Re: [Hardhats-members] Fwd: Text of Article from Modern Physician

[Joseph Conn]

Re: market size   According to an AMA survey from 2001, 33% of what it calls "patient care physicians" are in solo practice, another 11% are in practice in two-physician offices, 8.5% in three-physician offices. These exclude government and military docs.  That 52.5% is in practices so small most EMR vendors I've spoken with don't want to bother with them because the sales costs excede the returns.   The vendors' interests might change some if an Oklahoma gold rush mentality develops to get an EMR, and say a salesman's batting average rises to one hit for every three times up to bat, as opposed to one hit in 10, but while physicians are much more receptive to the idea of buying an EMR today than just four years ago, price is still the No. 1 barrier to EMR purchase, as cited by the recent MGMA survey and the Modern Physician IT survey last year.   The AMA says there is no direct number of "patient care physicians" to multiply these percentages against, because they are for a sample, not a total count, but that said, there are about 514,016 docs in what the AMA calls "office-based physicians in patient care,"which is not exactly the same as patient care physicians, I'm told, but it is probably close enough for handgrenades and this estimate.    So, doing the math, that's  171,167 in solo practice, 57,570 in dual-practice, 43,691 in trio-practice, and 272,428 in those three combined. That's the market that's being underserved right now and where EMR penetration rates are lowest (10%) according to the latest MGMA survey.               Joseph Conn Online Editor Modern Physician ModernPhysician.com Modern Physician STAT Heatlh IT Strategist 312-649-5395 [EMAIL PROTECTED]   Check out the NEW ModernPhysician.com, and register now for MP Stat and MP Point of Care >>> [EMAIL PROTECTED] 10/15/04 01:07PM >>> May I suggest shifting the frame of reference to the global context which is where open source really matters. In this context the numbers of potential adopters for VistA, whether for clinics or hospitals becomes staggering. Not one of any of the current vendors of any system has the capacity or business model to ramp up the way a well designed open source application with an effective community behind it can. VistA is a classic example of a disruptive technology...stay tuned we are just at the beginning of the ride. Joseph On Fri, 2004-10-15 at 17:03, Michael Ginsburg wrote: > Bill, >  > Let's not confuse ourselves. As far as I know, there are no commercial > vendors planning to release their products as Open Source or to put > them in the public domain. If I'm wrong, please let us know! If I'm > right, than the VistA community, regardless of the actual number, is > larger than a non-existent (fill in the blank) community. So worrying > about something that doesn't exist isn't going to help us. >  > Having said that, the size of the VistA community will be important as > we move forward. It's the law of Small Numbers. 1% market penetration > is 4000! That's a lot of potential customers for any business. These > are customers that will need help implementing their systems, training > their users and fixing problems when they arise. They will also be > constantly demanding upgrades and improvements. Figuring out how to > provide all that to the same standard set by the best non-VistA > vendors is the challenge for the VistA community. And I say community > because references and credibility are the keys to product acceptance. > If a VistA site crashes and burns it will reflect badly and impede the > efforts of everyone.  You are right, the community needs to get > serious. >  > As for documentation, I can assure you that VistA-Office EHR will be a > high quality product in all respects, including good documentation. As > for M, I see that as being a big plus since it's the only technology > that I know of that is purpose-built to handle medical information. >  > But that's just my opinion. >  > Mike > > >>> [EMAIL PROTECTED] 10/15/2004 4:17:15 PM >>> > > Hi Michael, >         ----- Original Message ----- >         From: Michael Ginsburg >         To: [EMAIL PROTECTED] >         Sent: Friday, October 15, 2004 1:18 PM >         Subject: Re: [Hardhats-members] Fwd: Text of Article from >         Modern Physician >         >         In my opinion, (and, as always, I speak only for myself) I >         would agree that in a head to head competition with "Open >         Logician" that VistA-Office EHR would lose. That is if all you >         were comparing was functionality. As a system for the >         physician's office, Logician is a more mature offering, no >         question. VistA-Office EHR is only in the embryonic stage. >         However, if you were to compare them in "open source" >         market and all that implies and entails, VistA-Office EHR >         would be the clear winner. To the best of my knowledge, >         Logician does not have a rabid (and I mean that only in the >         nicest sense!), international community of developers or an >         organized community of cooperating vendors who can supply >         professional services, with all working in concert to promote, >         support and enhance the application. >          >         This community you speak of...  how big is it exactly? >         Compared to the one the exists that could and would sign up to >         support Open Logician.  See my comments re: this topic in my >         response to Mark. >          >         On the topic of 'rabid' ... I've never seen that included in a >         recommended list of selection criteria.  Reliable, >         yes.  References, yes.  Responsive, yes.  Cost effective, yes. >          >         Frankly, I'm not sure that VistA has all that yet either and >         therein lies the challenge and the opportunity!  Yes, the >         serious discussions have to start, but, the VistA community >         doesn't need a survival strategy, it needs a growth strategy. >          >         We don't disagree on this.  It's perspective, I guess.  Growth >         vs. Survival.  My background in business has perhaps >         conditioned me to see that not as a choice, but as an >         imperative.  Grow or die.  That's the law of the market. >          >         This will be big. There are roughly 400,000 physicians in the >         US. If we achieve 1% market penetration... >          >         Your definition of "big" is underwhelming.  If 1% is your >         honest assessment of VistA Office's real market potential, I'd >         strongly suggest you keep it to yourself when talking to >         vendors like HP.  In fact, I'd strongly suggest you begin >         working on a statement to "spin" that in case they've already >         heard you.  "What I really meant..." >          >         Even it that's a good number though, the current VistA >         community couldn't support it unless you think Docs will just >         line up and wait.  They might.  I doubt it. >          >         What's needed is a serious discussion to address the two core >         issues. >         1) Documentation - it's got to be there.  No option. >         2) M - it's got to be a non-issue.  Best option here may be to >         wrap VistA in a SOAP bubble and treat it as a web service. >         GUI front-ends need to be built for both clinician and sys >         admin use. >          >         Get these issues resolved and VistA has a real chance.  >          >         But if all you're shooting for is 1%...  >          >         Back in the early '90's I learned an important lesson.  It's >         easier to get $5 million from a VC than it is $500K.  The >         reason is that they have to invest just as much time and >         effort into making the business successful either way.  The >         only thing that's different is the size of the potential >         reward. >          >         Personally, I think the potential here is much larger than >         1%.  But it all depends on the community getting serious.  I >         am. >          >         Best regards, >         Bill > ------------------------------------------------------- This SF.net email is sponsored by: IT Product Guide on ITManagersJournal Use IT products in your business? Tell us what you think of them. Give us Your Opinions, Get Free ThinkGeek Gift Certificates! Click to find out more http://productguide.itmanagersjournal.com/guidepromo.tmpl _______________________________________________ Hardhats-members mailing list [EMAIL PROTECTED] https://lists.sourceforge.net/lists/listinfo/hardhats-members