The Orem, Ut.-based KLAS Research released a study earlier this month that showed a crowded HIE vendor market. Survey respondents, who were nearly 50 percent hospital CIOs, considered a large number of unique vendors, 38, in their search for a HIE technology, but only five companies were considered in more than 10 percent of buying decisions.

Both Jason Hess, KLAS clinical research general manager and senior research director Mark Allphin were not very surprised with four of the five companies that were considered in buying decisions— Salt Lake City- based Medicity (23 percent); San Jose, Calif.-based Axolotl (22 percent); Atlanta-based RelayHealth (16 percent);and Verona, Wis.-based Epic (11 percent)—that had top mindshare, as they also popped up as early leaders in the space and were noted in KLAS’ February performance report. According to Hess, pure-play HIE companies like Medicity, Axolotl, and Wellogic have been in the HIE space “long before it was an understood concept by most providers.”


Jason Hess

Larger companies like Epic and McKesson, who owns RelayHealth, have the advantages of having name recognition for their EMR solutions. “[With] Cerner, Epic, and Relay for sure, the lionshare of the folks looking at them, were from their own EMR system,” Allphin says. Hess also cites the fact that providers might be more apt to use their enterprise vendor for their HIE to save money, as support and maintenance would already be covered by the existing contract.

The one surprise out of the HIE companies that were considered most in decision-making was Nashville, Tenn.-based ICA (Informatics Corporation of America), which was considered in 11 percent of the buying decisions. “One of the surprises was that ICA was so highly considered in the mix because they’re a relatively small company with a few number of installs,” says Hess. ICA counts the Health Information Exchange of Montana (HIEM), MidSouth eHealth Alliance, and St. Louis Integrated Health Network as their three clients to date.

The inherent difficulty of a study on HIEs, Hess confesses, is the relatively few successes in the field. The report notes about 100 live HIE organizations currently sharing patient data via commercial solutions, and with the comparatively large number of HIE vendors, that leaves each vendor with only a small pool of clients. For example, Medicity’s Novo Grid has the most clients in the acute-ambulatory market, claiming 64 live installations (KLAS validated only 22 of them). “We can’t put a lot of confidence behind the scores because there are just not a lot of data points yet, and that makes it challenging.”

Allphin believes the pressure is on for HIE vendors to win more and more clients. But he believes natural selection will undoubtedly rule in the field. “I think it’s pretty difficult to sustain forty some odd companies that can do this, so some of them are probably going to go away or get bought out.”