U.S. MARKET OVERVIEW
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1 U.S. MARKET OVERVIEW Hospital Electronic Medical Record (EMR) Applications 2010 Year End Report This historical report of the U.S. hospital market is brought to you as an online resource from the Dorenfest Institute.
2 EMR Applications Summary of Installation (2009/2010) Order Entry/Results Reporting Clinical Data Repository Clinical Decision Support CPOE Physician Documentation 46% 43% 56% 52% 2009 (N=5,235) 2010 (N=5,281) 82% 90% 88% 86% 91% 86% All applications within the EMR suite show an increase in installation over the past year with physician documentation and CPOE demonstrating the most growth. Order entry/results reporting is approaching market saturation.
3 EMR Applications Summary of Plans (in Not Automated Hospitals) Clinical Data Repository CPOE Order Entry/Results Reporting Clinical Decision Support System 620 2, , % 9.4% 9.1% 7.2% There is low to moderate activity for purchasing EMR applications for the first time. By percent, hospitals were most likely to identify an intent to purchase clinical data repository (CDR) or CPOE in the future. By volume, intent to purchase CPOE was mentioned most often. Physician Documentation 2, % Number in white represents number of not automated hospitals. Percent of "Not Automated" Hospitals Planning to Purchase Software
4 EMR Applications Summary of Plans (Replacing Current Software) Order Entry/Results Reporting Clinical Data Repository Clinical Decision Support System Physician Documentation 4,791 4,637 4, % 1.02% 0.95% 0.80% (2,736) Very few hospitals indicated plans to replace software in their EMR environment. By percent and volume, replacement of order entry/results reporting is most frequently mentioned followed by CDR and clinical decision support system. CPOE 0.10% (2,966) Number in white and parentheses represents number of hospitals with installed or contracted systems Percent of Hospitals with Installed or Contracted Systems Planning to Purchase Software
5 EMR Applications Summary of Plans Clinical Data Repository (n=103) Clinical Decision Support (n=89) CPOE (n=219) Order Entry/Results Reporting (n=91) Physician Documentation (n=145) 43% 40% 54% 57% 60% 99% 46% 96% Virtually all of the CPOE and physician documentation planned purchases will be among hospitals purchasing this software for the first time. While order entry/results reporting is the only market in which planned purchases will outpace replacement purchases, this margin is very narrow. Percent of Hospitals with Installed Software - Replacing Percent of Hospitals Planning to Purchase Software for the First Time
6 Summary of Installation 2,242 of 5,281 hospitals in 2010 (42 percent) have installed (or signed a contract to install) all five applications in the EMR suite. This is a substantial increase from 2009, when one-third of U.S. hospitals had installed all five applications. Only two hospitals use a single vendor for all EMR applications. Another 994 hospitals (19 percent) have signed a contract for or installed four of the five EMR applications tracked in this report. Only 286 hospitals in 2010 (five percent) had not installed or signed a contract to install any of the EMR applications in this report.
7 Clinical Data Repository Top 10 Installed and Contracted Systems Vendor # of Installations % of Market* MEDITECH % CERNER CORPORATION % MCKESSON % EPIC % CPSI % SIEMENS HEALTHCARE % HEALTHCARE MANAGEMENT SYSTEMS, INC % SELF-DEVELOPED % HEALTHLAND % ECLIPSYS CORPORATION % 34 Vendors share the remaining 6.66% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 4,609
8 Clinical Data Repository Top 10 Installed/Contracted Systems Hospitals Under 100 Beds Vendor # of Installations % of Market* MEDITECH % CPSI % HEALTHCARE MANAGEMENT SYSTEMS, INC % HEALTHLAND % CERNER CORPORATION % MCKESSON % SELF-DEVELOPED % EPIC % SIEMENS HEALTHCARE % ECLIPSYS CORPORATION % 27 Vendors share the remaining 5.05% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 2,079
9 Clinical Data Repository Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market MEDITECH % MCKESSON % CERNER CORPORATION % SIEMENS HEALTHCARE % EPIC % SELF-DEVELOPED % HEALTHCARE MANAGEMENT SYSTEMS, INC % CPSI % ECLIPSYS CORPORATION % GE HEALTHCARE % 18 Vendors share the remaining 5.11% of the market. N = 958
10 Clinical Data Repository Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market* MEDITECH % CERNER CORPORATION % MCKESSON % EPIC % SIEMENS HEALTHCARE % ECLIPSYS CORPORATION % SELF-DEVELOPED % GE HEALTHCARE % QUADRAMED % CPSI % 8 Vendors share the remaining 2.94% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 612
11 Clinical Data Repository Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market* MEDITECH % MCKESSON % CERNER CORPORATION % EPIC % SIEMENS HEALTHCARE % ECLIPSYS CORPORATION % SELF-DEVELOPED % GE HEALTHCARE % QUADRAMED % KEANE, INC % 7 Vendors share the remaining 3.45% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 406
12 Clinical Data Repository Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market MCKESSON % CERNER CORPORATION % SIEMENS HEALTHCARE % EPIC % MEDITECH % ECLIPSYS CORPORATION % SELF-DEVELOPED % GE HEALTHCARE % KEANE, INC % 6 VENDORS SHARE THE SAME NUMBER OF INSTALLATIONS AND MARKET SHARE % N = 218
13 Clinical Data Repository Top 10 Installed/Contracted Systems Hospitals 500+ Beds Vendor # of Installations % of Market* CERNER CORPORATION % EPIC % MCKESSON % SIEMENS HEALTHCARE % MEDITECH % ECLIPSYS CORPORATION % GE HEALTHCARE % SELF-DEVELOPED % QUADRAMED % TELUS HEALTH SOLUTIONS % KEANE, INC % 3 Vendors share the remaining 0.89% of the market. * The total percentage may exceed 100 percent due to rounding or some organization may have more than one vendor installed. N = 336
14 Clinical Decision Support Top 10 Installed or Contracted Systems Vendor # of Installations % of Market* MEDITECH % ZYNX HEALTH, INC % CERNER CORPORATION % MCKESSON % EPIC % CPSI % HEALTHCARE MANAGEMENT SYSTEMS, INC % SIEMENS HEALTHCARE % HEALTHLAND % ECLIPSYS CORPORATION % 41 Vendors share the remaining 10.72% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 4,432
15 Clinical Decision Support Top 10 Installed/Contracted Systems Hospitals Under 100 Beds Vendor # of Installations % of Market* MEDITECH % CPSI % HEALTHCARE MANAGEMENT SYSTEMS, INC % ZYNX HEALTH, INC % HEALTHLAND % CERNER CORPORATION % MCKESSON % EPIC % SIEMENS HEALTHCARE % SELF-DEVELOPED % 35 Vendors share the remaining 8.36% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 1,974
16 Clinical Decision Support Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market* MEDITECH % ZYNX HEALTH, INC % MCKESSON % CERNER CORPORATION % SIEMENS HEALTHCARE % EPIC % HEALTHCARE MANAGEMENT SYSTEMS, INC % SELF-DEVELOPED % CPSI % ECLIPSYS CORPORATION % 18 Vendors share the remaining 8.11% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 925
17 Clinical Decision Support Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market* MEDITECH % ZYNX HEALTH, INC % CERNER CORPORATION % MCKESSON % EPIC % SIEMENS HEALTHCARE % ECLIPSYS CORPORATION % SELF-DEVELOPED % WOLTERS KLUWER HEALTH % GE HEALTHCARE % 11 Vendors share the remaining 5.03% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 596
18 Clinical Decision Support Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market* ZYNX HEALTH, INC % MEDITECH % MCKESSON % CERNER CORPORATION % EPIC % SIEMENS HEALTHCARE % ECLIPSYS CORPORATION % QUADRAMED % SELF-DEVELOPED % GE HEALTHCARE % 8 Vendors share the remaining 5.58% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 394
19 Clinical Decision Support Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market* ZYNX HEALTH, INC % MCKESSON % CERNER CORPORATION % SIEMENS HEALTHCARE % EPIC % MEDITECH % ECLIPSYS CORPORATION % SELF-DEVELOPED % WOLTERS KLUWER HEALTH % GE HEALTHCARE % 11 Vendors share the remaining 6.13% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 212
20 Clinical Decision Support Top 10 Installed/Contracted Systems Hospitals 500+ Beds Vendor # of Installations % of Market* ZYNX HEALTH, INC % CERNER CORPORATION % EPIC % MCKESSON % ECLIPSYS CORPORATION % MEDITECH % SIEMENS HEALTHCARE % GE HEALTHCARE % SELF-DEVELOPED % QUADRAMED % WOLTERS KLUWER HEALTH % 6 Vendors share the remaining 2.42% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 331
21 CPOE Top 10 Installed or Contracted Systems Vendor # of Installations % of Market MEDITECH % CERNER CORPORATION % EPIC % MCKESSON % CPSI % SIEMENS HEALTHCARE % HEALTHCARE MANAGEMENT SYSTEMS, INC % ECLIPSYS CORPORATION % SELF-DEVELOPED % GE HEALTHCARE % 19 Vendors share the remaining 5.84% of the market. N = 2,943
22 CPOE Top 10 Installed/Contracted Systems Hospitals Under 100 Beds Vendor # of Installations % of Market MEDITECH % CPSI % HEALTHCARE MANAGEMENT SYSTEMS, INC % CERNER CORPORATION % EPIC % HEALTHLAND % MCKESSON % SELF-DEVELOPED % SIEMENS HEALTHCARE % ECLIPSYS CORPORATION % 15 Vendors share the remaining 6.19% of the market. N = 1,227
23 CPOE Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market MEDITECH % CERNER CORPORATION % EPIC % MCKESSON % SIEMENS HEALTHCARE % ECLIPSYS CORPORATION % CPSI % GE HEALTHCARE % SELF-DEVELOPED % HEALTHCARE MANAGEMENT SYSTEMS, INC % 7 Vendors share the remaining 2.31% of the market. N = 562
24 CPOE Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market MEDITECH % CERNER CORPORATION % EPIC % MCKESSON % ECLIPSYS CORPORATION % SIEMENS HEALTHCARE % GE HEALTHCARE % QUADRAMED % CPSI % KEANE, INC % 5 Vendors share the remaining 1.60% of the market. N = 423
25 CPOE Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market MEDITECH % CERNER CORPORATION % EPIC % MCKESSON % SIEMENS HEALTHCARE % ECLIPSYS CORPORATION % QUADRAMED % GE HEALTHCARE % SELF-DEVELOPED % 3 VENDORS SHARE THE SAME NUMBER OF INSTALLATIONS AND MARKET SHARE % N = 294
26 CPOE Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market CERNER CORPORATION % EPIC % MCKESSON % SIEMENS HEALTHCARE % MEDITECH % ECLIPSYS CORPORATION % GE HEALTHCARE % 5 VENDORS SHARE THE SAME NUMBER OF INSTALLATIONS AND MARKET SHARE % * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 160
27 CPOE Top 10 Installed/Contracted Systems Hospitals 500+ Beds Vendor # of Installations % of Market CERNER CORPORATION % EPIC % ECLIPSYS CORPORATION % MCKESSON % MEDITECH % SIEMENS HEALTHCARE % GE HEALTHCARE % QUADRAMED % SELF-DEVELOPED % N = 277
28 Order Entry/Results Reporting Top 10 Installed or Contracted Systems Vendor # of Installations % of Market* MEDITECH % CERNER CORPORATION % MCKESSON % SIEMENS HEALTHCARE % CPSI % EPIC % HEALTHCARE MANAGEMENT SYSTEMS, INC % HEALTHLAND % SELF-DEVELOPED % ECLIPSYS CORPORATION % 34 Vendors share the remaining 8.02% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 4,799
29 Order Entry/Results Reporting Top 10 Installed/Contracted Systems Hospitals Under 100 Beds Vendor # of Installations % of Market* MEDITECH % CPSI % HEALTHCARE MANAGEMENT SYSTEMS, INC % HEALTHLAND % CERNER CORPORATION % MCKESSON % SIEMENS HEALTHCARE % SELF-DEVELOPED % EPIC % GE HEALTHCARE % 29 Vendors share the remaining 7.78% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 2,249
30 Order Entry/Results Reporting Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market* MEDITECH % MCKESSON % CERNER CORPORATION % SIEMENS HEALTHCARE % EPIC % HEALTHCARE MANAGEMENT SYSTEMS, INC % SELF-DEVELOPED % CPSI % ECLIPSYS CORPORATION % GE HEALTHCARE % 12 Vendors share the remaining 4.75% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 969
31 Order Entry/Results Reporting Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market* MEDITECH % CERNER CORPORATION % MCKESSON % EPIC % SIEMENS HEALTHCARE % ECLIPSYS CORPORATION % GE HEALTHCARE % QUADRAMED % SELF-DEVELOPED % CPSI % KEANE, INC % 9 Vendors share the remaining 2.27% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 617
32 Order Entry/Results Reporting Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market* MEDITECH % MCKESSON % CERNER CORPORATION % EPIC % SIEMENS HEALTHCARE % GE HEALTHCARE % ECLIPSYS CORPORATION % QUADRAMED % SELF-DEVELOPED % KEANE, INC % 4 Vendors share the remaining 1.71% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 409
33 Order Entry/Results Reporting Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market* MCKESSON % CERNER CORPORATION % SIEMENS HEALTHCARE % EPIC % MEDITECH % ECLIPSYS CORPORATION % GE HEALTHCARE % SELF-DEVELOPED % KEANE, INC % QUADRAMED % 4 Vendors share the remaining 1.83% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 218
34 Order Entry/Results Reporting Top 10 Installed/Contracted Systems Hospitals 500+ Beds Vendor # of Installations % of Market* CERNER CORPORATION % EPIC % MCKESSON % SIEMENS HEALTHCARE % ECLIPSYS CORPORATION % MEDITECH % GE HEALTHCARE % QUADRAMED % SELF-DEVELOPED % STOCKELL HEALTHCARE SYSTEMS, INC % KEANE, INC % 1 Vendor share the remaining 0.30% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 337
35 Physician Documentation Top 10 Installed or Contracted Systems Vendor # of Installations % of Market* MEDITECH % CERNER CORPORATION % EPIC % MCKESSON % HEALTHCARE MANAGEMENT SYSTEMS, INC % SELF-DEVELOPED % CPSI % SIEMENS HEALTHCARE % ECLIPSYS CORPORATION % HEALTHLAND % 23 Vendors share the remaining 6.92% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 2,717
36 Physician Documentation Top 10 Installed/Contracted Systems Hospitals Under 100 Beds Vendor # of Installations % of Market MEDITECH % HEALTHCARE MANAGEMENT SYSTEMS, INC % CERNER CORPORATION % CPSI % SELF-DEVELOPED % EPIC % HEALTHLAND % MCKESSON % SIEMENS HEALTHCARE % ECLIPSYS CORPORATION % 15 Vendors share the remaining 4.43% of the market. N = 1,128
37 Physician Documentation Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market MEDITECH % CERNER CORPORATION % EPIC % MCKESSON % SELF-DEVELOPED % SIEMENS HEALTHCARE % ECLIPSYS CORPORATION % HEALTHCARE MANAGEMENT SYSTEMS, INC % GE HEALTHCARE % NEXTGEN HEALTHCARE % 9 Vendors share the remaining 4.28% of the market. N = 538
38 Physician Documentation Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market MEDITECH % CERNER CORPORATION % EPIC % MCKESSON % SIEMENS HEALTHCARE % ECLIPSYS CORPORATION % SELF-DEVELOPED % GE HEALTHCARE % QUADRAMED % NEXTGEN HEALTHCARE % 9 Vendors share the remaining 2.76% of the market. N = 398
39 Physician Documentation Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market MEDITECH % CERNER CORPORATION % EPIC % MCKESSON % SIEMENS HEALTHCARE % QUADRAMED % ECLIPSYS CORPORATION % GE HEALTHCARE % SELF-DEVELOPED % NEXTGEN HEALTHCARE % HEALTHCARE MANAGEMENT SYSTEMS, INC % 6 Vendors share the remaining 2.36% of the market. N = 254
40 Physician Documentation Top 10 Installed/Contracted Systems Hospitals Beds Vendor # of Installations % of Market CERNER CORPORATION % EPIC % MEDITECH % SIEMENS HEALTHCARE % MCKESSON % ECLIPSYS CORPORATION % GE HEALTHCARE % NEXTGEN HEALTHCARE % 8 VENDORS SHARE THE SAME NUMBER OF INSTALLATIONS AND MARKET SHARE % N = 140
41 Physician Documentation Top 10 Installed/Contracted Systems Hospitals 500+ Beds Vendor # of Installations % of Market* CERNER CORPORATION % EPIC % ECLIPSYS CORPORATION % MCKESSON % MEDITECH % SIEMENS HEALTHCARE % SELF-DEVELOPED % GE HEALTHCARE % QUADRAMED % 3M HEALTH INFORMATION SYSTEMS % 4 Vendors share the remaining 1.54% of the market. * The total percentage may exceed 100 percent due to rounding or some organization may have more than one vendor installed. N = 259
42 Clinical Data Repository Vendors Being Considered for a Planned Purchase Vendor # of Times Considered EPIC 19 MEDITECH 17 HEALTHLAND 17 CPSI 12 MCKESSON 9 HEALTHCARE MANAGEMENT SYSTEMS, INC. 8 CERNER CORPORATION 8 NEXTGEN HEALTHCARE 4 QUADRAMED 3 ECLIPSYS CORPORATION 3 SIEMENS HEALTHCARE 2 7 ADDITIONAL VENDORS BEING CONSIDERED 7
43 Clinical Decision Support Vendors Being Considered for a Planned Purchase Vendor # of Times Considered MEDITECH 16 HEALTHLAND 14 MCKESSON 9 HEALTHCARE MANAGEMENT SYSTEMS, INC. 8 CPSI 8 CERNER CORPORATION 8 EPIC 7 SIEMENS HEALTHCARE 3 QUADRAMED 2 NEXTGEN HEALTHCARE 2 ZYNX HEALTH, INC. 2 ECLIPSYS CORPORATION 2 4 ADDITIONAL VENDORS BEING CONSIDERED 4
44 CPOE Vendors Being Considered for a Planned Purchase Vendor # of Times Considered MEDITECH 49 CPSI 28 MCKESSON 24 HEALTHLAND 21 HEALTHCARE MANAGEMENT SYSTEMS, INC. 19 EPIC 18 SIEMENS HEALTHCARE 14 CERNER CORPORATION 7 ECLIPSYS CORPORATION 4 NEXTGEN HEALTHCARE 3 GE HEALTHCARE 3 7 ADDITIONAL VENDORS BEING CONSIDERED 9
45 Order Entry/Results Reporting Vendors Being Considered for a Planned Purchase Vendor # of Times Considered MEDITECH 53 CPSI 32 HEALTHLAND 29 MCKESSON 28 EPIC 20 HEALTHCARE MANAGEMENT SYSTEMS, INC. 19 SIEMENS HEALTHCARE 16 CERNER CORPORATION 9 ECLIPSYS CORPORATION 5 NEXTGEN HEALTHCARE 4 GE HEALTHCARE 3 SELF-DEVELOPED 3 7 ADDITIONAL VENDORS BEING CONSIDERED 8
46 Physician Documentation Vendors Being Considered for a Planned Purchase Vendor # of Times Considered MEDITECH 25 CPSI 23 MCKESSON 19 EPIC 19 HEALTHCARE MANAGEMENT SYSTEMS, INC. 16 HEALTHLAND 13 CERNER CORPORATION 10 SIEMENS HEALTHCARE 8 GE HEALTHCARE 5 NEXTGEN HEALTHCARE 4 4 ADDITIONAL VENDORS BEING CONSIDERED 8
47 EMR Applications Temporal Summary of Installation Clinical Data Repository (n=2958) Clinical Decision Support (n=2519) CPOE (n=1804) Order Entry/Results Reporting (n=3548) Physician Documentation (n=1632) 24% 24% 33% 21% 30% 34% 31% 31% 34% 37% 59% 36% 56% The majority of all EMR applications were purchased between 2000 to More than half of CPOE and physician documentation purchases occurred between 2005 and Prior to to to to to to 2010
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