addresses ongoing regulatory changes while also delivering continued product innovation will help as well. Asking about a recent regulatory change the industry has seen and how a vendor handled it is a perfect way to bring up the topic.
7. How do you assist novice or entry level users in becoming proficient quickly with the system?
Navigation is the one major issue new users face when trying to become proficient in a system. Asking a vendor how they address this key barrier is important. While training and reference materials are important, system interface and other tools can also assist with this need. Properly designed systems will create tools that allow a user to do nothing more than choose a process they want to complete within the system. If the system is designed appropriately, the solution should automatically navigate the user through the steps of the process they are completing and prompt them for the documentation or action needed.
8. What tools are available to the client to make system adjustments after implementation?
Even with proper detailed discovery, organizations will continue to grow and their needs will change with this growth. While a system can be designed with the intent to meet the needs of an organization at a specific point in time, no one can predict the exact future needs of a provider. To help ensure the solution will work in the long-term, investigate what tools and options are provided to make adjustments or changes in the future. If it is determined changes to forms or workflow within the system takes significant interaction from the vendor, budget expectations should be set with executive management to plan for these types of future needs. The ideal scenario is to find a product that provides clients the ability to make these types of changes with little to no vendor interaction.
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8 Things to Ask Your Vendor
The process of selecting an appropriate software solution for long-term, home care, or rehab providers can be challenging. Evaluating system functionality is an important aspect in choosing the appropriate software for your organization. Evaluating your prospective vendor’s preparedness to address ongoing changes to industry regulations, the rapid pace of innovation, and an established goal of 2014 for EHR should be of equal importance in the selection process.
The evaluation of a potential partner’s ability to address these types of issues doesn’t have to be complicated. Asking the appropriate questions of your vendor candidates will help determine their focus and readiness for the issues facing long-term and post-acute care in today’s market. Eight questions are provided below that should always be asked of a potential software partner in an effort to determine their readiness to handle the future. These questions can serve as discussion points between care providers and vendors to ensure a like-minded approach to the issues facing long-term and post-acute care.
1. How will you support our organization if we want to be part of an ACO (Accountable Care Organization) or HIE (Health Information Exchange)?
As part of the Medicare Shared Savings Program, ACO’s are a required component made available within the healthcare market. ACO’s are voluntarily established entities that must service a minimum population of 5,000 people. They are made up of multiple care entity types that work together to care for the outlined population. ACO’s will receive and distribute shared savings from the combined approach and focus on quality care. Additionally, they will share in repayment of any losses incurred from serving the population. Sixty-five quality measures are in place to determine the savings or losses each ACO will create. These quality measures will determine whether the ACO has to reimburse losses or enjoy the benefits of creating savings.
Software solutions will play a crucial role for organizations electing to participate in ACO’s. More specifically, participation in a HIE will be at the center of this role. As individuals move through the care continuum, each organization’s software will need to have the ability to share information across care settings and with participants in the ACO. The following capabilities should be provided by the software vendor in support of ACO participation:
2. What steps are you taking to ensure your solution meets industry standards for a certified EHR?
- Continuity of Care Document (CCD) for transfer of care
- Ability to feed an ACO-wide EHR or HIE
- Support and utilization of an ACO Master Patient Index (MPI) for the population
- Ability to produce Quality Measures data as required
- Tracking and reporting on cost and utilization data
With the growth of information technology in healthcare, the need for solution accreditation has grown as well. Recently, the Certification Commission for Health Information Technology (CCHIT) has expanded its focus beyond acute care EHR solutions to include long-term and post-acute care EHR certification. Various solutions within the industry are considered EHRs; however, CCHIT certification standards now exist to provide validity to these EHR functionality claims.
Discussing details with EHR vendors regarding their certification plans is important. Certification of an EHR by CCHIT standards ensures more than 400 criteria are met. Certification serves as a starting point for any solution claiming to be an EHR. This can save organizations time and resources to investigate systems for these critical components allowing providers to focus on analysis of the solution in other areas.
Come back next week to see what other questions you need to ask.
From HIMSS NEWS:
EHR vendor selection can be a complex and time-consuming task. Choosing the right EHR system is an important decision, which should be planned in advance. This guide has been created to save time researching vendor selection by providing resources to begin the search for an EHR.
Step 1: EHR Planning
- Decide between Application Service Provider (ASP) module and locally hosted EHR solution.
- Locally hosted EHR solutions are purchased through licensing agreements and generally stored in-house hardware and servers.
- ASP (SaaS or cloud modules hosted via the internet) are generally cheaper compared to the locally hosted module, which may require purchasing new hardware.
- Set a migration path for the EHR, useful for organizations that want to illustrate the overview of the EHR and how the EHR system will be developed.
Step 2: Set Goals That Can Be Achievable Through EHR Benefits
- Review the organization’s current goals and objectives to determine the EHR benefits to be achieved. The organization’s vision of the EHR must be articulated and strategically planned.
- Outline the scope and functional needs to achieve anticipated benefits from the EHR. Every organization is different and has different functional specifications (laboratory, e-prescribing or imaging capabilities)
- Review the practice’s key workflows. How does your practice currently create and maintain documentation within the medical record? Does the software work with your practice management system? The American Medical Association has a helpful resource on this topic: “15 questions to ask before signing an EMR/EHR agreement.”
- Create a matrix to compare EHR functions to benefits. A matrix is useful for vendor evaluation as it helps prioritize key functionalities and guides the decision making process.
Step 3: Compare EHR Vendor Products
- “Best-fit” vs. “Best-of-breed” EHR software
- “Best-fit” refers to a single EHR product providing a comprehensive integrated solution (practice management system and documentation available through one type of software).
- “Best-of-breed” refers to products selected from various vendors, which may not be interoperable with other software (separate software solutions for the operational and administrative functions).
- Research the EHR
- Is the software ONC-ATCB Certified? ONC-certified EHR technology has the capabilities necessary to support objectives of meaningful use and qualifies providers for incentives under the HITECH Act. Be sure to check the product version number and certification expiration. There are currently over 500 certified products; browse the ONC database to find more details about product capabilities.
- KLAS Research (provides reviews and reports on vendors)
- Black Book Rankings (market research firm ranks the top EHR vendors)
- Create a shortlist of 2-5 vendors with possible fits to the practice’s criteria.
Step 4: Request for Proposal
- Develop a written RFP based upon the requirements.
- Send the RFP to selected vendors asking them to provide an EHR proposal.
- Evaluate proposals by EHR functionality to meet organizational needs.
Step 5: Vendor Selection and Contract Negotiation
- Request a demo of the top 2-5 EHR vendors. If possible, request a usability test with test scenarios (i.e. “35-year-old Caucasian female with history of diabetes and hypertension).
- Make the final decision.
- Contract negotiation should include all details related to the services required, including any ongoing maintenance.
A typical medication pass in Long Term Care usually exceeds 2 hours.1 Nursing home residents take an average of 8.8 medications per day, and 32% take 9 or more medications.2
If a medication nurse is caring for an average of 30 residents and conducting two medication passes there is a potential to deliver and administer up to 400 medications per shift. Reducing the amount of time that a nurse requires to pass meds will conversely increase the amount of time that can be spent with a resident. The more time that is spent with a resident, the earlier problems and concerns are identified and appropriate interventions can be implemented.
How can medication nurses reduce time to pass meds? They can do so by looking for a solution that provides the following:
- Ability to easily access information
- Easily train staff and agency staff to utilize
- Identify date/time and meds and treatments due by Resident for a Time Frame such as First Shift
- Easily read with no illegible handwriting
- Easily identify what meds and treatments are Scheduled, Due or Past Due
- Minimal ‘clicks’ to document administration of meds and treatments
- Automatically remind staff of PRN follow ups
- View upcoming medications and treatments
- Administrations documented on a MAR should store in the electronic record
- Real time documentation of meds and treatments
Order Management or eMAR/eTAR should be designed to reduce the amount of time required for med passes. Nurse Managers are often the first to appreciate the ramifications of improved safety measures at the bedside, and are the first to recommend point-of-care technology for medication administration. If nursing finds a system with a device that they find effective and easy to use while allowing for more time with residents, they will become one of the most vocal champions for implementation.3
Tools like the HealthMEDX Vision eMAR/eTAR solution provide an easy to use point of care collection and administration method. While decreasing the amount of time required for a med pass and having an effective and easy to use point of care system is paramount in choosing and implementing an eMAR/eTAR solution, HealthMEDX Vision can deliver so much more in addition.
1Anals of LTC 10/1/2006 2Doshi JA, Shaffer T, Briesacher BA. National estimates of medications use in nursing homes: Findings from the 1997 Medicare current beneficiary survey and the 1996 medical expenditure survey. J Am Geriatr Soc 2005;53:438-443. 3Patient Safety and Quality of Healthcare; May/June 2007; Point of Care Error Prevention, Best Practices in Action; David Swenson RPh