The Doctor’s Company, a medical malpractice insurance firm, surveyed 5,105 doctors nationwide about EHR adoption. According to the report, here’s the top 5 states leading EHR adoption:
* 41% EMR Adoption by Oregon’s Physicians
* 39% EMR Adoption by Georgia’s Physicians
* 37% EMR Adoption by Florida’s Physicians
* 35% EMR Adoption by Washington’s Physicians
* 34% EMR Adoption by Virgina’s Physicians

Another interesting stat from the study said that 17% of doctors surveyed said they had no plans to use an EHR in their practice.

I’m sure we could talk about ~5,000 doctors not being a representative sample for 50 states, but the numbers are interesting. I think it’s also worth noting that the highest EHR adoption they found for a state was 41%. So much for all those people who say that EHR adoption has topped 50%. I still put it at the 25-30% range for overall EHR adoption.

I think it would be interesting to do a little digging and see how good the HIE efforts are in each of these states that have higher EHR adoption. While EHR isn’t an absolute pre-requisite for an HIE, it is in my book.

The 17% of doctors not wanting to adopt an EHR isn’t that surprising. In fact, I could have imagined it higher. Although, that’s going to change over the next 5 years. Sure, there will always be that 5% that won’t change, but most of the rest won’t have much choice.

Healthcare Financial News posted the following number of the EMR market.

Propelled by government incentives, a desire to improve patient outcomes and the bottom line, sales of electronic medical records reached $17.9 billion in 2011, up 14.2 percent from the previous year, according to market research publisher Kalorama Information.

I’m not sure of the exact EHR incentive figures for 2011, but I have seen the number $3.1 billion paid to 43,000 providers from Justin Barnes. It’s no doubt somewhere in that range and is an interesting number to compare against the $14.2 billion in EHR sales in 2011.

That’s quite a big difference in number. I’m sure many doctors would easily argue that the difference is because the EHR incentive money doesn’t cover all the costs to get an EHR. I’m sure there were also many EHRs purchased in 2011 that won’t see EHR incentive money until 2012. It will be really interesting to see these numbers again at the end of 2012. I also wish they’d have broken the number out by hospital EHR and ambulatory EHR. I have a feeling that hospital EHR software dominates that number.

The news recently came out that Hello Health has raised $10 million in funding. For those that aren’t familiar with Hello Health, here’s a pretty good description of what they do from the press release:

For years, physicians have experienced revenue reductions and, more recently, declining patient visits and must now look to ‘market their practices’ beyond quality of care to include: secure online communications that improve information and care team access, and provide greater convenience for patients. Hello Health is a Patient Management Platform that allows independent primary care physicians to transition from paper to electronic medical records and to provide a patient health portal through a subscription-based plan. Patients pay a small fee for the ability to schedule appointments, request lab results, renew prescriptions, share medical information and communicate (via HIPAA-compliant email, instant messaging and video consults) with their doctors and medical health professionals. The Hello Health Patient Management Platform was developed to provide an improved revenue stream for physicians while also enhancing patient engagement and providing better time and workflow management, all of which combine to strengthen the independence and sustainability of a practice.

I think it was a really interesting move for Hello Health to put a full blown EHR on top of their previous product offering. If you’re going to connect doctors with patients, then you really need to tap into the doctors EHR software. What better way to tap into that software than to just give the doctor the EHR software for free.

I also find it interesting that BlueCross BlueShield Venture Partners is part of the funding round. While this is the venture arm of BlueCross BlueShield, it’s still interesting to see a health plan get so close to EHR software. There are plenty of health plans getting connected to HIEs, but not as many to EHR software.

I think the model of healthcare that Hello Health is working on is quite interesting and could represent a larger trend in healthcare: technology facilitating lower cost healthcare. I’ll be writing more on this in the future.

A few days ago the news came out that Y Combinator startup company DrChrono has raised another $2.8 million in funding. Here’s the summary from Techcrunch:

Drchrono, a startup that simplifies the professional lives of doctors by bringing electronic health records and much more to the iPad, has raised $2.8 million in funding led by Yuri Milner, with Google’s Matt Cutts and other investors participating. The startup had previously raised $1.3 million in seed funding from Milner, General Catalyst, Charles River Ventures, 500 Startups, Gmail creator and FriendFeed cofounder Paul Buchheit, Cutts, and the Start Fund.

It’s an interesting mix of people that are funding DrChrono. Matt Cutts interests me a bunch since he works on the search engine team at Google in charge of Spam. Obviously, this is a quite different space.

The most interesting information in the Techcrunch article is the number of providers and patients that DrChrono has in its system.

The company also announced it now has more than 15,000 registered providers, and more than 400,000 patients using the drchrono platform.

Of course, we know how EMR companies are with these numbers. It’s one thing to have a registered provider and it’s quite another to have them actually using the EHR software. Also, I can’t help but wonder if the 400,000 patients includes imports of a physicians past patients. I’d love to hear some real numbers. For example, how many daily active users (doctors) do they have using their iPad EHR?

I also find it interesting that DrChrono has only taken $4.1 million in funding versus funding like CareCloud’s $27.3 million and Practice Fusion’s $38 million. Seems like DrChrono has chosen the much more conservative EHR software route as opposed to the more ambitious healthcare platform route that the others are working on.

I always find it interesting to see various list of EMR and EHR software. Most of the lists don’t have much thought put into their creation. However, it’s fun to look through all the lists and see which EMR companies end up making it on the list. Plus, it’s good to know the next time you see them talking about being a top EMR software where that list might have come from.

This list of Top EMR Software companies comes from the people at Medical Software Advice. I’m not sure how they get this list, but it’s an interesting one. No doubt the list is a bit biased by the EHR vendors that actually work with Medical Software Device. Maybe this is the top 10 EMR software companies that can market. There are some of the major EHR companies on this list though, so take a look. Always good to triangulate multiple top EMR lists to narrow down your selection process.

For those in the industry, you’ll enjoy reading through the descriptions of each company.

The money continues to flow into healthcare IT. Today’s announcement is an interesting funding, because it’s for a pretty niche healthcare IT product. Geek Wire announced that Valant Medical Solutions has closed a $937,000 angel round of funding.

Valant Medical Solutions, which has developed software to help psychiatrists manage billing and electronic medical records at their practices, has scored $937,000 in financing in an oversubscribed round, according to a SEC filing. The deal follows a $1 million round last December.

The timing was interesting since I’d been recently interacting with Valant Medical about possibly advertising across my network of EMR and EHR websites. I’m guessing a good portion of this new funding will go towards marketing their product and increasing their brand recognition.

As someone who has implemented an EMR in the mental health space, I can assure you that it’s quite different from a traditional EMR implementation. A simple example is the way a mental health counselor diagnosis. In mental health they use DSM IV as opposed to ICD-9, but the diagnosis also doesn’t usually change with every visit like it often does in most healthcare offices. Long story short, I think there’s definitely space for a behavioral health EMR to satisfy the unique needs of psychiatrists and counselors.

In the above linked article, I found this comment by David Lischner, founder of Valant Medical, quite interesting:

Our world domination strategy starts: “First with gaining market share, then connecting patients and providers, and lastly with providing a platform for transforming health care service delivery. Network effects will help us sustain market power as we add value to and extract revenue from all types of transactions within behavioral health care.”

I hope that Valant Medical makes it to the second and third things he mentioned. That’s when things should get really interesting.

I saw this tweet a little while ago that caught my eye.

Millennium Research Group predicts #EHR software market will reach $8.3 billion by 2016. Read more: http://t.co/AndxfJod

November 17, 2011 2:32 pm via Social Marketing HubReplyRetweetFavorite

@NaviNet

NaviNet, Inc.

According to the linked article, the Millenium Research Group is predicting strong revenue growth for the next half-decade. It also says that the medicare reimbursement penalties will continue to drive EHR demand.

Probably even more amazing than the market number is they say that 750 companies offering some kind of EMR solution entered the space in the span of two years.

None of this is really news for us participating in the space. Although, I imagine the $8.3 billion EMR market number will make its way into a number of investor presentations.

Today I was looking at my list of posts on EMR Thoughts and saw that this post will make the 100th post to EMR Thoughts!! So, I decided it’s time to celebrate that milestone.

The funny thing about celebrating milestones like this is that I use to do it all the time when I started EMR and HIPAA about 6 years ago. Now that I have so many site, I don’t remember to look back at the newer sites and realize how far they’ve come nearly as much.

The first post to EMR Thoughts was done on April 14 of this year. So, that’s 100 posts in 8 months. Not too shabby. I also love that EMR Thoughts has gotten 128 comments on the site in that time as well. That’s pretty amazing interaction with readers for a new blog. Considering how few people comment compared to just reading and leaving, I’m grateful for all of you that took the time to join in on the conversation.

I also just checked the pageview stats for the site and it looks like in the next day will top the 20,000 page views mark for this site as well. It will be fun to look back on that number a couple years from now. I have a feeling we’ll blow it out of the water over the next year.

I must admit that I really wasn’t sure the type of content that I’d post on EMR Thoughts. I just knew that I had way too much content and not enough places to post it, so I started the site. 100 posts in, EMR Thoughts has turned into my place to discuss the EMR and Healthcare IT market. Any post that has to do with the size of the market, changes in the market, investments in EMR or healthcare IT will likely end up on EMR Thoughts. A quick look at the list of posts on the EMR Thoughts archives page tells an interesting story about the EMR, EHR and Healthcare IT market.

Well, 100 posts down. Now on to the next 100. Although, I bet I’ll probably lose track and not celebrate until EMR Thoughts reaches 500 posts.

Thanks everyone for reading and a Big Thanks to the advertisers on the site.

@ElinoreBoeke – Elinore Boeke
90% of surveyed doctors expect to have EHRs within three years usat.ly/tSgBNG #HealthIT #EHR via @USATODAY

The survey also sets EHR adoption at 46% and quotes someone saying there are 1000 EHR software vendors out there. Well, I think all of those numbers are way off.

First, expect that doctors won’t meet their expectations cause 90% of doctors won’t have EHR within 3 years.

Second, I think we’re closer to 25-30% adoption. 46% probably includes a lot of people who have a PMS, but no real EMR. Maybe they do 1 or 2 small EHR like function.

Third, 1000 EHR software vendors, really? Even if you expand to things like ePrescribing I’d put the number closer to 600. If you take out the partial EHR software companies, I think it’s closer to 300. Granted, there are more and more EHR software coming out each day.

One of my favorite venture capitalist bloggers (yes, I’m a nerd like that) is Fred Wilson from Union Square Ventures. He’s been posting something like every day for the past 10 years or something close to that. I’m sure I take a lot of my blogging style from him which is funny since I mostly write about EMR and healthcare IT, but I’m only at 6 years of blogging. [Excuse the digression]

Anyway, yesterday Fred wrote a post about his view of Healthcare investment. Being in the healthcare IT world where he’d want to invest I read with keen interest to hear his thoughts. The first and last paragraph of his post sums up his position on healthcare investing:

A few weeks ago, I met with a VC who has been investing in healthcare for over 30 years. He asked if we invested in healthcare and I told him that we’d like to but we don’t really know how to fit it into our investment thesis which is focused on large networks of engaged users disrupting large markets. Clearly healthcare is a large market, possibly the largest measured as a percent of GDP. But we haven’t seen many large networks of engaged users emerging in healthcare.
…
It is likely that we’ll be doing more looking and studying and less investing in healthcare for a while (as we did in education). But I’m hopeful that entrepreneurs, industry observers, and of course all of you, will help us develop a thesis that allows us to start investing in healthcare. Like education, it feels like a market where you can make strong returns and also help facilitate important and needed changes.

Fred does clarify in his post that there are probably a lot of great healthcare IT investment opportunities out there, but that doesn’t mean that those opportunities meet the investment thesis for their VC investment portfolio.

I left my gut reaction to Fred’s post in the comments as follows:

One challenge with your investment thesis for healthcare is that healthcare is somewhat unique in that a HUGE amount of market power (see pharma, other medical procedures) is held by such a small number of people (see doctors). So, there’s a huge market, but there’s not a huge number of users to engage. Of course, there’s still the consumer (patient) side where you could have the large engaged users. Plus, patients are slowly becoming more engaged in their healthcare.

As a side note, I’ve started kicking around the idea of hosting a Healthcare “Disrupt” for healthcare IT companies to pitch their companies. Could be a great place to continue your research.

Fred then replied:

yes, that consolidation of market power is the primary reason we have avoided healthcare to date

As I’ve thought more about the consolidation of market power, healthcare is not completely unique in this but it does make for an interesting dynamic that doesn’t exist in a lot of consumer applications which Fred Wilson usually focuses on. Although, the patients getting involved could swing that pendulum the other way enough to get Fred Wilson and similar investors to start investing in healthcare.

Also, I’m dead serious about the idea of doing a Healthcare “Disrupt” like conference. We’ll see if we can get all the right people in place to make it happen.