The 2009 Behavioral Healthcare IT Vendor Survey

Although market conditions could be friendlier-more funding, more provider buy-in, more integration with the larger IT world-none of this has stopped a variety of focused, privately held vendors from offering behavioral healthcare customers a wide array of electronic tools.

The customers

Just who are these companies and their products focusing on? This year's survey discloses that the top five target markets are, in order:

• community-based behavioral healthcare providers
• residential-based behavioral healthcare providers
• city/county/behavioral health/social service agencies
• child/family service providers; and
• substance use/addiction treatment programs.

For a complete listing of behavioral health segments targeted by the 56 companies surveyed, along with a listing of their key products, see the chart on pages 16-17.

The products

Given the prominence of electronic medical and health records (EMRs/EHRs) in healthcare IT circles, it's no surprise that most products offer some tie to creating, managing, or storing them. Beyond these records, whose boundaries are often blurred (see sidebar: EHR, It Is), the breadth of capabilities offered in these IT products reflects the diversity in size, resources, and services of behavioral health providers. Some offer a comprehensive, enterprise solution that spans many capabilities, while others are highly specialized. In addition to EMRs, the range of IT product capabilities includes:

• HHS, grant, and case management
• Facility, clinic, and practice management
• Disease and addiction management
• Claims and payor management
• Workflow management
• Research, analysis, reporting, and compliance
• Documentation, imaging, forms creation, and management

The survey

To assist ourselves, and you, in breaking down the survey, we asked the vendors for responses in six overall categories, which included:

• Company demographics (Name, year founded, employees, website)
• Core product and target market/typical applications
• Customer locations (number of states in US, number of provinces in Canada, number of countries internationally)
• Product/System Architecture: Client/Server, Desktop, and ASP/SaaS
• Operating System compatibility (Note that in the Open Source category, the survey did not delineate between OS such as Linux, and the more specialized VistA.)

Product features and functionalities

To better illustrate the range of product features and functionalities, our survey broke them out according to the taxonomy used in a study of the top healthcare technology adoption/investment priorities conducted by our sister organization, Healthcare Informatics Research. The HCI taxonomy breaks healthcare IT investments into these broad categories:

• Clinical EHR and EHR-related
• Clinical care: Other than EHR
• Administrative and Financial
• Hardware and Infrastructure

Within these categories, respondents were asked to report whether their product offered features in each of 23 sub-categories. These are presented in the comprehensive chart that follows.

But here's where things get a little more complicated, based on the context of the vendor, their product, and their own self-reported answers. You'll find that not all boxes in the same category mean the same thing. One example: Virtually all respondents reported that their product offered Clinical Data Repository (CDR) and EHR capabilities. But closer inspection may reveal that one respondent offers enterprise-level capabilities, while other offerings operate from desktop PCs. A similar diversity exists in the EHR column, with numerous packages supporting comprehensive EHR capabilities and others offering a more limited set of EMR-related features: forms creation and conversion, scanning and image management, or database creation and management.

Now that we've done our best to gather, sort, and present this survey, it's your turn. With your comments, the arrival of long-awaited certification standards for EHR systems, and the continued evolution of other healthcare IT technologies, we're sure that we can expand the accuracy, detail, and precision of future surveys.

More online

For details about target markets, definitions of the categories used in our taxonomy of product features and functionalities, and other details of our IT Vendor Survey, visit https://www.behavioral.net/ITsurvey-revised.  

Sidebar

Open Source Options

Price points lower the bar for healthcare organizations with few investment dollars. Although open source software systems are typically available as free downloads, most organizations require a technically skilled support staff to implement, integrate, and maintain them.

The result of collaborative design and development, open source-based software is freely available without standard licensing or other fees. While a number of these applications have gained respectability among mainstream business owners, the healthcare industry, on the whole, has been slow to adopt them.

One possible exception is VistA. Developed by the Department of Veterans Affairs, VistA (Veterans Health Information Systems and Technology Architecture) has been adopted by government organizations including the U.S. Veterans' Administration, Department of Defense, and Indian Health Service. Developed with taxpayer dollars using the M or MUMPS programming language, VistA is available in the public domain. Although the VA's VistA implementations typically use a proprietary database that is a version of MUMPS and requires licensure, an open source database engine has been developed.

For the latest information about open source options, as well as legislative efforts to provide implementation funding, see our feature, “Health IT as a public utility,” on page 18.

Sidebar

EHR, It Is

Naming conventions continue to confuse end-users and industry insiders alike. According to a now-defunct industry group tapped by the federal government to provide definitions for key industry terminologies, the electronic medical record (EMR) and the electronic health record (EHR) are two separate entities. In that report, the definitions confine the EMR to a record developed and maintained by the healthcare provider organization. The EHR is much broader and more inclusive, comprising aggregated patient records across multiple care providers. A third component of health records is the personal health record (PHR), which is owned and controlled by individuals.

So, according to that official definition, what vendors are selling and what healthcare providers are implementing is an EMR. But that's not what has entered mainstream usage.

Across the industry, as well as in government publications and legislation, EHR is consistently used to refer to IT system records used by care providers. Consequently, use of the term EHR to identify all aspects of health-related data in electronic format is gaining broad acceptance both within the industry and among consumers whether as one set of health-related data created and managed by a single care provider or as sets of data suitable for sharing across organizational boundaries.

Although this Behavioral Healthcare IT survey was fielded using the term EMR, this publication will use the term electronic health record (EHR) when referring to an individual patient's medical record in electronic format. To learn more about the challenges of EHR implementation, please see the excellent article by Helene Cross, found on page 40.

Behavioral Healthcare 2009 September;29(8):12-14