Best EHR software providers were analyzed, shortlisted and categorized on a quadrant under Visionary Leaders, Innovators, Dynamic Differentiators, and Emerging Companies. The competitive leadership mapping (Quadrant) showcased provides information for the best EHR software providers. Vendor evaluations are based on two broad categories: Product Maturity and Company Maturity. Each category carries various criteria, based on which vendors have been evaluated.

The evaluation criteria considered under Product Maturity include the breadth of offering, delivery (based on industries that the vendors cater to, deployment models, and subscriptions), features/functionality, delivery, product quality and reliability, and product differentiation.

Visionary leaders are the best EHR software providers in terms of new developments such as product launches, innovative technologies, and the adoption of growth strategies. These players have a broad product offering that caters to most of the regions globally under the EHR Software category. Visionary leaders primarily focus on acquiring the leading market position through their strong financial capabilities and their well-established brand equity. The top EHR vendors categorized as visionary leaders are Epic Systems Corporation, WebPT, Cerner Corporation, Medical Information Technology Inc, eClinicalWorks, NXGN Management LLC, General Electric Company, Practice Fusion, Inc. and Advanced MD, Inc.

Innovators in the quadrant are the Best EHR software providers that have demonstrated substantial product innovations as compared to their competitors. The companies have focused product portfolios. However, they do not have very strong growth strategies for their overall business, when compared with the visionary leaders. Innovators in the best EHR Software quadrant include Allscripts Healthcare LLC, Athenahealth Inc., Greenway Health, LLC, Medhost, and Cantata Health.

Dynamic Differentiators are the top EHR vendors with very strong business strategies. However, they have a weaker product portfolio compared to the visionary leaders. They generally focus only on a specific type of technology related to the product under the EHR Software category. Best EHR software providers categorized as a dynamic differentiator are DrChrono Inc., CentralReach LLC, Intersystems Corporation, Azalea Health, and Therapy Notes LLC.

Emerging companies have a niche product and service offerings. Their business strategies are not as strong as that of the best EHR software providers. The emerging vendors include the new entrants in the market, emerging in terms of product portfolio and geographic reach, and require time to gain significant traction in the market. Emerging companies in the EHR Software space include CureMD Healthcare, Nextech Systems LLC, OfficeAlly Inc, BestNotes, and Welligent, Inc.

What are the types of EHR Software?

EHR software is broadly classified into General EHR’s and Specialty EHR’s.

General EHR's

General EHR’s are designed for use by universal practices. They have all the functions of EHR, such as CPOE, clinical decision support, controlled medical vocabulary, clinical data repository, ordering, and billing. Due to their multi-function, multi-specialty capabilities, these EHRs can be used in various specialties through flexible functioning and incorporated plugins.

Specialty EHR's
Specialty EHR caters to the needs of specialty therapeutic areas such as cardiology, psychology, oncology, dermatology, pain management, orthopedics, and pediatrics. Currently, more than 50–60 different types of medical and surgical specialty EHRs are available in the market. The availability of specialty clinical content can help in reducing the operating time for EHRs and creating comprehensive health records. However, despite these advantages, the adoption of specialty EHRs is lower owing to their higher cost.

What are the benefits of EHR Software?

• Better accessibility and improved communication: It becomes easier and efficient to communicate for multiple departments involved in patient care as the data is digitally stored and managed. The records and details of patient care can even be accessed remotely in case a need arises to do the same.
• Data aggregation, and integration: Data of patient's medical history and present medical process aggregates at one place enabling the practitioners to have access to instant insights and treat the patient more efficiently.
• Reduced Staffing cost: EHR software lower staffing requirements leads to reduced health care costs, it also reduces the scope of human errors. It is because of these benefits that the global EHR market is flourishing.

What are the key features to be considered in a good EHR software?

• Easy Patient Scheduling- A complete EHR should be capable to provide an appointment-setting feature that permits office staff to easily schedule patients, register them and select a reason for their visit. To ensure better collection and smoother functioning and avoid any issues, the EHR should be capable to send automatic appointment reminders via email or text messages.
• e-Prescriptions- e-Prescriptions is one of the important features a good EHR should possess. e-Prescriptions ensure that there is proper co-ordination between Providers and pharmacies to correctly fill the order. e-Prescriptions enable the Providers to electronically write prescriptions and either give a legible printout to the patient or directly send to the patient’s pharmacy of choice. With e-prescriptions, Providers can easily access a protected portal for electronic prescription of controlled substances which is an extremely regulated procedure as per state and Federal requirements.
• Clinical Documentation- Charting is a vital feature of a good EHR. Charting functionality enables physicians to digitally create and store patient’s clinical records and other Different forms of charting can be done depending on the type of input sources like a tablet, Mac book, or desktop. Programmable keyboard shortcuts save charting time, same as flowsheets. Using AI and ML for charting makes it a gold standard. Machine learning helps in automatically store the information based on your records given previously. This makes charting more useful and streamlined.
• Interoperability- Integration is always a must for any software, the same is with EHR. Interoperability is a crucial feature of a good EHR. As EHR is mostly handled by physicians and other medical staff it should be capable to link to all ancillary services offered in a medical industry including, payers, labs, pharmacies, and diagnostics centers. HIS (Hospital Information System) and billing system are common parts of integration. Billing integration enables you to streamline the billing process for your patients as well.
• Cloud hosting- A cloud-based EHR is an accessible, flexible, instinctive, and cost-effective solution for maintaining patient health files in the cloud instead of storing on internal servers located at a medical facility or practice. Data mining capabilities enable administrators to examine work processes for strengths and weaknesses and probe into patient data to identify behavior patterns, potential drug interactions, and health risk factors. EHR software runs on the cloud, hence no installation of hardware or software. With cloud-based EHR, Providers can get a faster return on investment with an implementation process much faster than traditional client-server systems. With bank-level security and advanced encryption, EHR systems can achieve HIPPA compliance through data centers.
• Meaningful Use Certification- The introduction of regulations like Medicare Access CHIP Reauthorization Act of 2015 (MACRA) and the Merit-based Incentive Payment System (MIPS) enable laying out the incentives and penalties. So, the healthcare organizations or physicians must use a certified EHR system to receive positive adjustments and incentives, else face penalties from the authorities.
• Patient Workflow Management- The EHR software understands the order of operations and enables users to save time. Many of the EHR software products provide customizable workflows. For instance, the software enables us to automate reminder emails for appointments and set reminders for phone calls to patients and sending test results.

Current Trends

• EHR/EMR adoption rates are increasing than ever at around 87 percent.
• 35 percent of respondents reported a lack of user-friendliness as the largest problem with their EHR system.
• Experts think that the greatest improvements in EHR will improve user-friendliness, accessibility, regulation, and standardization.
• Big changes like AI and the entrance of tech giants into space are on the horizon for the healthcare industry.

Recent Mergers & Acquisitions in EHR Systems:

• Teche Regional Medical Center (MEDHOST) operations have been acquired by Ochsner Health System (Epic)
• AHMC Healthcare Inc., (Evident) acquired Parkview Community Hospital Medical Center (NTT Data)
• Blair Health System (Meditech) has formally acquired Cerner
• PointClickCare acquires EHR & eMAR Vendor QuickMAR
• eMDs acquires ambulatory EHR Aprima
• Allscripts acquires prescription Platform ZappRx
• CareDx acquires OTTR for $16M
• CentralReach, a provider of EHR and practice management solutions acquires applied behavior analysis therapy software Pathfinder Health Innovations
• NextGen acquired Medfusion for $43M, separates data services business to form Greenlight Health
• Healthcare IT Consulting firm AbleVets has been acquired by Cerner

Future of EHR

• Integrating Artificial Intelligence (AI) and Voice Recognition with EHR- Artificial intelligence (AI) has already shown promise for assisting doctors with making diagnoses or recognizing historical trends about a patient’s condition. However, several companies are investigating bringing AI to EHR via voice recognition capabilities. At Vanderbilt University Medical Center, providers can query the tools by posing questions in natural language. For example, a physician could ask a voice-enabled EHR system for details about a patient’s last recorded iron levels from blood tests. The system would inform the doctor of those levels, plus tell them whether they’re in a healthy range. Allscripts and Northwell Health also recently signed a deal for a platform that blends AI with EHR and collects data from clinicians.
• Ready for the 5G Network- As technology is developing at a huge pace, the widespread rollout of the 5G network is set to happen in early 2020. Many residential areas are updating their infrastructure to newer technology and tests are occurring to check the performance. However, some analysts think the health care industry is not yet ready for 5G technology. Lack of compatibility between the EHR system seems to be a key reason. Hence, the stakeholders should take care and check how the technological developments impact HER and ultimately patient care.
• Integrating the Blockchain into EHR- Many industries are now incorporating blockchains into their solutions, Medical records too, hold huge potential to integrate blockchain. In one of the cases from Brazil with insurer Metlife, a blockchain platform facilitated recording cases of gestational diabetes in pregnant patients by syncing with their EHR information. The patient data then facilitated a smart contract to trigger pay-outs associated with that illness without the need to prove a diagnosis or even file a claim. Blockchain technology for EHR is still in the early stages, but it seems to have huge potential and keeps gaining momentum throughout 2020.

Key Takeaways

For Medical Practices:

• Invest in adequate EHR training while onboarding physicians and bring them up to speed when incremental changes are made
• Enlist physicians to help prioritize EHR development tasks and to design clinical workflows that take advantage of EHR capabilities (e.g., the Sprint team model)
• Tailor the size and makeup of physician development teams, considering the clinical resources available
• Deliver EHR development projects soon after physicians ask for them
• Establish an EHR governance process that gives the clinical organization nimbleness in responding to health emergencies and crisis scenarios
• Make analytics data available to physicians—presented in a way that is intuitive at the point of care
• Shift non-essential EHR data entry to ancillary staff. In the near term, consider increasing the number of medical assistants to act as “digital scribes” (though this option is expensive). In the long term, seek automated solutions to eliminate manual EHR documentation

For Payers:

• EHRs reflect the current fee-for-service payment paradigm. Commit to value-based care and provide adequate support to physicians under this model, including greater reimbursement for preventive care services and the use of digital health to engage patients
• Create common standards for billing and quality reporting across payers
• Streamline pre-authorization procedures
• Make claims data more accessible to physicians to enable a longitudinal view of their patients.

For Technologists:

• Clarify definitions of interoperability— in collaboration with other stakeholder groups—and adopt common technical standards to support them
• Develop systems and product updates in partnership with end-users—less than half of U.S. physicians believe EHR developers are responsive to their feedback
• Develop and market an ecosystem of third-party apps that put patients in control of their own health data
• Focus on eliminating the manual entry of data into the EHR by recruiting AI, natural language processing, and other emerging technologies.

Frequently Asked Questions

• Q: Who are the key stakeholders in the EHR space ?

  A:

  The EMR solutions market comprises several stakeholders such as Healthcare IT service providers, healthcare insurance companies/payers, healthcare institutions (medical groups, physician practices, and outpatient clinics), research and development companies, venture capitalists, Government agencies, corporate entities and market research and consulting firms. The demand side of this market is characterized by government support for the adoption of the EMR solutions. The supply side is characterized by advancements in technology.

• Q: Which regions provide high growth opportunities ?

  A:

  Geographically, the market spans the Americas, Europe, Asia Pacific and Middle East & Africa. Americas is dominating the global EHR-EMR market. Broad adoption of EHR-EMR, the presence of major players in the region and growth in the number of services in hospitals boost the growth of the market in the region. Europe is the second largest market after the Americas owing to growing adoption of IT in the healthcare sector for patient administration and engagement. Asia Pacific is slated to emerge as the fastest growing market due to escalated demand for software solutions in the healthcare sector and rising expenditure on healthcare facilities in the developing economies of the region.

• Q: What are the current trends in EHR space ?

  A:

  Technology is progressing at a breakneck pace, and this will have impact on the EHR of the further future. As AI and virtual assistants like Alexa and Siri become more accessible and more powerful, they will begin to appear in the health IT fields. Virtual assistants are also coming online to help with those physician burdens, the aspects of the physician workflow issues that computers can streamline. For patients, the big development is expanding online or smartphone access to your health information and the ability to combine information from different providers and update it automatically. Experts think EHR vendors will have to look beyond a patch for the problem. Tech giants entering the healthcare space are going to make big waves: Apple, Google and Amazon are all entering the healthcare space. Their presence will pressure EHR vendors to innovate or perish. The large tech giants are capable to invest in R&D and leading edge UX and UI without endangering their bottom lines. This competition might force EHR to make some of the crucial changes that previous sections have mentioned, or it might just increase the monopoly these tech giants have begun to form and change healthcare for the worse. There’s no reliable way to know how it will play out, but big changes are coming

• Q: What are the drivers and challenges faced by vendors in the market ?

  A:

  The global EHR-EMR market is primarily driven by an increase in the volume of medical records which requires proper management and storage. EHR-EMR provides the advantages of better accessibility, improved communication, data aggregation, and integration. EHR-EMR also lower staffing requirements and thus reduce health care costs, also reducing the scope of human errors. It is on account of these advantages that the global EHR-EMR market is proliferating. Technological advancements in EHR-EMR technology such as Blockchain, Byod, Artificial Intelligence, Opensource fuel the growth of the market. Cloud-based solutions also provide growth opportunities. Small healthcare providers who cannot make up-front investments are opting for free and web-based services which also eliminates the need for infrastructure and maintenance. Government funding is a crucial driver of the market. Governments in various economies are funding projects to automate health record systems which induce the demand for EHR-EMR. The growth of the healthcare and life-sciences industry also reflect positively on the EHR-EMR market. Challenges- various factors are likely to slow down the momentum for the EHR-EMR market. The growth of the market is inhibited by the economic slowdown at a global level which results in lack of capital and operational constraints. Even though both developed and developing countries exhibit high interest in automating health record, the introduction of EHR-EMR systems is obstructed by available technology which is inadequate to support the system and insufficient funds to migrate from the existing system to an electronic system. The high cost of implementing EHR-EMR system is a limiting factor to the market growth. Switching to EHR-EMR involves high costs of computers, electrical wiring and a vast amount of electricity supply. Health administrators and governments perceive the cost of implementing EHR-EMR systems very high and thus resist adoption. Additionally, lack of skilled staffs with adequate knowledge of computer and disease classification are vital issues. Other factors include resistance from medical professionals to switch to an electronic system and change their behaviors and attitudes, and lack of data processing facilities which are barriers to the implementation of EHR-EMR.

• Q: What are the key strategies adopted by the players in this market ?

  A:

  Major players are implementing various strategies such as partnerships, mergers, acquisition, product launches, etc. to sustain their market position.