Meaningful Use Attestation - EHR used by 22962 providers

This week CMS released the list of providers (anonymized) who attested for meaningful use in 2011.  The data comes from 22,962 providers and is a gold mine.   I have played with the dataset for a bit trying to see who has a the greatest electronic medical records market share.  
I admit, the stats may be misleading when it comes to the big EHR systems used by hospitals.  For instance, one install of Meditech can be used by hundreds of providers in a hospital setting and it would count here as one.  So, use your judgement when looking at the table below. Here are the results:

Rank	Unique EHR	Providers
1	Epic Systems Corporation	6330
2	eClinicalWorks LLC	1847
3	Allscripts	1502
4	athenahealth, Inc	1158
5	Community Computer Service, Inc.	999
6	GE Healthcare	921
7	NextGen Healthcare	899
8	e-MDs, Inc.	770
9	Greenway Medical Technologies, Inc.	712
10	Cerner Corporation	567
11	Sage	565
12	BioMedix Vascular Solutions	397
13	HCA Information & Technology Services, Inc.	264
14	MEDITECH	256
15	AmazingCharts.com, Inc.	252
16	Eyefinity/OfficeMate	239
17	meridianEMR, Inc.	210
18	McKesson	206
19	Sammy Systems	199
20	SOAPware, Inc.	179
21	Health IT Services Group	174
22	ChartLogic, Inc.	164
23	MedInformatix, Inc	147
24	Compulink	144
25	CPSI (Computer Programs and Systems), Inc.	142
26	Altos Solutions, Inc.	141
27	STI Computer Services, Inc.	134
28	Intuitive Medical Software	125
29	AllMeds, Inc.	113
30	Practice Fusion	113
31	Ingenix	107
32	Medflow	102
33	Aprima Medical Software, Inc	95
34	MedPlus, A Quest Diagnostics Company	94
35	gMed, Inc.	88
36	Meditab Software, Inc.	88
37	DrFirst	82
38	WellCentive	81
39	SuccessEHS	78
40	GEMMS, Inc.	77
41	Prime Clinical Systems, Inc.	77
42	SuiteMed	69
43	Pulse Systems	67
44	Clarkson Eyecare	65
45	gloStream, Inc.	59
46	NexTech Systems Inc.	58
47	Healthland, Inc.	54
48	Siemens Medical Solutions USA Inc	54
49	Waiting Room Solutions	48
50	HealthFusion	42
51	T-System Technologies, Ltd.	42
52	BizMatics Inc	40
53	Office Ally	39
54	digiChart, Inc.	38
55	M3 Healthcare Solutions	38
56	ACOM Health	37
57	Iatric Systems, Inc	32
58	Sevocity a division of Conceptual MindWorks, Inc	30
59	MacPractice, Inc.	29
60	NCG Medical Systems, Inc.	29
61	Healthcare Management Systems, Inc.	28
62	MTBC (Medical Transcription Billing Corporation)	28
63	MCS - Medical Communication Systems, Inc.	26
64	Trinity Health, Trinity Information Services	26
65	Advanced Data Systems Corporation	24
66	iSALUS Healthcare	24
67	MDLAND	24
68	UltraMed Software	24
69	Digital Medical Solutions Inc.	23
70	MedLink International, Inc	23
71	EMedicalNotes, LLC	21
72	ManagementPlus	21
73	ADP AdvancedMD	20
74	American Medical Software	20
75	GeniusDoc, Inc.	20
76	MPN Software Systems, Inc.	20
77	Addison Health Systems, Inc.	19
78	ClearPractice	19
79	Encite, Inc.	18
80	Trellix Engineering Corp.	18
81	Medical Informatics Engineering	17
82	Prognosis Health Information Systems	17
83	CodoniX	15
84	Intivia, Inc.	15
85	Health Innovation Technologies, Inc.	14
86	iMedicWare, Inc	14
87	Midwest Software, LLC	14
88	Penn Medical Informatics Systems, Inc.	14
89	Phoenix Ortho, LLC	14
90	Crowell Systems	13
91	Health Care Systems, Inc.	13
92	PlatinumMD	13
93	Businet, LLC	12
94	ExitCare, LLC	12
95	Indian Health Service	12
96	IOS Health Systems	12
97	Insight Software, LLC	11
98	OCERIS, Inc.	11
99	Sequel Systems, Inc.	11
100	Clinix MIS LLC	10
101	E-Z BIS, Inc.	10
102	MicroFour, Inc.	10
103	PBO	10
104	StreamlineMD, LLC	10
105	TriMed Technologies Corp	10
106	Darena Solutions LLC	9
107	dbMotion	9
108	MagView	9
109	Mighty Oak Technology, Inc.	9
110	Nuesoft Technologies, Inc.	9
111	SynaMed, LLC	9
112	Ulrich Medical Concepts	9
113	VIP Medicine, LLC	9
114	Criterions LLC	8
115	MED3000, Inc	8
116	Midas+ / ACS a Xerox Company	8
117	ABEL Medical Software Inc.	7
118	Crystal Practice Management	7
119	Henry Schein Medical Systems	7
120	Integrated Systems Management, Inc.	7
121	MEDHOST	7
122	Medical Office Online, Inc.	7
123	Noteworthy Medical Systems, Inc.	7
124	Orion Health	7
125	QRS Inc.	7
126	AllegianceMD Software, Inc.	6
127	DoctorsPartner, LLC.	6
128	eCareSoft Inc.	6
129	First Insight Corp	6
130	Health Systems Technology, Inc.	6
131	ifa united i-tech Inc.	6
132	Jefferson Technical Services, LLC	6
133	MediSYS	6
134	Spring Medical Systems, Inc.	6
135	Altapoint Data Systems, LLC	5
136	DrChrono.com Inc.	5
137	empowersystems	5
138	Forte Holdings	5
139	Health Management Associates	5
140	ICANotes, LLC	5
141	Medcom Information Systems, Inc.	5
142	Networking Technology dba RxNT	5
143	PatientNOW	5
144	ProMed Clinical Systems, LLC	5
145	Acurus Solutions Inc.	4
146	Aurora Health Care, Inc.	4
147	Comtron Inc.	4
148	CureMD Corporation	4
149	EyeMD EMR Healthcare Systems, Inc.	4
150	EZnotes, Inc.	4
151	Glenwood Systems LLC	4
152	Infor-Med Corporation	4
153	MedcomSoft	4
154	Medsphere Systems Corporation	4
155	Net Health Systems, Inc.	4
156	RazorInsights	4
157	TechSoft, Inc.	4
158	Valant Medical Solutions, Inc.	4
159	XLEMR	4
160	Covisint	3
161	Data Strategies, Inc.	3
162	Diversified Ophthalmics, Inc.	3
163	Doctor Office Management, Inc.	3
164	Emdeon Inc.	3
165	Future Health	3
166	H-DOX	3
167	HHT International, Inc.	3
168	Integrated Health Care Solutions	3
169	Integrated Practice Solutions, Inc.	3
170	IO Practiceware, Inc.	3
171	MedSym, Inc.	3
172	MedXLnce, Inc.	3
173	Netsmart Technologies	3
174	Outcome Sciences, Inc. (Outcome)	3
175	Partners Healthcare System	3
176	Rheumatology and Dermatology Associates PC	3
177	Soren Technology	3
178	TRANSMED NETWORK INC.	3
179	UNI/CARE Systems, Inc	3
180	Acrendo Software, Inc.	2
181	DigiDMS	2
182	eCast Corporation	2
183	EMRlogic Systems	2
184	Falcon, LLC.	2
185	Health Administration Systems, Inc.	2
186	HealthPort	2
187	Institute for Health Metrics	2
188	Keiser Computers, Inc.	2
189	KeyMedical Software, Inc.	2
190	MDoffice, Inc.	2
191	MedConnect, Inc.	2
192	Medical Voice Products, Inc.	2
193	Medtech, Inc.	2
194	nextEMR, LLC	2
195	Origin Healthcare Solutions	2
196	San Diego Hospitalist Physician Corp	2
197	Sunquest Information Systems, Inc.	2
198	Systemedx Inc.	2
199	TheraManager LLC	2
200	Thomson Reuters (Healthcare) Inc.	2
201	UnisonCare Corporation	2
202	VipaHealth Solutions, LLC	2
203	Williams Group	2
204	Zenith Technology Solutions, LLC	2
205	3M Health Information Systems	1
206	Abraxas Medical Solutions, Inc	1
207	Advanced Medical Information Solutions	1
208	Alma Information Systems, Inc.	1
209	AppMed, Inc.	1
210	Axolotl Corp	1
211	Benchmark Systems	1
212	Beth Israel Deaconess Medical Center	1
213	Bogardus Medical Systems, Inc.	1
214	Boston Medical Center	1
215	Colonial Valley Software, Inc.	1
216	ComChart Medical Software, LLC	1
217	Cyclops Vision Corporation	1
218	Design Clinicals, Inc.	1
219	Doc-tor.com, LLC	1
220	DocuTAP	1
221	eHealth Made EASY, LLC	1
222	EHR Doctors, Inc.	1
223	EHR Solutions Group, LLC	1
224	Elekta - IMPAC Medical Systems, Inc.	1
225	EPOWERdoc, Inc.	1
226	Exemplo Medical LLC	1
227	Infomedika, Inc.	1
228	InstantDx, LLC	1
229	LeonardoMD, Inc.	1
230	LOGICARE® Corporation	1
231	LSS Data Systems	1
232	Medaxis Corporation	1
233	Medrium Inc.	1
234	Microsoft Corporation	1
235	Mitochon Systems, Inc.	1
236	Mountain Computer Systems	1
237	MxSecure, Inc.	1
238	Northwestern University	1
239	ODOS Industries, Inc.	1
240	OEMR	1
241	Orchard Software	1
242	Pacific Medical Communications, Inc.	1
243	Patagonia Health	1
244	PatientKeeper	1
245	PCC Physician's Computer Company - Pediatric Software	1
246	PeriGen	1
247	Phyaura, LLC	1
248	Practice Velocity, LLC.	1
249	PracticeSuite, Inc.	1
250	QuikEyes, Inc.	1
251	Raintree Systems, Inc	1
252	RWHC QI Program	1
253	SMARTMD Corporation	1
254	Softworx Solutions	1
255	TransMedic	1
256	UAMS	1
257	Varian Medical Systems	1
258	VersaForm Systems Corp.	1
259	VersaSuite	1
260	Vision Infonet Inc	1
261	Visionary HealthWare, LLC	1
262	WEBeDoctor, Inc.	1
263	Wellsoft Corporation	1
264	WorldVistA	1

My experience with the Clinician Practitioner Consultant HIT Pro Exam

Back in 2009 the HITECH Act was passed seeking to improve American health care delivery and patient care through an investment in health information technology.  Most of the people I talk to think of this legislation in terms of "meaningful use" incentives.  A few people actually know that this act made provisions for other programs such as HIEs, "beacon communities", "SHARP programs", Community College and University based training and competency exams.  The competency exams (link here) test several EHR implementation areas such as project management, clinical and technical health IT skills.  

The Clinician/Practitioner Consultant qualification exam caught my attention and in August 2011 I registered for the  competency exam at www.pearsonvue.com/hitpro/ .  The exam was so new that there was no material that I could purchase in order to study.  Looking at healthit.hhs.gov I determined that the areas tested were divided in the following domains:

- Fundamentals of health workflow process analysis and redesign

- Quality improvement

- Working with HIT systems

- Health Information Management Systems

- Planning, Management, and Leadership for Health IT

In the end I had to rely on the clinical and technical knowledge I had accumulated over the years.  The 3 hour exam was intense and 

I was ecstatic to receive the news that I had passed it.  In November 2011 I received my Clinician/Practitioner Consultant  certificate, which I am proudly attaching here:

Mission accomplished!

Chattanooga HIE - by Middle Tennessee eHealth Connect

Here is profile of the MTeHC - the HIE that is going to help Chattanooga exchange health information.  

The Middle Tennessee eHealth Connect (www.midtnehealth.com) is a not-for profit regional health information exchange organization whose mission is to improve the effectiveness and efficiency of health care delivered to every member of the community without regard to payer by connecting health care providers throughout Middle Tennessee.

MTeHC uses Informatics Corporation of America (ICA) which was technology developed by Vanderbilt Medical Center for the broader health care market, and now delivers a comprehensive HIE solution to hospitals, IDNs, communities and states. 

Participating entities in the Nashville area:

• Saint Thomas Health Services
• Vanderbilt University Medical Center
• Metropolitan Hospital Authority (Nashville General Hospital)
• HCA TriStar Division
• Tennessee Hospital Association
• Meharry-Vanderbilt Alliance
• Metropolitan Government of Nashville and Davidson County
• State of Tennessee
• Nashville Academy of Medicine
• Tennessee Health Care Campaign
• Safety Net Consortium of Middle Tennessee

Participating entities in the Chattanooga area:

• Erlanger Hospital
• Memorial Hospital
• Parkridge Hospital - a part of the HCA TriStar Division

Health Information Exchange in Chattanooga … the latest developments

In my February post I described Chattanooga health community's attempt to get a Health Information Exchange started.    When we got together the main charge (established by the leadership group) was to determine if Chattanooga should form its own exchange or become a "community" within an already established HIE.   

The three workgroups (technical, clinical and security & privacy) debated over  several months,  looked at the issues from their respective points of view, and came up with the verdict:  join the MTeHC (Middle Tennessee eHealth Connect) out of Nashville.  

The decision was not easy but it had to do with the speed of implementation and the cost of running our own HIE.  

At end of November the workgroups were "reactivated"  and we started planning for the nitty gritty of hospital data exchange.   The initial aim of the health exchange is reduce the rate of readmissions for Erlanger, Memorial and Parkridge Hospitals.   Data sharing tests are projected to start somewhere in the April-June 2012 timeframe.  

While we are waiting for the data sharing agreements and the technical architecture for sharing of data to be built, the clinical workgroup would like to have "security messaging" functional as soon as possible.  This will allow clinicians to share data among each other using something like a secure webmail system. 

In my next post I will post MTeHC's profile.  

Southeast Regional Exchange!

Yay!  On February 4-th we had our first meeting to discuss the HIE for our region.  

These were the institutions attending the first meeting:

Erlanger

IVHIN - Knoxville

Memorial

MidSouth eHealth Alliance - Memphis

Office of e-Health - State of TN

Parkridge

Southern Adventist University

Tennessee Hospital Association

TriStar

The name adopted (for now) was Southeast Regional Exchange.  

We split in several workgroups (clinical, leadership, privacy & security and technical) and each adopted their own charter.  The charge for everyone is to determine whether we should form our own HIE or join an existing one.  This decision will be taken by the middle of April.

The technical workgroup, of which I am a part of, has the mission of coming up with the technical requirements for an HIE in our region and judge whether two of the existing Tennessee HIE can serve our needs.  The work has already started.  

This is definitely an exciting beginning for a faster coordination of care in the Chattanooga region.

The architecture of Tennessee's state HIE

Things are starting to move along with the building of the Tennessee HIE.  As part of my engagement with HIP-TN (Tennessee HIE) I continue to participate in the  meetings of the Technical Workgroup.  I have displayed a few diagrams showing the general architecture of the processes of querying for patients, documents and retrieval of documents.

Tennessee HIE architecture

Patient Discovery

Query for Documents

Document Retrieval

Tennessee statewide HIE vendor chosen!

I am back to blogging after a hiatus of a few months.  So, what has been going on? 


During this time I have participated in the HIP-TN Technical Workgroup writing the technical requirements for the state-wide HIE RFP (see http://www.hiptn.org/hip-tn-rfp/)  and evaluating the various HIE solution vendors.


We evaluated thirteen vendors based on their experience and response to our RFP (clinical, financial, technical).


A number of the respondents were eliminated in the first round because they could not meet the "mandatory requirements.  In the second round we split in little groups each evaluating a specific vendor.  The vendors that emerged out of the this round  participated in a "face-to-face" meeting in Nashville, where we all descended upon the "Tennessee Health Association" headquarters. 


Even after that we had two vendors that were very closely scored.  After further evaluation of their offering one vendor come out victorious:  Axolotl.  You can view the press release here.


I feel the vendors were evaluated in a fair manner with input from various workgroups which represented a wide range of organizations from the Tennessee healthcare spectrum.  


So who were the software vendors that participated?  Sorry, I cannot tell you.  The general consensus was that we would not divulge the names of those who responded to the RFP in order to avoid negative publicity for those companies.


The HIP-TN Technical Workgroup will continue to meet and provide feedback in the process of state wide HIE implementation.  Stay tuned!