If we were to base our analysis on Modern Healthcare’s findings, the industry’s “leading weekly publication on healthcare business and policy news, research and information,” then Cerner and Epic are the leaders in the current EHR market. Which of the two is better will depend on the setup of the health organization. Modern Healthcare says if it is a complete EHR system, then Epic is the better choice. However, for modular EHR system, Cerner is the leader in the market, according to Modern Healtcare’s review using Centers for Medicare & Medicaid Services (CMS) data from 2011 to early 2014, which ihealthbeat.org published just last month (May 5, 2014), in an article posted by entitled “Epic, Cerner Top Vendors for Hospital Meaningful Use Incentives.” (CALIFORNIA HEALTHCARE FOUNDATION, 2014).
In the same article, ihealthbeat.org says Epic users received almost 20 percent of Medicare payments for those who have implemented a complete EHR system, while Cerner ranked first with almost 26% for modular EHR system users in the four-year period. But since facilities run by independent medical practitioners use of a variety of EMRs on their respective practices, ihealthbeat.org says then Cerner may be considered as the nation’s Number 1 choice for an EHR system, apparently because independent medical practitioners don't want to spend a ton of money in a hospital that has an EHR system where they only serve as independent admitters.
As far as the other leading software McKesson is concerned, meanwhile, a website appropriately named ehr-software.findthebest.com found it very much inferior compared to Epic in Practice Size, Platforms, Feature EHR/EMR and Practice Management categories (ehr-software, 2014). Apparently, McKesson’s “fault” was having two systems initially – Horizon and Paragon – until it decided to make the latter their sole platform for its EHR system. In the same ihealthbeat.org article, McKesson ranked fourth in the modular EHR category, and was even behind Meditech, which, consistently placed second behind Epic and Cerner in both complete and modular HER categories, therefore, another software that has penetrated the market with effective results.
While stiff competitors Epic and Cerner CCIT (Certification Commission for Health Information Technology) certified, McKesson is certified by Drummond Group. Both CCHIT and Drummond Group are ONC Authorized Testing and Certification Bodies assigned by the Office of the National Coordinator for Health IT. Although CCHIT has been around since 2006, Drummond is a trusted organization and serves the Fortune 500 companies. According to HealthIT.gov, Cerner's product's classification is Modular, while both Epic and McKesson have complete and modular EHR systems. Epic has among its meaningful use capabilities an integrated speech recognition system; telemedicine and guided medication reconciliation, barcoding, documentation reminders and apps for viewing test results, appointments and refills. Cerner also has CPOE, document imaging, medical devices for alerts, RxStation, smart pump integration, automated messaging, etc. McKesson also makes use of CPOE, has E-prescribing, automated diagnostic order entry, etc.
To break it down further, healthsystemCIO says Epic (was) the “only truly integrated and highly functional practice and hospital EMR” (Ciotti, 2011). The author, Vince Ciotti, said Cerner is probably “more functional on the hospital side” owing to the fact that the makers of Cerner – Judy & Co. – was a decade ahead of their competitors. This analysis, even though published back in April 2011, may still run true today because of the obvious fact that healthcare providers are still months – some maybe years – away from being fully EHR-ready amid a looming deadline for those providing care to Medicare and Medicaid patients.
Another online publication specializing in EHR, EHR Intelligence, says that Epic is an “intelligent choice” in the sense that clinicians are easily convinced to buy and adopt the product despite its hefty price. To give us an idea how much Epic could cost a hospital – much to the chagrin I’m sure of many a stakeholder – the 600+-bed Main Medical Center in Portland, Maine, was said to have spent a staggering $200 million in its Epic electronic health record implementation. (Miliard, 2013). It is worthy to note, however, that Healthcare IT News also states in the same article that despite the huge sum, the Epic EHR system was still problematic, and that Main Medical Center may spend more to iron whatever kinks the system is affecting the facility.
Speaking of costs, Open Health News says Duke University will pay $700 million for its health system. $700 million?! (Maduro, 2013). On a smaller scale, Open Health News reported that a 48-bed Bartlett Regional Hospital in Juneau, Alaska with a 12-bed Adult Behavioral Health Facility and a 16-bed Chemical Dependency Recovery Center ran into some financial problem after spending $7.37 million, plus an annual maintenance fee of $1.55 million. (No wonder, the EHR system implementation has been pushed up to the last days as provided in the new law.)
Tons of EMR softwares on the market
The beauty of a capitalist society like the U.S. is, is that anyone can compete in the open market. The same thing goes in the EMR industry, where more than a hundred software titles are available on the market depending on which ones are applicable to one's particular practice. According to EMR comparisons and reviews site Softwareadvice.com, the most popular EMRs, didn’t include the expensive Epic nor Cerner systems. Understandably because these softwares are for individual and small medical practices. The same site said the Top Ten are: MediTouch, Benchmark Systems, Kareo, 2014 Waiting Room Solutions, Office Practicum, Medios HER, NueMD, Centricity, ChiroTouch and Electronic Medical Assistant by Modernizing Medicine. Other softwares also in the market are ECLIPSE, which is mostly tailored to physical therapists, ACOM Health RAPID for chiropractors, while Qualifacts CareLogic Enterprise is “designed specifically for mental and behavioral healthcare organizations.” (McCormack, 2014)
Of these software companies, Centricity is an interesting because it was created by General Electric, which – not only do they manufacture home appliances – produce jet engines. In my humble opinion, Centricity may be a potential software developer that can compete against Cerner and Epic if they so chooses with its billions from GE. Another common name in the top EHR software developers in the market is ADP with its AdvancedMD EHR and Practice Management Software. ADP of course is among the leading automated payroll maintenance organizations that thousands of companies subscribe to as it takes care of all money matters in employee payrolls, including tax deductions, Social Security contributions and other taxes.
Now, weather a flood of softwares will mean a reduction in price remains to be seen. The fact remains that with so many softwares in the market even for individual practice use may, however, negate the ideal vision of having an electronic health record system that can be read, translated and analyzed by the majority, if not all, health providers. In the end, what good will these do if a patient in critical condition will have to wait before they can be admitted and provided with medical care if the software used to collect their medical record is foreign in an emergency room or that the hospital uses a different system? Fortunately, while being a student, I have been presented with these actual problems medical organizations now face. Hopefully, by the time I am confronted with this reality and come up with the most feasible, cost-effective, practical but a more universally-accepted system. I guess there is merit to the phrase “socialized healthcare” after all.
Bibliography
CALIFORNIA HEALTHCARE FOUNDATION. (2014, My 5). Epic, Cerner Top Vendors for Hospital Meaningful Use Incentives. ihealthbeat.org .
Ciotti, V. (2011, April 12). Health System CIO. Retrieved June 5, 2014, from healthsystemcio.com: http://healthsystemcio.com/2011/04/12/breaking-down-an-epic-versus-cerner-selection/
ehr-software. (2014). Find the Best. Retrieved June 5, 2014, from ehr-software.findthebest.com: http://ehr-software.findthebest.com/compare/70-408/Epic-Care-Ambulatory-EMR-vs-McKesson-Practice-Choice
Maduro, P. G. (2013, July 3). EHR Systems & Cost Transparency in the Healthcare Industry.
McCormack, M. (2014, June 6). Compare Electronic Health Record Software. Software Advice (Softwareadvice.com). Miliard, M. (2013, December 27). Healthcare IT News.
In the same article, ihealthbeat.org says Epic users received almost 20 percent of Medicare payments for those who have implemented a complete EHR system, while Cerner ranked first with almost 26% for modular EHR system users in the four-year period. But since facilities run by independent medical practitioners use of a variety of EMRs on their respective practices, ihealthbeat.org says then Cerner may be considered as the nation’s Number 1 choice for an EHR system, apparently because independent medical practitioners don't want to spend a ton of money in a hospital that has an EHR system where they only serve as independent admitters.
As far as the other leading software McKesson is concerned, meanwhile, a website appropriately named ehr-software.findthebest.com found it very much inferior compared to Epic in Practice Size, Platforms, Feature EHR/EMR and Practice Management categories (ehr-software, 2014). Apparently, McKesson’s “fault” was having two systems initially – Horizon and Paragon – until it decided to make the latter their sole platform for its EHR system. In the same ihealthbeat.org article, McKesson ranked fourth in the modular EHR category, and was even behind Meditech, which, consistently placed second behind Epic and Cerner in both complete and modular HER categories, therefore, another software that has penetrated the market with effective results.
While stiff competitors Epic and Cerner CCIT (Certification Commission for Health Information Technology) certified, McKesson is certified by Drummond Group. Both CCHIT and Drummond Group are ONC Authorized Testing and Certification Bodies assigned by the Office of the National Coordinator for Health IT. Although CCHIT has been around since 2006, Drummond is a trusted organization and serves the Fortune 500 companies. According to HealthIT.gov, Cerner's product's classification is Modular, while both Epic and McKesson have complete and modular EHR systems. Epic has among its meaningful use capabilities an integrated speech recognition system; telemedicine and guided medication reconciliation, barcoding, documentation reminders and apps for viewing test results, appointments and refills. Cerner also has CPOE, document imaging, medical devices for alerts, RxStation, smart pump integration, automated messaging, etc. McKesson also makes use of CPOE, has E-prescribing, automated diagnostic order entry, etc.
To break it down further, healthsystemCIO says Epic (was) the “only truly integrated and highly functional practice and hospital EMR” (Ciotti, 2011). The author, Vince Ciotti, said Cerner is probably “more functional on the hospital side” owing to the fact that the makers of Cerner – Judy & Co. – was a decade ahead of their competitors. This analysis, even though published back in April 2011, may still run true today because of the obvious fact that healthcare providers are still months – some maybe years – away from being fully EHR-ready amid a looming deadline for those providing care to Medicare and Medicaid patients.
Another online publication specializing in EHR, EHR Intelligence, says that Epic is an “intelligent choice” in the sense that clinicians are easily convinced to buy and adopt the product despite its hefty price. To give us an idea how much Epic could cost a hospital – much to the chagrin I’m sure of many a stakeholder – the 600+-bed Main Medical Center in Portland, Maine, was said to have spent a staggering $200 million in its Epic electronic health record implementation. (Miliard, 2013). It is worthy to note, however, that Healthcare IT News also states in the same article that despite the huge sum, the Epic EHR system was still problematic, and that Main Medical Center may spend more to iron whatever kinks the system is affecting the facility.
Speaking of costs, Open Health News says Duke University will pay $700 million for its health system. $700 million?! (Maduro, 2013). On a smaller scale, Open Health News reported that a 48-bed Bartlett Regional Hospital in Juneau, Alaska with a 12-bed Adult Behavioral Health Facility and a 16-bed Chemical Dependency Recovery Center ran into some financial problem after spending $7.37 million, plus an annual maintenance fee of $1.55 million. (No wonder, the EHR system implementation has been pushed up to the last days as provided in the new law.)
Tons of EMR softwares on the market
The beauty of a capitalist society like the U.S. is, is that anyone can compete in the open market. The same thing goes in the EMR industry, where more than a hundred software titles are available on the market depending on which ones are applicable to one's particular practice. According to EMR comparisons and reviews site Softwareadvice.com, the most popular EMRs, didn’t include the expensive Epic nor Cerner systems. Understandably because these softwares are for individual and small medical practices. The same site said the Top Ten are: MediTouch, Benchmark Systems, Kareo, 2014 Waiting Room Solutions, Office Practicum, Medios HER, NueMD, Centricity, ChiroTouch and Electronic Medical Assistant by Modernizing Medicine. Other softwares also in the market are ECLIPSE, which is mostly tailored to physical therapists, ACOM Health RAPID for chiropractors, while Qualifacts CareLogic Enterprise is “designed specifically for mental and behavioral healthcare organizations.” (McCormack, 2014)
Of these software companies, Centricity is an interesting because it was created by General Electric, which – not only do they manufacture home appliances – produce jet engines. In my humble opinion, Centricity may be a potential software developer that can compete against Cerner and Epic if they so chooses with its billions from GE. Another common name in the top EHR software developers in the market is ADP with its AdvancedMD EHR and Practice Management Software. ADP of course is among the leading automated payroll maintenance organizations that thousands of companies subscribe to as it takes care of all money matters in employee payrolls, including tax deductions, Social Security contributions and other taxes.
Now, weather a flood of softwares will mean a reduction in price remains to be seen. The fact remains that with so many softwares in the market even for individual practice use may, however, negate the ideal vision of having an electronic health record system that can be read, translated and analyzed by the majority, if not all, health providers. In the end, what good will these do if a patient in critical condition will have to wait before they can be admitted and provided with medical care if the software used to collect their medical record is foreign in an emergency room or that the hospital uses a different system? Fortunately, while being a student, I have been presented with these actual problems medical organizations now face. Hopefully, by the time I am confronted with this reality and come up with the most feasible, cost-effective, practical but a more universally-accepted system. I guess there is merit to the phrase “socialized healthcare” after all.
Bibliography
CALIFORNIA HEALTHCARE FOUNDATION. (2014, My 5). Epic, Cerner Top Vendors for Hospital Meaningful Use Incentives. ihealthbeat.org .
Ciotti, V. (2011, April 12). Health System CIO. Retrieved June 5, 2014, from healthsystemcio.com: http://healthsystemcio.com/2011/04/12/breaking-down-an-epic-versus-cerner-selection/
ehr-software. (2014). Find the Best. Retrieved June 5, 2014, from ehr-software.findthebest.com: http://ehr-software.findthebest.com/compare/70-408/Epic-Care-Ambulatory-EMR-vs-McKesson-Practice-Choice
Maduro, P. G. (2013, July 3). EHR Systems & Cost Transparency in the Healthcare Industry.
McCormack, M. (2014, June 6). Compare Electronic Health Record Software. Software Advice (Softwareadvice.com). Miliard, M. (2013, December 27). Healthcare IT News.
Thanks for sharing this information. I found it very informative as I have been researching a lot lately on practical matters such as you talk about..
ReplyDeletechiropractic EHR software