Small vendors have big plans

Medical Informatics Engineering, which has carved out a healthy niche for itself as a regional EHR player in the Midwest, has about 68 employees. Cerner, by comparison, has nearly 8,000.

But CEO Bruce Lisanti likes it that way. Being a small firm is not a hindrance, he said, but a help. And MIE's agile size has helped set the company apart from the competition in a crowded market, over which a handful of big "brand-name" vendors loom.

Even as a recent KLAS survey found smaller community hospitals gravitating toward MEDITECH, McKesson and Epic, Lisanti is satisfied with his firm's place in the market.

"This marketplace has probably hundreds of EMR vendors," he said. "So a lot of what we're doing is differentiation. Helping people understand how you select this EMR over that one."

It's working, he says. "Were really starting to see a good uptick in activity."

One recent big score was MIE's selection by outsourcing giant Affiliated Computer Services to do Medicare and Medicaid processing in 28 states. "What ACS looked at was not just the technology, not just a list of 100 or 200 features," said Lisanti. "What they were looking for was flexibility and adaptability. We were never designed to run in a pure server environment. We're 100 percent web-based. And that gives us a lot of flexibility."

Many big vendors, siloed and proprietary, can't claim that.

"Our real strength is the whole ability to interact with the rest of the world easily," said Lisanti.

Provider frustration

A recent Black Book Rankings survey found widespread frustration from providers with their vendors, with 90 percent of them not ready to meet meaningful use. Ninety-three percent of respondents griped about a lack of substantive support from their vendor; 89 percent reported implementation delays due to the cost of additional support from EHR vendor/consultants; and 77 percent complained of a lack of available and/or trained staff to properly support implementation.

Smaller firms are well positioned to offer a more personal touch, said Jack Smyth, President and CEO of Houston-based Spring Medical Systems. "Smaller firms are always able to move more quickly and to be more personal than larger firms,” he said. “Spring Medical customers can usually get me, the CEO, on the phone to discuss any issues they have. That's much appreciated."