The EMEA market for electronic health record (EHR) IT is estimated to have been worth $3.7B in 2018 (both acute and ambulatory applications) according to Signify Research’s 2019 global EMR market report. However, only one vendor, Cerner, is estimated to have had a double-digit revenue share in 2018. In terms of suppliers the EMEA market is highly fragmented with a mixture of local and international vendors addressing individual countries with few vendors having a truly region-wide footprint.
The table below shows estimated revenue shares in 2018 for the acute & health system EHR market in EMEA (excluding revenues for ambulatory only solutions), alongside the countries/sub-regions where each vendor had a significant share of its EMEA business.
Acute/Network EHR Estimate Revenue Share – EMEA – 2018
2018 Revenue Share
DACH, UK/Eire, Middle East
DACH, Nordics, Eastern Europe
UK/Eire, Middle East, Spain/Portugal
Benelux, UK/Eire, Spain/Portugal
Italy, France, Spain/Portugal
Benelux, Nordics, UK/Eire, Middle East
Source: Signify Research
Note: Does not include ambulatory only revenue/vendors
Are you ready to transition to ICD-10? The countdown is on. As those of us in healthcare know, next week the industry in the United States will (finally) undergo a significant change as we transition from ICD-9 to ICD-10. ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems and is used primarily to document diagnoses in a codified manner. The most recent revision has nearly five times more codes than its predecessor because of its increased complexity and specificity of ICD-10 codes.
Healthcare organizations in the U.S. have been preparing for the ICD-10 transition for nearly five years. Multiple delays, brought on by substantial lobbying efforts against the transition, led to elongated wait time, but the time has come and we’re ready to launch. Personally, I’m glad. I look forward to healthcare moving beyond this conversation; the infighting ICD-10 has caused among members and associations in the community has done us all a disservice. Perhaps, on October 2, the day after the implementation deadline, we can begin to move on to other issues — slowly, of course — so that the brilliant minds in healthcare can once again focus on more pressing, important issues than the dollars and cents of claims and the numbers needed for them to be paid by our payer partners.
As the transition date draws near, make sure you’ve got all your priorities and details in line. ICD-10 is no lightweight matter, as you have likely discovered. Cerner created the following video, “10 Things You Should Know to Get Ready for ICD-10,” that I’m posting here, with the company’s permission. Though my publishing it is a bit last minute, the video offers some tips that might help you prepare for “doomsday.”
This video reviews what Cerner considers the top 10 things you need to do to prepare for ICD-10; it also covers technical pieces related to Cerner’s Millennium solutions, as well as operational pieces to help with the transition. Overall, it’s a nice resource that may provide you a bit of last minute ICD-10 insight and comfort for the change again. Here’s to your ICD-10 health. Enjoy!
Cerner has announced it will bring its patient app, HealtheLife, to Apple Watch.
Cerner’s newly-released iOS 8 HealtheLife app is designed to make it easier for patients to manage their health from Apple Watch, with push notification reminders to track health data and a display dashboard for tracked metrics.
“Apple Watch is the next evolution connecting consumers and their health team to the clinical community, regardless of physical location,” said Brian Carter, senior director and general manager, personal health, Cerner. “This is just the first step in the evolution of sharing personal health data – to provide physicians with access to actionable data anytime, anywhere, not just what’s collected at the doctor’s office.”
This month, Cerner will conduct initial deployments with clients to collect biometric values from the Apple Watch-compatible HealtheLife app, including weight, blood pressure and blood sugar values. With the patient’s consent, the data will be sent directly to Cerner Millennium® electronic health record.
“The status of a person’s health is greatly related to what they’re doing personally on a day-to-day basis. This information is vital to providers so they can focus on personalized patient care and population health management,” said Carter.
Emory Healthcare and Agnesian HealthCare will be the first health systems to deploy this technology. Emory, the largest health system in Georgia, will receive data from patients through HealthKit.
“Cerner’s technology aligns with our strategy to further engage patients in their own health,” said Dr. Julie Hollberg, chief medical information officer, Emory Healthcare. “Patients can monitor their vitals on a daily basis and share that data with their care teams, enabling providers to keep a closer eye on their patients.”
Cerner Corporation (Nasdaq: CERN) and Siemens AG today announced they signed a definitive agreement for Cerner to acquire the assets of Siemens’ health information technology business unit, Siemens Health Services, for $1.3 billion in cash. By combining investments in R&D, knowledgeable resources, and complementary client bases, the acquisition creates scale for future innovation. As part of the agreement, Cerner and Siemens will form a strategic alliance to bring new solutions to market that combine Cerner’s health IT leadership and Siemens’ strengths in medical devices and imaging.
“We believe this is an all-win situation for the clients of both organizations and all of our associates and shareholders,” said Neal Patterson, Cerner chairman, CEO and co-founder. “Through more than $4 billion of cumulative investments in R&D, Cerner has established a strong market standing and is positioned for continued growth. Siemens’ health care IT assets provide additional scale, R&D, an impressive client base, and knowledgeable and experienced associates who will help Cerner achieve our plans for the next decade. In addition, the alliance we’re creating will drive the next generation of innovations that embed information from the EMR inside advanced diagnostic and therapeutic technologies, benefiting our shared clients.”
Based on 2014 estimates, Cerner and Siemens Health Services have combined totals of more than:
20,000 associates in more than 30 countries
18,000 client facilities, including some of the largest health care organizations in their respective countries
$4.5 billion of annual revenue
$650 million of annual R&D investment
The transaction is expected to be more than $0.15 accretive to Cerner’s non-GAAP diluted EPS in 2015, and more than $0.25 accretive in 2016. Non-GAAP earnings are expected to exclude share-based compensation expense, one-time transaction costs, and acquisition-related amortization and deferred revenue adjustments.
Travelers through the trade show floor at HIMSS14 continue to find themselves in the city of senses that is the HIMSS conference. From flashy devices, bright lights, loud music, champagne by the glass and interesting architecture, in many ways this show reminds me of the last time the show was in Orlando. Same energy and excitement, and much the same feel from the show floor. Though it seems like little has changed from the exhibitor perspective, it’s still a nearly overwhelming experience here.
This year, more than 35,500 are here in Orlando, up from 32,500 last year.
The following are some images of the more than 1,200 vendors at the show.
Alere has one of the most visually interesting booths at the show:
The market for electronic health and health records (EHRs) is set to experience rapid growth over the coming years, with EMR peer group value estimated to climb from approximately $10.6 billion in 2012 to $17 billion by 2017, at a Compound Annual Growth Rate (CAGR) of 9.8 percent, according to research and consulting firm GlobalData.
The company’s new report estimates that McKesson had the largest healthcare information technology software and services revenue in 2012, with $3,300 million, placing it as the EHR market leader. McKesson is followed by Cerner and Allscripts, which achieved revenues of $2,666 million and $1,477 million, respectively.
According to GlobalData, this rapid EHR market growth is because of incentives offered under the American Relief and Recovery Act of 2009, which delivers opportunities for providers to transform unstructured, paper-based data into electronic digitized information that can be shared across the entire care industry.
If you love drama, there may be no better time than now to be in health IT. Specifically, the CommonWell Health Alliance movement – spearheaded by vendor giants Allscripts, Athenahealth, Cerner, Greenway and McKesson — to promote health information exchange.
However, as we all know, the one giant in the room not to be invited to the dance, Epic, is crying foul.
Guest post by Kim Lennan, Director of Healthcare Markets at Sensage
Healthcare organizations of every size face a growing number of threats and regulations associated with patient data management. Pharmacies must be on the lookout for falsified prescriptions issued to employee family members. Hospitals must track access to patient records, from both inside and out, to identify individuals trying to gain health details about a celebrity, a neighbor or family member. Network connections must be analyzed to pinpoint situations when passwords have been compromised or mobile devices have fallen in the wrong hands. Finally, meaningful use Stage 1 requires the identification of devices, systems and applications that are dormant or redundant.
To address these scenarios, IT teams must establish monitoring capabilities around a disparate set of systems and activities. This leads to incredibly manual, risk-prone event data collection, correlation and analysis processes across clinical and non-clinical sources, which discourages most IT teams from even taking the first step.
A successful event data management initiative provides three important benefits, which are often overlooked:
The ability to understand patterns and establish baselines by which risk can be measured against. When you know what “secure” activities look like, you can create alerts when an unusual activity exceeds acceptable boundaries or thresholds. For example, if you know a set of workstations are not used during the hours of 11 p.m. to 4 a.m., you can easily set up a notification when a flurry of activity takes place on one of them during that period.
The much-needed context to drive better policy creation and compliance. If you are able to demonstrate events that create risk, you are more likely to drive understanding with users and influence appropriate behaviors. For example, correlate data from your time management system with log-out details on a shared workstation to identify high-risk individuals who fail to log out when they go off duty, leaving that system open to compromise.
The valuable insight needed to investigate a breach or establish compliance with internal or external regulations and policies. All too often, the data that can tell the story was either not collected or is impossible to analyze after the fact. In cases where an incident or breach spanned more than 90 days, most organizations have no historical perspective to review, which could prove a non-event.
For greatest success, security practitioners, auditors and compliance teams will need to align around processes that aid their shared efforts and actions. Here are some must-haves that need to be in place — or at minimum discussed:
Collect and centrally store all event data, even if you don’t think you need it. This is especially important since you don’t always know what you have—or what you will need—in the way of historical data analysis.
Establish basic measurements, understand them, then expand. Start somewhere … anywhere … to establish a metric and then work to make that metric useful or replace it with a better one that you’ve discovered in the process. Don’t just poke around or take a whack-a-mole approach to your discovery process — prioritize your effort so that you can accumulate and maintain a portfolio of metrics that maximize the value of your initiative.
Be consistent or face the consequences. Don’t spend a month on analysis then move on if nothing pops up. Maintaining consistent vigilance is the key to spotting trends or variance. Erratic monitoring and analysis leads to a false sense of security and reduces your ability to continuously reflect and refine based on known patterns.
Be ready to change. There is a tendency to take a finding, create a counter-measure around it, and then never look back. Be intellectually honest when you make new discoveries, particularly if they show a need to change an established rule, alert or policy. While flexibility and change seemingly conflict with “be consistent,” get comfortable with the idea that you will often learn something new which will require a policy or process change.
Engage experts and ignite managers. The dynamic nature of attacks may also lead you to integrate data from systems you didn’t initially consider using to drive critical correlations. As you think about what data to analyze, solicit input from teams who know the systems, devices, people or information associated with all areas of infrastructure. They may shed light on interdependencies or relationships that are critical to better metric definition. Leverage “the truth” established with the experts to ignite the support needed from managers.
A healthy, sustainable data management initiative starts with a single version of the truth. When everyone is looking at the same data, there is an increased likelihood that anomalies will be spotted and risks can be detected more rapidly. Here are some of the capabilities to look for:
A data management solution that makes event data collection from any source a simple task.
A scalable system that gives you the ability to collect and store vast amounts of data without ever-increasing hardware or maintenance costs.
Correlation capabilities that leverage a standards-based event taxonomy so analysis is possible across all data, regardless of source, without additional work from you.
Flexible analysis options that address the needs of every user – from standard reports to customizable dashboards and ad-hoc querying.
There is much we are learning every day when it comes to protecting patient data, and – to evolve – we must adopt new disciplines and continuous improvement around risk monitoring. We applaud Cerner, our innovative partner, and customers like Adventist Health Systems, who are breaking new ground with the “science of risk management” and developing a centralized approach to the systematic inspection across their clinical and non-clinical landscape.
In a recent conversation with Steve Ferguson, vice president of Hello Health, he described how the company is identifying new revenue sources for practices while working to engage patients. Even though the company’s business model is one that sets it apart and helps it rival other free EHRs, like Practice Fusion, I left the conversation with him wondering why more venodrs weren’t trying the same thing as Hello Health: trying something no one in the market is trying to see, if by change, a little innovation helps pump some life into the HIT market.
Along the same lines, myself and thousands of others in HIT have wondered why systems are not interoperable and, for the most part, operate in silos that are unable to communicate with competing systems.
Certainly, there’s a case to be made for vendors protecting their footprints, and for growing them. In doing so, they like to keep their secrets close; it’s the a business environment after all and despite the number of conversations taking place by their PR folks, improving patient health outcomes comes in only second (or third) to making money.
However, let’s move closer to my point. Given the recent rumors that Cerner and McKesson are working on a joint agreement to enable cross-vendor, national health information exchange, I’m wondering: Why don’t other vendors partner now and begin to build interoperable systems.
According to the rumors, the deal, if completed, could shift the entire interoperable landscape for hospitals, physicians and patients. It would position Cerner, which has more EHR users, and McKesson, which has a strong HIE product in RelayHealth with a loyal user base, to take on Epic Systems, a leading EHR vendor.
An announcement is expected at HIMSS13.
Here’s why this is important news: Interoperability mandates are coming. Like most things, it’s really just a matter of time. Systems will be forced to communicate with other, competing systems. They should already. It’s actually a bit shocking that given the levels of reporting required of care givers, the push for access to information through initiatives like Blue Button and patient’s access to information through mobile technology that there’s not more openness in the market.
The Cerner/McKesson news is incredibly refreshing and worth a look. Two major competitors may be realizing that by partnering they’ll be better able to take on each company’s biggest competitor: Epic.
Imagine connected systems exchanging data. The thought alone would be marketable across several sectors of the healthcare landscape and the move worthy of reams of coverage, which would lead to great brand awareness for each and the change to do what all EHR companies aim for: To create thought leaders; to stand out; to set the market on its heels.
If nothing else the partner vendors would stand ahead of the pack when future interoperability mandates are enacted and will be seen as experts in the exchange game. Tongue and cheek aside, the idea really is a good one and with no one currently doing it, it’s a great opportunity for a couple of HIT companies to actually move change forward and create an environment where information can be easily exchanged across practices, across specialties and across borders.
Then, perhaps, we’ll see a real commitment to improved patient health outcomes rather than them simply trying to improve bottom lines.