Free EHR Is Market Leader Among Small Practices

May 20, 2015

A free, cloud-based electronic health record (EHR) system is the market leader among practices with three or fewer clinicians, while the top program among larger groups comes from a vendor that caters to hospitals, a new survey reports.

Practice Fusion, made by the eponymous company, has 15% of the solo ambulatory market and 12% of all practices of one to three clinicians, according to the survey by AmericanEHR Partners, a free online resource for adopting this digital technology founded by the American College of Physicians and Cientis Technologies. AmericanEHR Partners conducted its survey from January 2013 through November 2014.

The popularity of Practice Fusion reflects the propensity of small, independent, and cash-strapped practices to choose an EHR system based on price, said Thomas Stringham, founder and chief executive officer of Cientis Technologies, which develops Web-based tools, apps, and communities for clinicians. "That's a big part of the company's ability to capture much of this market," said Stringham.

Practice Fusion doesn't blow away the competition in the rating system devised by AmericanEHR Partners, but nevertheless holds its own. It numbers among the top 10 products in five of 10 rating categories — implementation experience, training, support experience, interfaces, and purchase experience (fourth from the top).

Practice Fusion and nine other EHR systems accounted for 55% of solo practice, and virtually the same lineup accounted for 51% of practices with one to three clinicians.

Top EHR Systems by Market Share* for Solo Practices

Practice Fusion 15%
eClinicalWorks 9%
EpicCare Ambulatory EMR 5%
Amazing Charts 5%

*5% and above

Source: AmericanEHR Partners

Top EHR Systems by Market Share* for Practices of 1 to 3 Clinicians

Practice Fusion 12%
eClinicalWorks 9%
EpicCare Ambulatory EMR 5%

*5% and above

Source: AmericanEHR Partners

Using Mandated Software

The survey by AmericanEHR Partners confirmed what many other surveys have found — the dominant vendor among larger medical groups is Epic. Its EpicCare Ambulatory EMR (electronic medical record) had a 14% share of groups with four to 10 clinicians, 25% share of groups with 11 to 25 clinicians, and 16% share of those with 26 clinicians and more.

Epic markets its software to megagroups and hospitals, but smaller practices owned by these Big Box entities use the software as well. "In most cases, it's being mandated," said Stringham, noting that physicians who work in hospital-owned practices don't call the shots on software purchases.

Among groups of all sizes, EpicCare Ambulatory EMR shows up in only one of the 10 rating categories — order management — in the AmericanEHR Partners survey. "They're not leading the market in terms of satisfaction," said Stringham. His company's research, he said, has found that physicians would like their EHR systems more if they had a role in selecting them.

Nipping at Epic's heels in terms of larger-group market share are eClinicalWorks, Cerner Millennium PowerChart PowerWorks, and NextGen Ambulatory EHR. eClinicalWorks is second in the four-to-10 category, Cerner second in the 11-to-26 category, and NextGen second in the plus-26 category.

More information about the AmericanEHR Partners survey is available at the organization's website.

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