Tuesday, January 10, 2012

Data on Meaningful Use Attestation

Some very interesting data on meaningful use attestations thus far. While the reports already posted by CMS provide good information (such as the map below with a state by state breakdown), the data released on Data.gov enables systematic analysis of the distribution of certified EHR vendors and products among those providers that have attested to meaningful use within the CMS EHR Incentive Programs. The data set can be analyzed by vendor, state, provider type, provider specialty, and practice setting. One data point that would make this even sexier is the dollar amount paid for each attestation, but hopefully that can be included in future releases. I'll be doing some deeper analysis of this data, but some initial interesting facts are noticeable about state and vendor figures.

Here are the top 25 states in number of attestations for meaningful use as of November 2011:

Attestations State/Territory
1761 Texas
1653 Ohio
1533 Illinois
1450 Pennsylvania
1387 Florida
1287 California
1272 New York
963 Minnesota
931 Massachusetts
812 Wisconsin
752 New Jersey
638 New Hampshire
606 Oregon
588 Virginia
525 North Carolina
520 Michigan
502 Georgia
457 Washington
384 Tennessee
370 Arizona
351 Missouri
302 Indiana
288 Colorado
280 Oklahoma

Here are the top 25 vendors by attestation:

Attestations Vendor 
6330 Epic Systems Corporation
1847 eClinicalWorks LLC
1502 Allscripts
1158 athenahealth, Inc
999 Community Computer Service, Inc.
921 GE Healthcare
899 NextGen Healthcare
770 e-MDs, Inc.
712 Greenway Medical Technologies, Inc.
567 Cerner Corporation
565 Sage
397 BioMedix Vascular Solutions
264 HCA Information & Technology Services, Inc.
252 AmazingCharts.com, Inc.
239 Eyefinity/OfficeMate
210 meridianEMR, Inc.
206 McKesson
199 Sammy Systems
179 SOAPware, Inc.
174 Health IT Services Group
164 ChartLogic, Inc.
147 MedInformatix, Inc
144 Compulink


  1. Nice job Brian, particularly interesting to see relative newcomers such as athenahealth and eCW having more attestations then Cerner. Even GE has more than Cerner! And then there is Siemens, who doesn't even make the list and Meditech who is way down the list despite what is still a large presence in the small community hospital market. Many things to ponder.
    Cheers, John

  2. Thanks @john_chilmark, it will be really interesting as we get updated data and can analyze trends and I also hope to see dollar amounts added.

  3. I would like to see the data separated for EP and EH incentives paid per vendor.As it is listed as together, I cannot determine the top vendors per incentive as either Ambulatory or Hospital. Possible?

  4. Also potentially insightful would be seeing vendor performance normalized by national user volume to understand the percentage of their userbase represented by the attestations (i.e. what percentage of allscript's users are represented by the 1500 attestations)

  5. can you break down the epic numbers a bit more? is this for ambulatory only or does it include hospital attestation too...my epic ambulatory buddies have all not attested for meaninful use and tell me the process for them is difficult.

  6. Umm, you can't just look at the raw data. You have to actually analyze it. Epic's 6K attestations in a void don't mean anything. Cerner has fewer attestations - because they're all hospitals with only a handful of EPs. Just like Meditech. Epic has a good mix of both. Most important stat might be attestation rate as a % of total EMR customers, where Athena seems to be the best.

  7. Is there a way to check if these vendors were used to attest with other systems or did the attestation happen betwenn hospitals using the same vendor?

  8. Brian,

    Notice thst there are duplicate provider IDs in the ID column of the raw data. This is because it's not uncommon for providers (especially hospitals) to be using more than one vendor. Some are using complete EHR vendors with modular EHR vendors; others are using multiple versions of the same complete EHR, which shows up as multiple vendor instances in the raw data. Point is you can't simply add the rows to get to the actual number of hospital attestations completed. You will need to collapse the duplicate id rows to get to that number. On the vendor number question, you'll want to ask whether instances of Epic Spring 2008 and Summer 2009 running in the same hospital really equal 2 Epic installations. I would consider that 1 instance. I think your numbers are close, but for the above reasons not 100% accurate.

    Louis Wenzlow

  9. I have wondered about those ID numbers myself Louis. When looking at the raw data, if I collapse all the duplicate ID's it does reduce the number of reported attestations, but I can't understand why they are listed twice unless they are separate attestations. I'm confused as to how a hospital or EP can have both versions installed for the purposes of the same attestation. For example, an EP in Colorado with ID number 422 is listed twice using OfficeMate/ExamWRITER. The only difference I can see in the two rows is one is version 10 and the other is version 10.0 ~ as more data is released I hope to get some clarity around this question.

  10. I've worked with some of the hospitals in my region that have attested. I can pinpoint some of them from this data. In those cases where the hospitals submitted a certified EHR id # with multiple associated vendors, the data file shows multiple rows with duplicate ids for each vendor instance (usually a complete EHR vendor and one or more modular vendors). I therefore believe that each id # is associated with a specific EP or hospital, and a duplicate indicates that the provider selected multiple vendors or versions in the ONC CHPL when they generated their EHR id #. If you sort by id for hospitals, you will begin to see a pattern of complete EHR vendors and their partner vendors or other vendors that hospitals often interface into that specific HIS environment.

    I'm not sure what's going on in those cases where multiple versions of the same vendor are listed. Perhaps in the case you site, the provider wasn't sure which one to pick so he picked both to be safe. With the Epic Spring 2008 and Summer 2009, is it possible that not all of the Epic modules were updated at the same time, so the hospital was running at least one module with the older version? I don't know Epic well enough to know if this is possible.


  11. Valuable information. Now what is the impact
    To quality outcomes and patient safety? Would
    love to see some trended data on this!

  12. I think it's great to see the number of attestations, but wouldn't it make more sense to show the percent of providers by vendor to show which vendors are really the most efficient and helpful? I'm surprised a NextGen has about the same as an eMDs and less than athenahealth when we know their marketshare is much higher!