Continuum of Care 2017
A Comprehensive Look at EMRs in a Connected Continuum

Enterprise & Multi-Setting Vendors

Cerner, MEDITECH First to Market; Epic Getting Serious

Cerner has approached the continuum through a set of acquisitions. Leveraging the intellectual property from these acquisitions, they have developed integrated solutions for LTC and behavioral health. Homecare technology was also acquired but has seen little development and is not integrated with Millennium; homecare customers rate their experience an F. MEDITECH has approached the continuum through acquisition and native development. They also have solutions for all settings and have recently reinvested in the continuum by releasing integrated ambulatory and homecare modules; customer adoption of behavioral health and LTC is light. Epic is getting serious after underperforming in homecare for over 10 years. Their LTC solution now has light adoption, and their dedicated behavioral health module will be released in 2018.

Allscripts has always claimed to be the anti-monolithic EMR, so it is harder to measure what benefit they provide across the continuum. Beyond acute and ambulatory care, Allscripts checks other boxes through an ownership stake in Netsmart, which operates independently. Netsmart has significant market share across all post-acute care and behavioral health settings thanks to recent acquisitions. However, these solutions are not integrated.

New athenahealth and MEDITECH Platforms Expand Integrated Options

Provider organizations today expect integration between the acute and ambulatory care settings, and Epic and Cerner have capitalized on a lack of competing integrated platforms. Recently, athenahealth, MEDITECH, and eClinicalWorks (in beta) have released integrated platforms, giving smaller health systems better-integrated options than ever. athenahealth’s cloud-based, functionality-light inpatient solution has energized critical access hospitals, who until now felt stuck with aging technology. MEDITECH’s Web Ambulatory platform delivers integration and a significant technology and UI overhaul, though its clinic billing has struggled. eClinicalWorks’ solution is still in beta. With more integrated options for smaller health systems, single-setting ambulatory and hospital solutions will likely continue to be displaced.

Homecare

Leaders Thornberry and Homecare Homebase Serve Two Ends of Spectrum

An aging population is putting pressure on homecare agencies to grow and prove they are a good fit for narrow networks. Today, most agencies make standalone HIT decisions, and single-setting solutions Thornberry and Homecare Homebase stand out for meeting customers’ needs. Thornberry’s customers are generally smaller and rave about Thornberry’s high-touch relationships and go-forward vision. Homecare Homebase offers a robust solution that can scale to the largest of agencies. Enterprise solutions offer an inferior experience or have been slow in coming: Cerner’s solution is not on the Millennium platform and has major gaps and poor support; Epic’s solution gets a ratings boost for its integration but continues to underperform overall, with little recent development; initial feedback on MEDITECH’s new integrated 6.x platform is limited and positive.

Long-Term Care

Time for Long-Term Care to Shine? MatrixCare on the Rise

LTC is also increasing in importance as health systems focus on reducing readmissions and more quickly discharging patients to less costly settings. Most LTC providers are not part of a health system and generally opt for non-enterprise solutions. Three single-setting LTC vendors have had noteworthy changes over the past year. MatrixCare’s acquisition of AOD has generated customer optimism around the future road map thanks to strong executive leadership (on top of steady support). These changes have positioned MatrixCare as the top-performing vendor, outpacing PointClickCare and CPSI (American HealthTech). HealthMEDX’s performance has dropped due to unmet development and interoperability promises—challenges customers hope the recent acquisition by Netsmart will rectify. Cantata Health’s (NTT DATA) performance has also dropped considerably due to little development, slow updates, and poor usability. Enterprise vendors Cerner, Epic, and MEDITECH offer integrated LTC solutions. Cerner is meeting most needs; they have made recent platform improvements and bolstered their team’s expertise. KLAS plans to provide insight into Epic’s and MEDITECH’s customer experience going forward.

Urgent Care

Convenience Driving Revenue; Practice Velocity Excels

Urgent care is the setting least impacted by the evolution toward the continuum, with revenue driven more by convenience than value-based care contracts. Health systems most often leverage their enterprise ambulatory care or ED solution for urgent care. Among urgent care–specific solutions, Practice Velocity outperforms DocuTap thanks to strong relationships and development.

Behavioral Health

Square in the Crosshairs of the New Continuum

Many providers feel behavioral health is a key for providing better care and controlling costs since behavioral health issues present as comorbidities with a number of chronic diseases. Since this topic has become more relevant, KLAS plans in 2018 to answer key questions about technology vendors. Netsmart has the largest market share, with solutions for private practice and psychiatric hospitals. Other key vendors with mindshare include Cerner, Core Solutions, Credible, and Qualifacts. MEDITECH, like Cerner, has released an integrated offering; Epic’s is slated for 2018.

Acute & Ambulatory Care EMR

Large Health Systems Still Favoring Epic’s and Cerner’s Comprehensive Solutions

The acute and ambulatory care settings continue to be the hub for health system EMR decisions, the results of which will impact decisions in other care settings for years to come. Large health systems evaluating acute and ambulatory care platforms continue to most frequently select Epic for the physician usability and strong departmental functionality. Cerner is also widely considered for the comprehensive functionality. Health systems frequently weigh the revenue cycle as part of this decision, often tipping things strongly in Epic’s favor. Large health systems infrequently select Allscripts and MEDITECH today—Allscripts’ smaller breadth of functionality and MEDITECH’s previous lack of an integrated ambulatory platform (recently GA) have often been deal breakers.

Designer
Natalie Jamison