EHR market begins to sort itself out

Electronic health-record (EHR) systems are becoming a central part of the physicians’ everyday work, especially those that are employed by integrated health systems. As such, they become a potentially valuable communications channel for the pharma industry, especially those that are cloud-based and accepting of pharma industry input. But one of the problems (there are others) is the diversity of vendors: estimates range from the mid-400s to over 700 distinct vendors.

Now, according to the physician practice data collected by SK&A, a unit of Cegedim Relationship Management, the market is beginning to sort itself out. SK&A’s latest surveying shows that Epic Systems leads, with 10.8% of physicians polled, using it. eClinicalworks, No. 2, is close behind, with 10.0%, and Practice Fusion is arguably the up-and-comer, rising from the seventh to fourth position since 2012 (Table). Moreover, nine of the 10 top EHR systems were on the list in 2012; the only new player is Athenahealth. However, these 10 vendors represent only 53% of the overall market—so it is still a very fragmented market.

SK&A data show that physician involvement with the systems is rising: they are now used by 61% of physicians, up from 50.3% a year ago. System usage has been spurred by federal funding of healthcare IT (HIT) going back to the economic stimulus package of the first Obama administration. “Meaningful use” requirements of HIT will soon penalize healthcare offices receiving federal reimbursements that are not digitized.

For the pharma industry, however, the picture is more nuanced, based on the business models of the EHR vendors. Some sell on-premise IT systems that are essentially closed; others—notably Practice Fusion—have open systems and are supported by funding from pharma and other healthcare players. A third path is for the systems to be linked to other information sources. Athenahealth purchased Epocrates, an online drug-information database (which provides some access to pharma), in 2012; PDR Network, among others, provides drug information and ancillary communications such as Dear Dr. letters to a “PDR Partnership Network” that ultimately connects with 225 EHR systems. (The company has also recently opened a business unit expressly for pharma marketers.)

For pharma, the attraction is to have a presence in front of physicians during their “digital workflow”—including at the point of care. But the landscape is rapidly evolving, and best industry practices are a long way from being established.