Competitive Analysis Report

Transcription

1 Copyright 2014 Jewson Enterprises Base Year Competitive Analysis CA - I JEWSON ENTERPRISES INTERNET-BASED POMIS REPORTS Competitive Analysis Report By Vinson J. Hudson POMIS Analyst Jewson Enterprises 1497 Main Street, Suite 155 Dunedin, FL Office Center: Mobile: [email protected] Website:

2 CA - II POMIS Forecast Performance Billions Resourcer- Intensive Sales Innovations in Cloud-Basecd Delivery Decline of Legacy POMIS Consolidation Triggers Demand to Meet MU Stages Dec Jan Aug Dec Jan Aug Dec Jan Aug Dec Jan Aug Dec Jan Aug Dec Billions Source: Jewson Enterprises POMIS Knowledge Base Company Profile Jewson Enterprises is a physician s office management & medical information systems (POMIS) market research and analysis firm that specializes in performing competitive intelligence gathering of information; interpretations, insights, and impressions about the performance of EHR-EMR & PM solutions companies, providing actionable reports and discussions: Competitive Analysis Report, Performance Ratings Trust Exchange Reports, and custom private reports. II

3 CA - III COMPETITIVE ANALYSIS Contents COMPETITIVE ANALYSIS REPORT BY VINSON J. HUDSON POMIS ANALYST POMIS Forecast Performance Company Profile INTRODUCTION 1 THE POMIS INDUSTRY 1 POMIS VENDORS 2 GEOGRPHICAL DISTRIBUTION 6 DELIVERY METHODS 9 CLIENT-SERVER DELIVER METHOD VENDORS ANALYSIS 11 MEDICAL BILLING SERVICES DELIVERY METHODF VENDORS ANALYSIS 12 CLOUD-BASED DELIVERY METHOD ANALYSIS 13 MAJOR MARKET PRODUCT CATEGORIES 13 PRACTICE MANAGEMENT SOLUTIONS VENDOR ANALYSIS 15 MANAGED CARE INFORMATION SYSTEMS (MCIS) ANALYSIS 15 EHR-EMR SOLUTIONS VENDORS ANALYSIS 16 EHR-EMR SOLUTIONS COMPETITORS 16 CHARACTERISTICS OF EHR-EMR SOLUTIONS VENDORS 16 Exhibits EXHIBIT CA 1: TOP TWENTY-FIVE VENDORS MARKET SHARE BY MAJOR SEGMENTS EXHIBIT CA 2: REVENUE GROUPING OF VENDORS BY SELECTED SEGMENTS MILLIONS OF DOLLARS... 4 EXHIBIT CA 3: VENDOR REVENUES SEGMENTED BY GROUPS MILLIONS OF DOLLARS... 4 EXHIBIT CA 4: POMIS VENDORS SEPARATED BY THE RULE ON REVENUES... 5 EXHIBIT CA 5: DISTRIBUTION OF POMIS VENDORS RELATIVE CUSTOMER MARKETS... 5 EXHIBIT CA 6: DISTRIBUTION OF VENDOR HEADQUARTERS BY STATE... 7 EXHIBIT CA 7: LEADING REVENUE LEADERS MILLIONS OF DOLLARS... 8 EXHIBIT CA 8: VENDOR REVENUES SEGMENTED BY GROUPS MILLIONS OF DOLLARS... 8 EXHIBIT CA 9: REVENUE SHARE OF PRIVATELY VERSUS PUBLICLY HELD VENDORS MILLIONS OF DOLLARS... 9 EXHIBIT CA 10: DISTRIBUTION OF DELIVERY METHODS EXHIBIT CA 11: PIC CHART OF REVENUE DELIVERY METHODS MARKET SHARE EXHIBIT CA 12: LEADING CLIENT-SERVER REVENUE VENDORS MILLIONS OF DOLLARS EXHIBIT CA 13: LEADING MEDICAL BILLING SERVICES VENDOR REVENUES MILLIONS OF DOLLARS EXHIBIT CA 14: LEADING CLOUD-BASED VENDORS MILLIONS OF DOLLARS EXHIBIT CA 15: PIE CHART DISTRIBUTION OF MAJOR PRODUCT CATEGORIES REVENUES MILLIONS OF DOLLARS EXHIBIT CA 16: DISTRIBUTION OF VENDORS BY MAJOR PRODUCT CATEGORIES EXHIBIT CA 17: LEADING PRACTICE MANAGEMENT SOLUTIONS ONLY VENDORS MILLIONS OF DOLLARS EXHIBIT CA 18: LEADING MANAGED CARE INFORMATION SYSTEMS VENDORS MILLIONS OF DOLLARS EXHIBIT CA 19: REVENUE LEADING VENDORS OFFERING EHR-EMR SOLUTIONS ONLY MILLIONS OF DOLLARS EXHIBIT CA 20: REVENUE LEADERS OFFERING INTEGRATED EHR-EMR SOLUTIONS I I II II III

4 Copyright 2014 Jewson Enterprises Base Year Competitive Analysis CA - 1 COMPETITIVE ANALYSIS INTRODUCTION Competitor identification is a key task for your managers and executives interested in scanning the crowd competitive terrain, shoring up their defenses against likely competitive incursions, and planning competitive attack and response strategies. Before you can assess the relative strengths and weaknesses of rival competitors, you must first identify the competitive group and develop an accurate sense of the domain in which strategic interactions are likely to occur. Although we do an excellent job of investigating POMIS vendors, we focus on the role of customer provider needs in defining the marketplace to show how a greater recognition of provider needs can expand awareness of what lurks on the competitive horizon. We compare your rivals on the bases of relevant dimensions,. This document focuses on administrative, financial, and clinical systems vendors, called: Client-Server Systems Vendors, Medical Billing Services Vendors, and Cloud-based vendors. EHR-EMR solutions and practice management systems (PMS) are primarily analyzed. Included are managed care information systems (MCIS) vendors. The results reflect information from the marketplace of reliable sources. Although the POMIS Vendor Database monitors more than 600 vendors, this competitive analysis focuses on the leading 100 vendors holding 87.0% share of the industry. These vendors are compared by several factors of market performance. Details of other competing vendors are provided in the POMIS Vendor Database as a Microsoft Access RDBMS. Vendors used had revenues greater than $200,000 and active in business. These vendors include: traditional practice management solutions, EHR-EMR solutions, and managed care information systems vendors in ambulatory care settings. The total revenues of each vendor are estimated. Some vendors offer hospital information systems (HIS). That part of the business is excluded in the revenue analysis of this report. THE POMIS INDUSTRY The POMIS industry is engaged in management and medical information technologies assembled or produced by computer systems and services companies that are sold physician organizations, including Jewson Enterprises 1497 Main Street, Suite 155 Dunedin, FL Office Center: Mobile: [email protected] Website:

5 CA - 2 implementation, training, and ongoing support. POMIS targets the performance of companies or vendors that make this transaction complete. POMIS VENDORS Number of Vendors: 614 as of June 14, 2014 Revenues: $10,933.2 million Ownership: Publicly held and privately held companies Major Products: Electronic Health Records-Electronic Medical Records (EHR-EMR) systems; managed care information systems (MCIS); and practice management systems (PMS) Deployment Methods: Client-server systems; medical billing services; and Cloud-based providers Customer Targets: o Solo & 2-physicians o Medical group practices practice size, multi-specialties, integrated health networks, and single-specialties, such as primary care (e.g., General/Family practice, Internal Medicine, Pediatrics, Obstetrics/Gynecology, Anesthesiology, Cardiovascular Surgery, Emergency Medicine, General Surgery, Ophthalmology, Orthopedics, Radiology, Urology, and others. o Hospital-based practices organized outpatient departments and emergency departments o Academic medical centers departments and divisions of accredited medical schools o Managed care plans IHNs, IPAs, PHOs, MSOs, and HMOs Free-standing ambulatory care facilities o Urgent care centers o Behavioral & Mental Health o Ambulatory surgery centers (ASC) o Medical imaging centers o Community health centers (CHC) o Rural health centers o Mental health centers o Planned Parenthood Agencies o Cancer/Hematology Centers o Pain Management Centers o Sports Medicine Clinics o Heart Centers o Etc. Vendors that are specialist in successful implementations of solutions are targeting their customers as: Small medical practices solo through 10-physicians practices Medium-sized medical practices 11 through 49-physicians practices Large ambulatory care enterprises 50 physicians and greater These groups have definitive buying cycles and good governance with some kind of visible plan whether weak or strong. A multi-specialty practice s buying behavior can be characterized. A singlespecialty practice requires understanding of specialty practice workflows and content needs. 2

6 CA - 3 Exhibit CA 1: Top twenty-five vendors market share by major segments Company Name POMIS Revenue Top 25 Leaders Relative to Major Market Segments - Millions of Dollars & Percent Client-Server Revenue MBS Revenue Cloud- Based Revenue PMS Revenue MCIS Revenue EHR-EMR Revenue EHR-EMR & PMS Ownership $10, $6, $ $3, $ $1, $ $9, McKesson Technology Solutions 8.5% 10.6% 10.8% 3.2% 0.0% 1.7% 0.0% 10.1% Publicly held Allscripts Healthcare Solutions, Inc. 6.2% 8.1% 0.0% 4.0% 0.0% 0.0% 0.0% 7.5% Publicly held EPIC SYSTEMS CORPORATION 5.7% 8.1% 0.0% 2.4% 0.0% 11.1% 0.0% 5.7% Privately held GE Healthcare Information Technology 5.3% 6.5% 0.0% 4.2% 0.0% 0.0% 0.0% 6.4% Publicly held TRIZETTO CORPORATION 4.9% 2.0% 0.0% 12.7% 0.0% 53.1% 0.0% 0.0% Privately held Vitera Healthcare Solutions 4.8% 6.5% 0.0% 2.5% 0.0% 0.0% 0.0% 5.8% Privately held NEXTGEN HEALTHCARE INFORMATION SYSTEMS, INC. 4.0% 4.6% 5.5% 2.2% 0.0% 0.0% 0.0% 4.9% Publicly held athenahealth, Inc. 3.9% 0.0% 15.5% 8.7% 0.0% 0.0% 0.0% 4.7% Publicly held CERNER CORPORATION 3.7% 4.0% 0.0% 4.1% 0.0% 0.0% 0.0% 4.5% Publicly held eclinicalworks, LLC 2.6% 1.9% 0.0% 5.0% 0.0% 0.0% 0.0% 3.2% Privately held Merge Healthcare Incorporated 2.1% 2.9% 0.0% 1.1% 0.0% 0.0% 0.0% 2.6% Publicly held ZOTEC PARTNERS 2.1% 0.0% 23.5% 0.0% 32.0% 0.0% 0.0% 0.0% Privately held DST Health Solutions, Inc. 2.0% 2.7% 0.0% 0.9% 0.0% 14.9% 0.0% 0.7% Publicly held Varian Medical Systems, Inc. 1.8% 2.9% 0.0% 0.0% 0.0% 0.0% 0.0% 2.2% Publicly held ELEKTA/IMPAC Medical Systems, Inc. 1.5% 2.4% 0.0% 0.0% 0.0% 0.0% 0.0% 1.8% Publicly held MEDICAL INFORMATION TECHNOLOGY, INC. (MEDITECH) 1.4% 1.4% 0.0% 1.8% 0.0% 0.0% 0.0% 1.7% Publicly held Siemens Medical Solutions USA, Inc 1.4% 2.2% 0.0% 0.0% 0.0% 0.0% 0.0% 1.7% Publicly held Healthcare Financial Services of TeamHealth 1.0% 0.2% 8.7% 0.4% 0.0% 0.0% 0.0% 1.2% Privately held T-System, Inc. 1.0% 0.0% 0.0% 3.3% 0.0% 0.0% 0.0% 1.2% Privately held Medac, Inc. 0.8% 0.0% 9.4% 0.0% 0.0% 0.0% 0.0% 1.0% Privately held EPBS Intermedix 0.8% 0.0% 8.6% 0.0% 0.0% 0.0% 0.0% 0.9% Privately held Netsmart Technologies, Inc. 0.7% 0.0% 5.5% 0.9% 0.0% 0.0% 0.0% 0.9% Privately held Origin Healthcare Solutions, LLC 0.7% 0.2% 2.1% 1.4% 0.0% 0.0% 0.0% 0.9% Privately held Orion Healthcorp, Inc. 0.7% 0.0% 6.1% 0.7% 11.5% 0.0% 0.0% 0.0% Privately held Delta Health Technologies, LLC 0.6% 0.5% 1.6% 0.5% 0.0% 0.0% 0.0% 0.7% Privately held Source: Jewson Enterprises POMIS Knowledge Base 3

7 CA - 4 Exhibit CA 2: Revenue Grouping of Vendors by Selected Segments Millions of Dollars Revenue Grouping of Vendors by Selected Segments, Millions of Dollars $1,457.00, 13% $2,013.47, 18% $5,426.20, 50% $2,036.45, 19% Leading 10 Vendors 11 to 25 Vendors 26 to 100 Vendors 101 Vendors Plus Source: Jewson Enterprises POMIS Knowledge Base Exhibit CA 3: Vendor Revenues Segmented by Groups Millions of Dollars Revenue Groupings of POMIS Vendors, Millions of Dollars All Vendors Top 200 Vendors Top 100 Vendors Top 75 Vendors Top 50 Vendors Top 25 Vendors $10, $10, $9, $9, $8, $7, Top 10 Vendors $5, Source: Jewson Enterprises POMIS Knowledge Base 4

8 CA - 5 Exhibit CA 4: POMIS Vendors Separated by the Rule on Revenues Depiction of Rule Based on Vendor Revenues Distribution Remaining 20%, $2, Vendors With 80%, $8, Source: Jewson Enterprises POMIS Knowledge Base Exhibit CA 5: Distribution of POMIS Vendors Relative Customer Markets Distribution of Vendors in Customer Markets Managed Care Plans Academic Medical Centers Large Enterprises to IHNs Hospital-Based Practices Solo to 5-physicians group 6-physicians to 99-physicians group Source: Jewson Enterprises POMIS Knowledge Base 5

9 CA - 6 GEOGRPHICAL DISTRIBUTION There are 600 POMIS vendors, down from 707 vendors in Health reform and the stimulus money incentives are affecting growth. Consolidation and mergers have and will continue to occur for at least large acquisition-centric vendors and vendors in the $3 - $20 million category that want to compete. Several medical billing services vendors have dropped out of business because most are underfinanced to deliver services based on the requirements from their customers. Several proponents in billing services have consolidated them into a services organization that hosts applications. Some enterprising business groups are beginning to consolidate billing services to get some market advantage. The evolution of the health care industry is toward an ambulatory medicine focus that requires open, integrated information systems with new medical office functionalities and connectivity to enterprisewide and community-wide networks. Functionalities include applications in care coordination, managed care contract management, healthcare transaction processing exchange and editing, EDI services now and pending, human-engineered operating systems, remote computing (e.g., pen-based and/or wireless) for physician-patient interfaces to clinical records systems, office-based medical records systems using relational database management technologies, and computer-based patient record network systems. Most vendors are small entrepreneurs running billing services or independent dealerships. Hundreds of billing services have licensed practice management systems from medical software publishers or major systems vendors. Likewise, hundreds of dealers market practice management systems from software publishers that will be listed later. These small, independent groups of vendors have built regional/local presence along with consulting services, using direct and referral sales, and low cost support capability. The distribution channel for products and services is essential to reaching medical office practices. Systems vendors who demand control over their channel of distribution use direct sales, while software publishers use dealers, distributors, and resellers who license the software system for marketing. Medical billing services use direct sales; some billing services have formed a kind of franchise chain to reach medical offices in strategic local geographic areas. 6

10 CA - 7 Exhibit CA 6: Distribution of Vendor Headquarters by State Vermont South Dadota New Mexico North Dakota Iawa Montana Maine Origon Hawaii Arkansas Alaska South Carolina Rhode Island Oklahoma New Hamshire Nevada Kentucky Idaho Delaware Connecticut Nebraska Minnesota Louisiana Alabama Kansas Wisconsin Washington Utah Colorado Maryland Tennessee Ohio Virginia Indiana Arizona Missouri Massachusatts Illinois North Carolina Pennsylvania Michigan Georgia New Jersey Texas Forida New York California Source Jewson Enterprises POMIS Knowledge Base 7

11 CA - 8 Exhibit CA 7: Leading Revenue Leaders Millions of Dollars Leading Revenue Leaders, Millions of Dollars eclinicalworks, LLC CERNER CORPORATION athenahealth, Inc. NEXTGEN HEALTHCARE INFORMATION Vitera Healthcare Solutions TRIZETTO CORPORATION GE Healthcare Information Technology EPIC SYSTEMS CORPORATION Allscripts Healthcare Solutions, Inc. McKesson Technology Solutions $285.0 $406.0 $422.3 $440.4 $525.0 $535.5 $580.0 $625.0 $680.0 $927.0 Source: Jewson Enterprises POMIS Knowledge Base Exhibit CA 8: Vendor Revenues Segmented by Groups Millions of Dollars All Vendors Top 200 Vendors Top 100 Vendors Top 75 Vendors Top 50 Vendors Top 25 Vendors Top 10 Vendors Vendor Revenues Segmented by Groups - Millions of Dollars $0.00 $2, $4, $6, $8, $10, $12, Source: Jewson Enterprises POMIS Knowledge Base 8

12 CA - 9 Exhibit CA 9: Revenue Share of Privately Versus Publicly Held Vendors Millions of Dollars Revenue Share of Privately and Publicly Held Vendors - Millions of Dollars Privately Held Vendors, $5, Publicly Held Vendors, $5, Source: Jewson Enterprises POMIS Knowledge Base DELIVERY METHODS POMIS is delivered under one or more of the following categories: Client-Server Configuration. Medical Billing Services Provider. Cloud-Based Provider. 9

13 CA - 10 Exhibit CA 10: Distribution of Delivery Methods Distribution of Delivery Methods MBS+C/S+Cloud MBS+C/S Only MBS+Cloud Only C/S+Cloud Only Cloud Only C/S Only MBS Only Cloud-Based (Cloud Client-Server (C/S) Medical Billing Services (MBS) Source: Jewson Enterprises POMIS Knowledge Base Exhibit CA 11: Pic Chart of Revenue Delivery Methods Market Share Market Segment of Delivery Methods - Millions of Dollars Cloud-Based Segment, $3, Medical Billing Services Segment, $ Client-Server Segment, $6, Source: Jewson Enterprises POMIS Knowledge Base 10

14 CA - 11 CLIENT-SERVER DELIVER METHOD VENDORS ANALYSIS Exhibit CA 12: Leading Client-Server Revenue Vendors Millions of Dollars Leading Client-Server Vendors in Revenues - Millions of Dollars DST Health Solutions, Inc. Varian Medical Systems, Inc. Merge Healthcare Incorporated CERNER CORPORATION NEXTGEN HEALTHCARE Vitera Healthcare Solutions GE Healthcare Information EPIC SYSTEMS CORPORATION Allscripts Healthcare Solutions, Inc. McKesson Technology Solutions $ $ $ $ $ $ $ $ $ $ $- $ $ $ $ $ $ $ $ Source: Jewson Enterprises Knowledge Base 11

15 CA - 12 MEDICAL BILLING SERVICES DELIVERY METHODF VENDORS ANALYSIS Exhibit CA 13: Leading Medical Billing Services Vendor Revenues Millions of Dollars Leading Medical Billing Services Vendor Revenues - Millions of Dollars NEXTGEN HEALTHCARE Orion Healthcorp, Inc. AdvantEdge Healthcare Solutions, Inc. MedAmerica Billing Services, Inc. EPBS Intermedix Healthcare Financial Services of Medac, Inc. McKesson Technology Solutions athenahealth, Inc. ZOTEC PARTNERS $52.85 $57.96 $58.80 $64.10 $82.40 $83.46 $90.00 $ $ $ $0.00 $50.00 $ $ $ $ Source: Jewson Enterprises Knowledge Base 12

16 CA - 13 CLOUD-BASED DELIVERY METHOD ANALYSIS Exhibit CA 14: Leading Cloud-Based Vendors Millions of Dollars Source: Jewson Enterprises POMIS Knowledge Base MAJOR MARKET PRODUCT CATEGORIES The major product market segments are: Practice Management Systems Management Care Information Systems EHR-EMR Solutions Integration of EHR-EMR & PM Solutions 13

17 CA - 14 Exhibit CA 15: Pie Chart Distribution of Major Product Categories Revenues Millions of Dollars Product Segmentation Revenue Analysis - Millions of Dollars $ $1, $9, $ Practice Management Solutions EHR-EMR Solutions Only Managed Care Information Systems EHR-EMR Solutions & PMS Source: Jewson Enterprises Knowledge Base Exhibit CA 16: Distribution of Vendors by Major Product Categories Distribution of Major Product Categories Mix MCIS Only PMS+MCIS Only PMS+EHR-EMR+MCIS Managed Care Information Systems EHR-EMR Only PMS Only PMS+EHR-EMR Only EHR-EMR Solutions Practice Management Systems (PMS) Source: Jewson Enterprises POMIS Knowledge Base 14

18 CA - 15 PRACTICE MANAGEMENT SOLUTIONS VENDOR ANALYSIS Exhibit CA 17: Leading Practice Management Solutions ONLY Vendors Millions of Dollars Leading PM Solutions ONLY Vendors - Millions of Dollars PRACTICE ALTERNATIVES, INC. HEALTH CARE SOFTWARE, INC. MedPro Solutions, LLC Medical Management Resources, Inc. Professional Management, Inc ACADIANA COMPUTER SYSTEMS, INC. AdvantEdge Healthcare Solutions, Inc. MedAmerica Billing Services, Inc. Orion Healthcorp, Inc. ZOTEC PARTNERS $15.0 $16.1 $16.2 $16.3 $18.3 $26.0 $58.8 $64.1 $80.5 $225.0 $- $50.0 $100.0 $150.0 $200.0 $250.0 Source: Jewson Enterprises Knowledge Base MANAGED CARE INFORMATION SYSTEMS (MCIS) ANALYSIS Exhibit CA 18: Leading Managed Care Information Systems Vendors Millions of Dollars Leading MCIS Vendors in POMIS Database - Millions of Dollars McKesson Technology Solutions Brightree, LLC Eldorado/MPHASIS $16.7 $28.8 $30.4 EPIC SYSTEMS CORPORATION DST Health Solutions, Inc. $112.2 $150.5 TRIZETTO CORPORATION $535.5 $- $100.0 $200.0 $300.0 $400.0 $500.0 $600.0 Source: Jewson Enterprises Knowledge Base 15

19 CA - 16 EHR-EMR SOLUTIONS VENDORS ANALYSIS EHR-EMR SOLUTIONS COMPETITORS An -EHR-EMR system competitor offers a system either as a standalone EHR-EMR systems vendor, as a practice management systems vendor, or as a SaaS provider. The EHR-EMR systems vendor specializes in clinical applications that are distributed directly to the medical practice or through an alliance with traditional practice management systems vendors that interface or integrate the -EHR-EMR with their practice management solution. Some POMIS vendors have developed their own -EHR-EMR and offer it directly to their customer base. The newer, emerging SaaS competitors use Internet technology as the deployment model of practice applications. It s nationally clear that health information is vital. It s vital to manage national health expenditures, to increase access to care, to maximize the quality of care, and to optimize patient outcomes. Citizens who seek care expect their caregivers to know allergies, chronic conditions, current medications, and other pertinent health care information to deliver effective treatment. Information technology will affect these mandates through efficiency improvements, which enables changes in health care workflow processes. CHARACTERISTICS OF EHR-EMR SOLUTIONS VENDORS In order for -EHR-EMR systems to meet needs in an ambulatory care setting for clinical, legal, and administrative requirements, its information infrastructure must support various component-ware functions: data capture, storage, processing, communication, security, and presentation. Since the marketplace varies from solo practitioners of several specialties to integrated health enterprises, there are three configurations: One for the solo and 2-physicians practice, One for medical group practices that may differ by number of remote locations, and IHNs that bring together physician s offices and group practices as an enterprise of differing deliveries of care. For example, a physician in a solo and 2-physicians practice is looking for a system to address managed care financial/administrative requirements and a patient/clinical-oriented system to rapidly document patient visits, reduce managed care paperwork, and automatically code member/population/patient episode of care. Larger groups, on the other hand, have more sophisticated needs of managed care contract management integrated with the concern for enterprise-wide EHR-EMR functionalities. The -EHR-EMR system license or user price varies for the first year of implementation by number of physicians/providers. In a SaaS model, the subscription price varies from $450 to $2,000 per physician per month after basic upfront costs. Most applications, although fulfilling our definition, are a mixture of database management functions and word processing program innovations. Others have adopted a chart dictation system, pen-based technology, wireless technology, or patient education strategy built around EHR-EMR system functionality. There is a small marketplace of medical office practices that have developed or are developing their own EHR-EMR systems, using component-ware from vendors. Other -EHR-EMR systems vendors are 16

20 CA - 17 clinical software publishers who market standalone systems directly to medical offices and indirectly through marketing agreements with POMIS vendors. Lastly, POMIS vendors have developed their - EHR-EMR systems that are integrated into their traditional practice management system. Exhibit CA 19: Revenue Leading Vendors offering EHR-EMR Solutions Only Millions of Dollars Revenue Leading EHR-EMR Only Vendors in Top Dollars in Millions Medflow, Inc. Health Communication Systems (HCS) Novarad Corporation CODONIX, INC. Forerun, Inc. HealthMEDX, Inc. CHARTCARE, INC. iknowmed $- $5.00$10.00$15.00$20.00$25.00$30.00$35.00$40.00$45.00$50.00 Source: Jewson Enterprises POMIS Knowledge Base Exhibit CA 20: Revenue Leaders Offering Integrated EHR-EMR Solutions Revenue Leaders Offering Integrated EHR-EMR Solutions Merge Healthcare Incorporated eclinicalworks, LLC CERNER CORPORATION athenahealth, Inc. NEXTGEN HEALTHCARE EPIC SYSTEMS CORPORATION Vitera Healthcare Solutions GE Healthcare Information Allscripts Healthcare Solutions, Inc. McKesson Technology Solutions $ $ $ $ $ $ $ $ $ $ $- $ $ $ $800.00$1, Source: Jewson Enterprises POMIS Knowledge Base 17