Epic and Cerner are the two most successful Electronic Medical Records (EMR) companies in the US Health Information Technology (HIT) marketplace, accounting for 50 percent of the market with combined revenues that exceed $10B per year. They have been the biggest beneficiaries of the U.S. government’s Meaningful Use EMR spending of over $30B. Their customer lists read like a who’s who of health systems in the U.S.  

While Allscripts, NextGen, MediTech, Athena and a few other EMR companies have innovative products and committed customers, Epic and Cerner own the most customer and market mindshare.

How can a HIT company navigate amongst Epic and Cerner?
With such dominant forces in the market, how can a healthcare technology company navigate a path through these two giants? Begin by gaining a deep understanding of the following general messaging coming from these large EMR companies:

  • Consolidating applications with one EMR vendor reduces interface complexities and simplifies IT management
  • Various arrays of EMR add-on applications are “good enough”
  • Having apps consolidated with a top EMR vendor is safe and simple
  • Customers can trust in development roadmaps for new apps from established vendors with a proven track record of past performance
  • To paraphrase an IBM mantra from the 1960’s and 1970’s, “No one ever got fired for choosing Epic or Cerner”

Can smaller non-EMR health tech companies survive and thrive in this environment?
The answer is a resounding YES, and we see it every day with our clients.  

Success is driven by being crystal clear upfront on how you decide to deal with the dominant EMR companies in the market. Taking these powerhouse companies head-on simply doesn’t makes sense for a small to medium sized health tech firm. However, there are two better approaches that can help you carve out a profitable niche: 1) hitch your business to the leading EMR vendors’ wagon, or 2) make your offering a complement to the mega vendors. Both strategies can work, but it’s critical to select your approach carefully.

There are several key factors and suggested behaviors associated with each approach to help your company succeed quickly.

Option #1: Align with leading EMR companies

  • Be willing to subjugate your brand
  • Plan to share revenues
  • Modify your messaging, selling motion and pricing to align with their go-to-market strategy
  • Invest in becoming certified in their App Store or writing apps to their API set
  • Work to stay out of swim lanes they see as core to their growth
  • Hire ex-EMR company team members or advisors who can help you understand their DNA and mindset

Option #2: Work around the EMR giants

  • Invest the time to understand and constantly monitor their strategy while maintaining an ongoing assessment of your real strengths and possible areas of conflict that you should avoid.
  • Prepare for resistance from the EMR-Centric IT team who will naturally be inclined to defend and represent the EMR vendor’s POV.
  • Craft a believable message on the reasons your company is in the best position to deliver a solution that augments the EMR leaders’ product. You can do this by developing a compelling ROI. Regardless of the approach, it’s super important to create a safe zone for your prospects to recommend your offering.
  • Develop true product differentiation to deal with “good enough” arguments. Your product really needs to be better and provide value beyond the EMR.
  • Have legitimate answers and respect for the IT questions that will come your way.  All those technical issues aren’t just FUD (Fear Uncertainty and Doubt) created to thwart your efforts.  You need to have your IT act together because 99.99% of your deals will have to go through IT before signature.
  • Create a friendly way to connect to the EMR vendor.  We know of several health tech companies who work through Redox or Nordic Consulting (both Madison WI companies with a great deal of Epic DNA) to calm IT concerns about their ability to work with Epic.  Likewise, several companies have written their apps to sync with Cerner’s M-Pages API.

How to proceed?
Making the right decision on this question is key for your business growth.  The marketplace has voted, and the leading EMR vendors’ dominance will not subside any time soon. Finding the best course in this turbulent sea is fundamental for you, your investors, and your clients. Take the time to build out your arguments and make sure you solicit the best external advice you can.

If you have feedback, questions or best practices you would like to share; we would love to hear from you. Share your experience in the comments below, or contact us to learn more.



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