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Am J Manag Care. 2013 Nov;19(10 Spec No):SP353-61.

Evolving vendor market for HITECH-certified ambulatory EHR products.

Author information

1
Mathematica Policy Analysis, 1100 1 St NE, 12th Fl, Washington, DC 20002. E-mail: mgold@mathematica-mpr.com.

Abstract

BACKGROUND:

The ambitious goals of the Health Information Technology for Economic and Clinical Health (HITECH) Act require rapid development and certification of new ambulatory electronic health record (EHR) products.

OBJECTIVES:

To examine where the vendor market for EHR products stands now and the policy issues emerging from the market's evolution.

STUDY DESIGN:

Descriptive study with policy analysis.

METHODS:

We had 3 main sources of information: (1) documents describing this evolving market, which is not well represented in peer-reviewed literature; (2) operational data on certified ambulatory EHR products and their use by Medicareeligible professionals attesting for meaningful use payments from January 2011 to October 2012; and (3) telephone interviews with 10 vendors that account for 57% of the market.

RESULTS:

Those attesting for Medicare meaningful use payments used ambulatory EHRs from 353 different vendors, although 16 firms accounted for 75% of the market. The Herfindahl-Hirschman Index showed the ambulatory EHR market to be highly competitive, particularly for practices of 50 or fewer professionals. The interviewed vendors and the external analysts agreed that stage 1 requirements set a relatively low bar for market entry, but that likely will change as requirements get more demanding.

CONCLUSIONS:

The HITECH Act met its initial goals to motivate growth of diverse ambulatory EHR products. A market shakeout may emerge, though current data reveal no signs of it. Policy makers can influence the shape and value of such a shakeout, and the extent of disruption, through their approach to certification and "usability" and "interoperability" strategies and requirements.

PMID:
24511890
[Indexed for MEDLINE]
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