By now it’s not a secret that EMRs are “records” and yet we’ve been trying to cram communication functions down their throat. Meanwhile the hottest tools in enterprise tech are souped up versions of AIM (remember that, you AOL fans?)– with companies like Slack & HipChat providing group-based instant messaging and changing the way teams work. As health care becomes a team sport, you’re going to see many approaches from the major EMR vendors and new entrants in the coming months to fix the communication problem. And yes at Health 2.0 this Fall I’ll be running a full panel on the topic that the Clinical User Experience Sucks–how do we fix it?
This week athenahealth, one of the few big cloud-based players in EMR-land introduced athenaText. (Don’t bother asking why there are no caps in the company name yet the simple word “text” gets a capital T in the middle of the product name! It’s as you’d expect an instant message product (rather than SMS one) but with some differences. For a start it integrates direct into the athenaClincals EMR, but it also pulls in both drug info and physician contacts from the Epocrates product that athenahealth owns (and which has several hundred thousand physicians on it). The goal is to spread the product virally (think Skype or Slack). But first things first. What is it and how does it work? I spoke with VP of UX at athenahealth, Abbe Don, to find out more and to get a demo, which you can see below.
Despite this widespread adoption EHRs, reliable market share data by vendor is still very hard to come by. So, when CMS recently updated its attestation data for midyear 2012, we took notice. Attestation, remember, is the process by which practitioners legally verify that they have used an EHR in way that merits one of those incentive payments. The data set includes more than 77,000 different attestations from 2011 through May of 2012 (note that it is not immediately clear why the data set has different totals than the CMS press release).
The sheer number of options for hospitals and providers stood out to us immediately. There are 405 separate EHR vendors that hospitals or providers have used to attest to meaningful use, with 336 of these providing ambulatory EHR products. It’s worth pausing here to note that by our count of the data found on the CMS Certified Health IT Product List, there are more than 550 separate ambulatory vendors with complete EHRs approved by CMS, meaning that despite the huge number of options, there were still well over 200 approved ambulatory vendors that have not had a single user qualify for an incentive payment yet!
Despite this enormous number of options, users attesting were fairly concentrated in the top vendors. Of these 336, the top 15 vendors represented 75% of all providers attesting. On the inpatient side, this concentration was even more pronounced, with the top 6 representing 75% of the total hospital attestations.
When we organize and dig into the data, a few other points stand out.