While there’s nearly universal adoption of practice management and electronic health record tools after eight years of steady growth, a more robust replacement market has not yet developed, according to recent research from HIMSS Analytics.

The findings are somewhat surprising, contends HIMSS Analytics Director of Research Brendan FitzGerald, who helped compile the annual snapshot of solution adoption and purchase intentions from hospital-owned and freestanding physician practices.

“When we really started tracking this in 20008, it was pretty flat but things really picked up in 2010 and people realized they needed to get on the EHR adoption bandwagon, and it went up from there,” says FitzGerald. “Adoption rates in 2010 were nearly 30 percent for freestanding physician practices, and now we’re looking at close to 80 percent. Certainly, a lot of progress has been made.”

According to HIMSS Analytics’ recently released eighth Annual Outpatient PM and EHR Essentials Brief, market adoption has been trending upward since the initial study and is nearing universal market adoption rates for outpatient EHR solutions.

The study reveals nearly 78 percent of survey respondents representing a freestanding outpatient facility report having an EHR—a roughly 30 percent growth rate in the outpatient market over the last five years. EHR adoption rates at hospital-owned practices are also near universal, at about 90 percent.

Nonetheless, despite widespread adoption, few providers state they have plans to purchase or replace their systems. FitzGerald predicts there will be some “churn” in the market as providers have buyer’s remorse now that the first wave of EHR adoption is complete, but not as much as expected.

“With incredibly high adoption levels one might expect a burgeoning replacement market for these solutions across the outpatient market. However, the most recent study findings indicate that a robust replacement market has yet to develop,” states HIMSS Analytics. “Physician practices seem to indicate they plan to move forward with the solutions they have worked so hard to implement and use over the last few years. This is not to say that there isn’t opportunity within this market, when looking at the Outpatient EHR, the study indicates that over 15 percent do have plans to replace or purchase.”

In addition, the HIMSS Analytics report notes that with some physicians on the verge of retirement and choosing not to invest in EHR technology and others who do not feel they need it, the opportunity for adoption in the freestanding market is somewhat limited.

Still, FitzGerald sees opportunity in the market for vendors as providers look to meet the requirements of Medicare Access and CHIP Reorganization Act (MACRA).

“The big driver of EHR adoption for physician practices to date has been Meaningful Use, but that will shift to alternative payment models in the MACRA framework,” he says. “With all the changes, there’s going to be the need for hand-holding from a vendor perspective to help the practices through this.”

Part of the 2016 study included a question surrounding Clinical Practice Improvement Activities (CPIAs) within MACRA. “The adoption and use of technology will be essential in meeting CPIAs,” concludes HIMSS Analytics.

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