The ‘Top 20’ EHR Vendors and Microbrews

Recently Healthcare IT News ran an article highlighting the top EHR vendors, based on various factors including Meaningful Use. The list was prepared by the Black Book, a division of market research firm Brown-Wilson Group, and was based on a four-month poll of 30,000 healthcare providers and professionals.

I thought this would be an interesting article, and probably helpful too, given the large universe of EHR vendors and systems out there. (MGMA, the Medical Group Management Association, lists over 300 systems in their most recent study.). So any effort to narrow the field and select best of breed systems ought to be interesting. Or so I thought.

Alas the actual “list” consists of six different lists, broken down into size of medical practice (single provider, 2-5 providers, 6-9, etc., on up to 250+). Within each category, Black Book ranks the top 20 EHR vendors. So even within this so-called “top” list, there are still many dozens of top choices.

What is the implication for a provider and/or his/her administrator? It highlights the intense challenges faced by health care practitioners and managers in evaluating, selecting and implementing EHRs.

I can think of no other industry – transportation, hospitality, retail, telecommunications, etc. - that would have anywhere near 20 TOTAL software providers/systems, let alone 20 “top” systems. In any other industry, if you were to select an accounting or customer service or billing or desktop publishing system, you could count the list of viable choices on one hand. In healthcare, there are dozens and dozens of viable candidates, each claiming to be the best, based on the following self-proclaimed parameters:

1. Certified by some specialty association or certifying body (there are so many);
2. Claiming they are different from all the rest, because they are designed for doctors, by doctors (nearly all vendors have at least one physician on their advisory board);
3. Winner of all kinds of awards (the categories are sometimes so narrow and seemingly far-fetched that I’m waiting for the award for The Top EHR System For Doctors West of St Louis Who Are Left Handed And Have An Irish Surname.); and
4. Intuitive, easy to use, web-based and plug-and-play.

The point is, if you step back and kind of squint, they definitely all look and sound the same.
Many people ask, “Why are there so many EHR systems? Why can’t the HIT industry just settle on one or two?”

The situation reminds me of the explosion of microbreweries in recent years. Why are there over 500 microbreweries in the US (according to the Brewers Association)? Wouldn’t it be more efficient to just have a handful of brands?

In America we like choice. We like to be different. We want what we want, and we don’t want anyone to tell us what to do or limit our choices.

So we are left with an EHR marketplace where there are literally hundreds of choices, and a list of “top” providers is still an unmanageable number. And in spite of many standards for interoperability, the situation is a technology “tower of Babel” unlike any other industry.

Maybe having a good microbrew first could help the EHR selection process.