Too Much of a Good Thing

Gary Baldwin, for HealthLeaders News , July 17, 2007

I've been reporting these past few weeks on a story slated to appear in our September print issue, "EMR Wars." Yes, we work that far ahead. My story will analyze the prospects of automating the physician office practice, which is the toughest nut to crack in the clinical IT world.

Despite all the hoopla, despite all the potential clinical and financial benefits, fewer than one-fourth of physician practices use EMRs to document their care.But as my story will point out, you are now beginning to see EMR implementations in the small group practices that dominate the industry.

Numerically, these installations may not seem like much. Ten practices here, twenty practices there, maybe representing a few dozen odd physicians. But these deployments, spurred on by several factors, are notable. Sparked, in part, by relaxed Stark regulations, hospitals are stepping up to the plate and helping subsidize physician acquisition of EMR technology.

In addition, independent practice associations and management services organizations are figuring out ways to be technology champions for their members and clients.

As I wrapped up my reporting, a common observation made by several sources really stuck out. They described the difficulty of conducting an EMR vendor search. Not just in sorting out the functions of the systems, but in wading through an overwhelming number of companies. One IPA identified more than 300 potential EMR partners. They'd tick off the names of the companies to which they sent RFPs. Some were well-known names, the Misyses, the Allscripts, the NextGens of the world. But many I had never heard of before, and wondered, "Maybe I don't know this industry as well as I thought."

The proliferation of vendors gives pause to many physician practices entertaining the idea of purchasing EMR technology. Several that I spoke to included fiscal stability in their vendor evaluation matrix. They wanted to make sure, in the words of one source, that "their vendor partner wouldn't go belly up" within a few months. They wanted longevity.

Others predicted how a vendor shake-out was all but inevitable, predicting that as the market matures, many companies will disappear, or be acquired. Some went as far to say that this market consolidation could only be a good thing in terms of industry acceptance. Fewer vendors means fewer systems to interface to.

The presence of so many vendors speaks well to the competitive spirit of the technology industry. But sometimes too much choice is a bad thing. For many physicians, the free-for-all marketplace is something to avoid, or at least be extremely cautious about before entering.

Gary Baldwin is technology editor of HealthLeaders magazine. He can be reached at

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