U.S. MARKET OVERVIEW Ambulatory Applications (Hospital-Owned Ambulatory Facilities) 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.
Ambulatory Definitions Practice Management: an application that provides the registration, scheduling, and billing functions for a physician office or clinic. Electronic Medical Record: an application that provides support for clinical documentation, order entry, clinical data repository, provider order entry, and templates for provider clinical documentation for ambulatory facilities. Laboratory: an application that provides the necessary functions for registering outpatient/ambulatory encounters, creating test orders, creating worklists, reporting results, creating insurance/patient bills, and managing quality assurance and workflow functions. These applications must be CLIA* compliant. *Clinical Laboratory Improvement Amendments (http://www.cms.hhs.gov/clia/)
Ambulatory Definitions Pharmacy: an application that provides the necessary functions for registering outpatient/ambulatory encounters, creating medication orders, performing drug conflict checking, creating fill lists, billing insurance companies/patients, and managing the drug inventory for the ambulatory services. Radiology: an application that provides for the registration and scheduling of outpatient/ambulatory encounters, diagnostic orders, worklists, results reporting, insurance/patient billing, and workflow management for completing all ordered services.
Ambulatory Applications Summary of Installation (2009/2010)* Practice Management AEMR Laboratory Radiology Pharmacy 15% 17% 16% 17% 5% 5% 53% 56% 97% 97% With an installation rate of 97 percent, practice management software has reached market saturation. About half of the ambulatory facilities (56 percent) have installed or contracted to install ambulatory EMR (AEMR) software. Implementation rates for most of the applications in this suite increased in the past year. 2009 (N= 22,870) 2010 (N= 24,573)
Ambulatory Applications Summary of Plans (in Not Automated Ambulatory) AEMR Practice Management Radiology 10,671 718 0.01% 1.67% (18,322) 3.21% By percent and volume, hospitalowned ambulatory facilities are most likely to purchase ambulatory EMR systems for the first time. Pharmacy 0.01% (2,065) Laboratory 0.00% (20,396) Number in white or parenthesis represents number of not automated ambulatory facilities. Percent of "Not Automated" Ambulatory Facilities Planning to Purchase Software
Ambulatory Applications Summary of Plans (Replacing Current Software) AEMR Radiology Practice Management Laboratory 0.34% (13,826) 0.27% (4,117) 0.25% (23,781) 0.22% (4,153) In general, activity in this market is low. By volume, replacement of practice management software is the highest when compared to the other ambulatory applications. By percent, plans to replace ambulatory EMR is the highest. Pharmacy 0.07% (1,347) Number in parentheses represents number of ambulatory facilities with installed or contracted systems Percent of Ambulatory Facilities with Installed or Contracted Systems Planning to Purchase Software
Ambulatory Applications Summary of First Time Purchases & Replacements AEMR (N=390) Laboratory (N=9) Pharmacy (N=2) Practice Management (N=71) Radiology (N=12) 12% 50% 88% 100% 83% 92% 50% 17% 8% With the exception of AEMR and pharmacy, most of the planned ambulatory applications purchases will be replacement purchases. Only twelve percent of AEMR purchases will be replacements. Percent of Ambulatory Facilities with Installed Software - Replacing Percent of Ambulatory Facilities Planning to Purchase Software for the First Time
Ambulatory Applications Summary of Installation 2009 (N=11,970) 2010 (N=13,777) 61% 63% There are 13,777 hospital-owned ambulatory facilities that have installed both practice management software and an EMR. Nearly twothirds (63 percent) of these facilities use the same vendor for both solutions in 2010. N represents number of ambulatory facilities that have both practice management and ambulatory EMR. Percent represents the percentage of ambulatory facilities with same vendor for practice management and ambulatory EMR.
N=24,573 Summary of Installations 23,983 ambulatory facilities (98 percent) indicated they have installed (or signed a plan to install) at least one of the five ambulatory applications tracked in this report. 23,830 facilities have either installed or signed a contract for Practice Management or EMR. Of these facilities, 13,777 indicated having installed or signed a contracted to install both practice management and EMR software. 5,925 ambulatory facilities have installed software or signed a contract for at least one of the ancillary ambulatory applications (Laboratory, Pharmacy and Radiology). 1,078 of these facilities have installed or signed a contract for all three ancillary applications.
Ambulatory EMR Top Ten Installed and Contracted Systems Vendor # of Installations % of Market* EPIC 3,471 25.28% ALLSCRIPTS 1,611 11.73% GE HEALTHCARE 1,575 11.47% CERNER CORPORATION 1,499 10.92% NEXTGEN HEALTHCARE 1,060 7.72% LSS DATA SYSTEMS 1,033 7.52% ELCINICALWORKS 803 5.85% MCKESSON 685 4.99% SELF-DEVELOPED 322 2.35% ECLIPSYS CORPORATION 271 1.97% 69 Vendors share the remaining 10.28% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 13,730
Ambulatory Laboratory Top Ten Installed and Contracted Systems Vendor # of Installations % of Market* SUNQUEST INFORMATION SYSTEMS 940 25.69% CERNER CORPORATION 743 20.31% MEDITECH 680 18.58% SCC SOFT COMPUTER 431 11.78% EPIC 239 6.53% MCKESSON 220 6.01% GE HEALTHCARE 75 2.05% CPSI 54 1.48% SIEMENS HEALTHCARE 38 1.04% P-WAVE, INC. 30 0.82% 20 Vendors share the remaining 5.74% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 3,659
Ambulatory Pharmacy Top Ten Installed and Contracted Systems Vendor # of Installations % of Market EPIC 559 42.25% CERNER CORPORATION 175 13.23% PDX, INC. 147 11.11% MCKESSON 93 7.03% MEDITECH 92 6.95% QS/1 DATA SYSTEMS 61 4.61% GE HEALTHCARE 56 4.23% SIEMENS HEALTHCARE 34 2.57% SXC HEALTH SOLUTIONS, INC. 17 1.28% SELF-DEVELOPED 14 1.06% CAREPOINT, INC. 14 1.06% 15 Vendors share the remaining 4.62% of the market. N = 1,323
Ambulatory Radiology Top Ten Installed and Contracted Systems Vendor # of Installations % of Market* CERNER CORPORATION 877 21.90% EPIC 695 17.36% MEDITECH 624 15.58% GE HEALTHCARE 554 13.51% SIEMENS HEALTHCARE 418 10.44% MCKESSON 366 9.14% MERGE HEALTHCARE 105 2.62% CPSI 56 1.40% SUNQUEST INFORMATION SYSTEMS 47 1.17% AGFA HEALTHCARE 47 1.17% 25 Vendors share the remaining 5.82% of the market. * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed. N = 4,004
Practice Management Top Ten Installed and Contracted Systems Vendor # of Installations % of Market* GE HEALTHCARE 3,841 16.27% LSS DATA SYSTEMS 3,154 13.36% EPIC 2,947 12.48% MCKESSON 2,251 9.53% ALLSCRIPTS 1,779 7.54% SIEMENS HEALTHCARE 1,590 6.73% CERNER CORPORATION 1,038 4.40% SOURCE MEDICAL 1,031 4.37% NEXTGEN HEALTHCARE 1,025 4.34% MEDICAL INFORMATION MANAGEMENT SYSTEMS, LLC. 145 Vendors share the remaining 21.41% of the market. N = 23,609 713 3.02% * The total percentage may exceed 100 percent due to rounding or some organizations may have more than one vendor installed.
Ambulatory EMR Vendors Being Considered for a Planned Purchase Vendor # of Times Considered HEALTHLAND 51 MCKESSON 50 CERNER CORPORATION 50 NEXTGEN HEALTHCARE 32 ECLINICALWORKS 25 ALLSCRIPTS 15 CPSI 14 EPIC 7 ECLIPSYS CORPORATION 7 LSS DATA STSTEMS 6 HEALTHCARE MANAGEMENT SYSTEMS, INC. 3
Ambulatory Laboratory Vendors Being Considered for a Planned Purchase Vendor # of Times Considered MCKESSON 2 CERNER CORPORATION 2 MEDITECH 1
Ambulatory Pharmacy Vendors Being Considered for a Planned Purchase NONE MENTIONED Vendor # of Times Considered
Ambulatory Radiology Vendors Being Considered for a Planned Purchase Vendor # of Times Considered MCKESSON 1 MEDITECH 1 CERNER CORPORATION 1
Practice Management Vendors Being Considered for a Planned Purchase Vendor # of Times Considered MCKESSON 9 ECLIPSYS CORPORATION 9 CERNER CORPORATION 9 ALLSCRIPTS 9 NEXTGEN HEALTHCARE 1 LSS DATA SYSTEMS 1 EPIC 1 ECLINICALWORKS 1
Ambulatory Applications Temporal Summary of Contracts AEMR (N=6,056) Laboratory (N=1,198) Pharmacy (N=362) Practice Management (N=11,871) 27% 16% 10% 22% 44% 40% 36% 67% 31% 40% 34% More than half of contracts for all applications have been signed since 2000. Two-thirds of ambulatory EMR contracts were signed between 2005 and 2010. Radiology (N=1,366) 10% 61% 26% Prior to 1985 1985 to 1989 1990 to 1994 1995 to 1999 2000 to 2004 2005 to 2010
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