Ambulatory care, also known as outpatient care, is medical care that is provided in an outpatient setting and does not traditionally require admission for a hospital stay.
Examples of outpatient facilities include medical offices, ambulatory surgery centers, hospital outpatient departments, and dialysis centers. Ambulatory care typically focuses on diagnosis, observation, consultation, treatment, and rehabilitation services.
What are ambulatory EHRs?
Ambulatory electronic health records (EHRs) are specifically designed for use in outpatient or ambulatory care settings.
These EHR systems are distinct from standard electronic health records, which are typically used in inpatient hospital settings and are designed to perform a different set of functions. Ambulatory EHRs are tailored to support the unique workflow of outpatient care, such as managing office visits, prescriptions, and billing. By contrast, standard EHRs may be designed for more complex tasks like bed management, interoperability with other departments, clinical decision support, and more.
Today, EHRs can be found in nearly all hospitals and at most physician group locations, with the most common inpatient EHR vendor being Epic. As of 2021, 96% of hospitals and 72% of office-based physicians have adopted EHRs.
Below, we explore the market share of the top ambulatory EHR vendors.
Top 10 ambulatory EHR vendors by market share
| Rank | Vendor | # of installs | % of market share |
| 1. | eClinicalWorks | 7,685 | 13.9% |
| 2. | Epic Systems Corporation | 5,394 | 9.7% |
| 3. | athenahealth | 4,172 | 7.5% |
| 4. | NextGen Healthcare | 2,699 | 4.9% |
| 5. | Practice Fusion, an Allscripts Company | 2,638 | 4.8% |
| 6. | Veradigm Inc. | 2,138 | 3.9% |
| 7. | Greenway Health | 1,897 | 3.4% |
| 8. | eMDs | 1,812 | 3.3% |
| 9. | Eyefinity | 1,550 | 2.8% |
| 10. | ModMed | 1,511 | 2.7% |
Fig 1. Data from the Definitive Healthcare PhysicianGroupView product. Data is proprietary and updated on a continuous basis. Accessed October 2023.
Which ambulatory EHR vendor has the largest market share?
eClinicalWorks has the highest market share in the ambulatory EHR space, with about 14%. Epic Systems Corporation ranks second with nearly 10% of the market share. Rounding out the top three is athenahealth with a 7% market share.
The top three ambulatory EHR vendors hold about 31% of the ambulatory EHR market at outpatient physician groups. Once you get outside the top three vendors, market share drops considerably for the remaining vendors on the list.
How big is the ambulatory EHR market?
In recent years, the healthcare landscape has experienced significant and profound shifts in patient care settings. The ambulatory—or outpatient—market has grown in patient volumes and popularity while hospital visits have declined. We explore this trend in greater detail in our blog, “Shifting care from hospitals to ASCs.
As a result of this shift, the ambulatory EHR market is growing steadily. In 2021, the ambulatory EHR market size was valued at $5.3 billion and has been forecast to reach $7.1 billion by 2027.
Beyond the rising number of ASCs, some of the factors propelling the growth of the ambulatory EHR market include: (1) An increased need for fluid movement of healthcare information, particularly in a post-COVID healthcare world, and (2) Support from government initiatives to better maintain patient health record portals, like the HITECH Act that offered healthcare providers financial incentives to begin using EHR software.
Despite the great opportunity for success in the ambulatory market, some challenges exist. Digitally documenting healthcare cases generates a lot of data—often too much data for most healthcare providers to manage. Many small physician groups, clinics, and urgent care centers do not have the necessary infrastructure to process the volume of data needed to successfully implement ambulatory EHR solutions. IT systems and expertise are also both costly expenditures that may be beyond the budgets of some providers.
Ambulatory EHR vs inpatient EHR
Ambulatory EHR systems are designed primarily for outpatient centers and small physician practices, where patient visits do not include an overnight stay. Inpatient EHRs are designed for use on patients staying at a facility for at least one night and are, therefore, primarily used by hospitals.
Ambulatory EHRs tend to be less complex than inpatient EHRs and have different certification criteria that are more focused on patient-centric features.
Electronic health records vs electronic medical records
Most people tend to use the terms electronic health record (EHR) and electronic medical record (EMR) interchangeably. However, there are some technical differences between the two.
While both contain digital records of a patient’s chart, EHRs tend to have a bit more functionality and have a more complete picture of a patient’s overall healthcare history.
EMRs track a patient’s medical and treatment history in one facility, offering a narrower view of a patient’s medical history. EHRs can do all the things an EMR can – and more. EHRs contain more data on a patient than that collected in a provider’s office, including things such as patient allergies and lab results, helping to form a more comprehensive picture of a patient’s medical history.
EHRs are also designed so all healthcare professionals, such as laboratories and specialists, can share data on a patient across different practices.
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