Thursday, May 20, 2010

EHRs – Size of Physician Market, Number Sold, By Whom, Comprehensiveness of Systems Sold

Today I received the following email from Chris Thorman, Senior Marketing Manager for Software Advice in Austin, Texas (chris@softwareadvice.com). I pass it along to you without editorial comment.


This article comes from Chris Thorman, who blogs about web-based EMRsat Software Advice


EHR Software Market Share Analysis

Calculating market share for the electronic health record (EHR) market is no easy task. There are over 300 software vendors, many market segments (consider: size of practice served, specialties services, inpatient/outpatient) and very “fuzzy” sources of data.

Nevertheless, the team at Software Advice set out to see what numbers we could pull together. We limited our analysis to the outpatient EHR software market. Moreover, we decided to measure market share based on the number of physicians users, rather than vendor revenue or other metrics. We tried to keep it simple. It’s not.

Number of Doctors Using EHR Software


First, let’s define the total size of the market we are analyzing. Of the approximately 788,000 physicians in the United States, 65% of them work in an outpatient facility or physician’s practice, according to the Bureau of Labor & Statistics. That’s 512,000 possible physicians who are in the outpatient EHR software market.

According to a recent study of office-based physicians released by the Center for Disease Control and Prevention (CDC), 44% of those of 512,000 office-based doctors had adopted either a partial, basic, or fully functional EHR system. That’s 225,000 outpatient doctors using an EHR to some extent. Here’s how EHR adoption breaks down among the total number (512,000) of outpatient physicians in the United States:

Outpatient EHR Adoption , 2009

• No EHR adoption, 56%
• Basic EHR adoption, 21%
• Partial EHR adoption, 17%
• Fully functional EHR adoption, 6%


The CDC defines “partial” EHR systems as those not exclusively used for billing. “Basic” systems include the following functionalities: patient demographic information, patient problem lists, clinical notes, orders for prescriptions, and viewing laboratory and imaging results.

Systems defined by the CDC as “fully functional” include all functionalities of a basic system plus these functionalities: medical history and follow-up, orders for tests, prescription and test orders sent electronically, warnings of drug interactions or contraindications, highlighting of out-of-range test levels, electronic images returned, and reminders for guideline-based interventions.

Outpatient EHR Market Share

So, what EHR software are the 225,000 physicians using? Based on number of physician users, here’s how the market breaks down:

Outpatient EHR software market share by vendor, 2010


• Epic, 17%
• AllScripts, 15%
• eClinicalWorks, 15%
• NextGen, 13%
• SOAPware, 12%
• GE Centricity, 10%
• Other Vendors, 10%
• Practice Fusion, 7%

Software Advice’s analysis showed that a handful of vendors – Allscripts, Epic, eClinicalWorks NextGen, and GE Centricity – own more than three-quarters of the ambulatory EHR software market. This is a similar trend that other EHR market reports and analysis have noted.

Here is the data Software Advice was able to gather on the top EHR vendors, based on volume of physician users:

Vendor Physician Users Practices Served


Epic 45,000 N.A.
Allscripts 40,000 N.A.
eClinicalWorks 40,000 6,500
GE Centricity 35,000 2,500
NextGen 35,000 2,000
SOAPWare 30,000 8,000
Practice Fusion 18,500 10,000
Eclipsys 11,000 N.A.
Sage Health 10,000 N.A.
Greenway Medical 6,000 1,400

Clarifications, Disclaimers, Footnotes, Contradictions, etc.


As mentioned in the introduction, the EHR software market has many “fuzzy” sources of data. In fact, when all of the physician users are calculated in the table above, the number of physicians using EHRs in the United States is more than 40,000 over what the CDC reported. Clearly, we need to dig into these numbers a bit more.

In most cases, the information was gathered directly from the EHR software vendors. For those vendors that weren’t able to be contacted, publicly reported information was used. In some cases, exact numbers of physicians and practices were available. In some cases, approximations were used by Software Advice and the software vendors (In the case of a discrepancy, please contact us).

Here are a few questions that came up during the research process whose answers would help refine our market share numbers:

• Sage Health. How many of Sage Health’s users are using their Intergy EHR product in conjunction with their practice management software versus those using just Sage’s practice management software, in particular, Medical Manager?

• Allscripts. How many of Allscripts users are still using Misys practice management systems? Like Sage, they have a huge practice management installed base, but not all of those customers are using their advanced EHR systems.

• Epic and NextGen. How many of their users are exclusively outpatient customers? Both of these EHR vendors are meaningful players in the inpatient EHR market. We need to exclude those physicians from our analysis.

• GE Centricity. General Electric didn’t distinguish between physician (MD) users and mid-level providers in their count of users. This would be a helpful distinction to have in this analysis.

• Practice Fusion. Being a free EHR system, it would be important to see how many of Practice Fusion’s EHR users are actively using their software, instead of just kicking the tires on a cool new web-based EHR and “freemium” business model.

Feedback (We Need Your Help)

Software Advice knows many of you are just as, if not more, intimately plugged into the EHR software market than we are. That’s why we’d like your feedback to help figure out these numbers.

Which vendors’ numbers are higher? Lower? Who are the up and coming players that will earn significant market share in the coming years?

For comments on this post, email Chris at chris@softwareadvice.com
EHR Software Market Share Analysis

Calculating market share for the electronic health record (EHR) market is no easy task. There are over 300 software vendors, many market segments (consider: size of practice served, specialties services, inpatient/outpatient) and very “fuzzy” sources of data.

Nevertheless, the team at Software Advice set out to see what numbers we could pull together. We limited our analysis to the outpatient EHR software market. Moreover, we decided to measure market share based on the number of physicians users, rather than vendor revenue or other metrics. We tried to keep it simple. It’s not.

Number of Doctors Using EHR Software


First, let’s define the total size of the market we are analyzing. Of the approximately 788,000 physicians in the United States, 65% of them work in an outpatient facility or physician’s practice, according to the Bureau of Labor & Statistics. That’s 512,000 possible physicians who are in the outpatient EHR software market.

According to a recent study of office-based physicians released by the Center for Disease Control and Prevention (CDC), 44% of those of 512,000 office-based doctors had adopted either a partial, basic, or fully functional EHR system. That’s 225,000 outpatient doctors using an EHR to some extent. Here’s how EHR adoption breaks down among the total number (512,000) of outpatient physicians in the United States:

Outpatient EHR Adoption , 2009

• No EHR adoption, 56%
• Basic EHR adoption, 21%
• Partial EHR adoption, 17%
• Fully functional EHR adoption, 6%


The CDC defines “partial” EHR systems as those not exclusively used for billing. “Basic” systems include the following functionalities: patient demographic information, patient problem lists, clinical notes, orders for prescriptions, and viewing laboratory and imaging results.

Systems defined by the CDC as “fully functional” include all functionalities of a basic system plus these functionalities: medical history and follow-up, orders for tests, prescription and test orders sent electronically, warnings of drug interactions or contraindications, highlighting of out-of-range test levels, electronic images returned, and reminders for guideline-based interventions.

Outpatient EHR Market Share

So, what EHR software are the 225,000 physicians using? Based on number of physician users, here’s how the market breaks down:

Outpatient EHR software market share by vendor, 2010


• Epic, 17%
• AllScripts, 15%
• eClinicalWorks, 15%
• NextGen, 13%
• SOAPware, 12%
• GE Centricity, 10%
• Other Vendors, 10%
• Practice Fusion, 7%

Software Advice’s analysis showed that a handful of vendors – Allscripts, Epic, eClinicalWorks NextGen, and GE Centricity – own more than three-quarters of the ambulatory EHR software market. This is a similar trend that other EHR market reports and analysis have noted.

Here is the data Software Advice was able to gather on the top EHR vendors, based on volume of physician users:

Vendor Physician Users Practices Served


Epic 45,000 N.A.
Allscripts 40,000 N.A.
eClinicalWorks 40,000 6,500
GE Centricity 35,000 2,500
NextGen 35,000 2,000
SOAPWare 30,000 8,000
Practice Fusion 18,500 10,000
Eclipsys 11,000 N.A.
Sage Health 10,000 N.A.
Greenway Medical 6,000 1,400

Clarifications, Disclaimers, Footnotes, Contradictions, etc.


As mentioned in the introduction, the EHR software market has many “fuzzy” sources of data. In fact, when all of the physician users are calculated in the table above, the number of physicians using EHRs in the United States is more than 40,000 over what the CDC reported. Clearly, we need to dig into these numbers a bit more.

In most cases, the information was gathered directly from the EHR software vendors. For those vendors that weren’t able to be contacted, publicly reported information was used. In some cases, exact numbers of physicians and practices were available. In some cases, approximations were used by Software Advice and the software vendors (In the case of a discrepancy, please contact us).

Here are a few questions that came up during the research process whose answers would help refine our market share numbers:

• Sage Health. How many of Sage Health’s users are using their Intergy EHR product in conjunction with their practice management software versus those using just Sage’s practice management software, in particular, Medical Manager?

• Allscripts. How many of Allscripts users are still using Misys practice management systems? Like Sage, they have a huge practice management installed base, but not all of those customers are using their advanced EHR systems.

• Epic and NextGen. How many of their users are exclusively outpatient customers? Both of these EHR vendors are meaningful players in the inpatient EHR market. We need to exclude those physicians from our analysis.

• GE Centricity. General Electric didn’t distinguish between physician (MD) users and mid-level providers in their count of users. This would be a helpful distinction to have in this analysis.

• Practice Fusion. Being a free EHR system, it would be important to see how many of Practice Fusion’s EHR users are actively using their software, instead of just kicking the tires on a cool new web-based EHR and “freemium” business model.

Feedback (We Need Your Help)

Software Advice knows many of you are just as, if not more, intimately plugged into the EHR software market than we are. That’s why we’d like your feedback to help figure out these numbers.

Which vendors’ numbers are higher? Lower? Who are the up and coming players that will earn significant market share in the coming years?

For comments on this post, email Chris at chris@softwareadvice.com

73 comments:

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We cannot ignore the fact that EHR systems have become an integral part of many health care practitioners. Also, there have been an increase in medical billing services that are currently being offered. The practice management software, for instance, is a great tool in helping manage claims, resolve unpaid balances, billing inquiries and payments. Definitely, these innovations in the medical field guarantee accurate information and faster processing of transactions.

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As much as three quarters of hospital staff are usually burdened with some sort of billing-related work in a traditional billing system. Opting for electronic medical billing solutions (ones that come with free EMR plans) that fit easily into the healthcare business' workflow are key to freeing up staff resources.
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