Friday, August 31, 2007

Looking at EHR adoption growth from the supply-side

One of MAeHC's EHR vendors, eClinicalWorks, has made Inc. magazine's Top 500 Fastest Growing Private Companies in America. eCW has won plenty of accolades in health industry rankings, but this is the first time that I've seen an EHR company rank highly in national comparisons across all industrial sectors; with over 2500% growth, they ranked #34 overall, #4 among all software companies, and #1 among Massachusetts companies. Congratulations to Girish Kumar, Mahesh Navani, Dr. Rajesh Dharampuria, and the entire eCW team.

It made me wonder how much of this is a market phenomenon vs an individual company story. If EHR use is substantially growing, supply would have to be increasing through some combination of new entrants and substantial growth for existing companies. Since the EHR market is very fragmented with many more private companies than public (CCHIT certified more than 90 vendors last year), I would expect to see a lot of EHR companies on the Inc list. Well, they may be there, but I couldn't find them. My non-scientific, non-exhaustive searching of the Inc. website found only one other CCHIT-certifed vendor: Greenway, at #1570 with 227% growth. I also found a practice management vendor (AdvancedMD), which came in at #465.

Of course, the larger players such as Allscripts, NextGen, GE, wouldn't appear on the Inc list because they're publicly traded. According to their SEC filings, they've shown healthy -- but not spectacular -- growth (15-20%) over the past year.

In 2004, President Bush set a goal to have the majority of Americans on an "interoperable EHR" by 2014. Robert Kolodner recently projected that the US would reach this objective. Outside of eCW's huge growth, there doesn't seem to be much obvious evidence that the EHR market is on the steep part of the "hockey stick" growth path that would be required to take us from the current situation -- where probably 10% of Americans' records are on an "interoperable EHR" -- to the goal of having 51% seven years from now.

5 comments:

Blackford Middleton said...

Micky -- actually, MedicaLogic was an Inc. Magazine Top 500 company in 1997 or 1998 (i can't remember which). Best, Blackford

Micky Tripathi said...

Good to know -- would love to hear of any others. Thanks Blackford.

Paul Levy said...

Not on this topic, but please check out this link. I think you all will enjoy it: http://runningahospital.blogspot.com/2007/09/hbs-on-it-case.html

David S. said...

At the other end of the spectrum, how about AcerMed, recently out of business? Apparently the tide is not going up fast enough to lift all boats.

Micky Tripathi said...

Thanks Paul and Dave.

What these comments exemplify, I think, is the growing digital divide. Larger, organized institutions are moving forward (and few, if any, faster than BIDMC!), while the small independent docs proceed at a sluggish pace.