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Synergy MD Taking your Business from Paper to Electronic Founded By Joseph Giglio, Leonel Sosa, Shama Barrett, Jonathan Itskov, Tara Thomas Table of Contents 1.0 Executive Summary.................................................................................................................................3 2.0 Company Description and Analysis.......................................................................................................3 2.1 Business Name, Description................................................................................................................4 2.2 Mission Statement................................................................................................................................5 3.0 Product or Service Description...............................................................................................................5 3.1 Product Description.............................................................................................................................5 3.2 Business Concept..................................................................................................................................6 4.0 Industry / Market Analysis......................................................................................................................7 4.1 Market Analysis (size, growth, trends)..............................................................................................8 4.2 Consumer Analysis (needs, wants, behavior etc.).............................................................................9 4.3 Competition.........................................................................................................................................10 4.4 SWOT Analysis...................................................................................................................................13 4.5 Keys to Success...................................................................................................................................15 5.0 Marketing & Sales..................................................................................................................................15 5.1 Marketing objectives..........................................................................................................................16 5.2 Target market.....................................................................................................................................18 5.3 Value Proposition and Positioning...................................................................................................19 5.4 Pricing strategy...................................................................................................................................22 5.5 Distribution strategy..........................................................................................................................24 5.6 Promotion/IMC Strategy...................................................................................................................25 5.7 Sales Forecast first 36 months..........................................................................................................26 6.0 Finance Management.............................................................................................................................28 6.1 Minimum start up Requirement......................................................................................................28 6.2 Important Assumptions.....................................................................................................................29 6.3 Break Even Analysis..........................................................................................................................30 7.0 References...............................................................................................................................................32 1.0 Executive Summary Synergy MD is new and innovative. The system offers a wide variety of programs, charts and options surrounding patient care. It is reliable and safe. The user friendliness of the system is one of ease. The system make it easier for patient and physician to keep track of pertinent health care information that is crucial in providing and receiving the best care treatment. Physician are in the business of caring and treating patient not spending time sorting through paper. We are here to make your transition from paper to electronic as quickly, safely and in the most secure way possible. In conclusion I have to say the Implementation of and EMR can only prove to be useful to any organization. Synergy MD will give get you back to doing just that caring and providing treatment for patients. 2.0 Company Description and Analysis Founded in 2016 Synergy MD is an innovative web-based model for Electronic health record. A physician priority should be his patients. Paperwork should never minimize the time that could be spend caring for patients. Synergy MD will allow for just that, our business will give you the opportunity to streamline your business while focusing on what matters the most caring for your patients. Synergy MD will help to transform your business so that it is more efficient by giving you the ability to view your patients records at the click of a button, no more time will be wasted in gaining access to patient records. Figure 2.0 Satisfaction Rates of EHR based on Facility size 2.1 Business Name, Description Our system will help with scheduling, reduction in medical error, improved safety and overall administrative efficiency and workflow of your business. There will be no more bulky paper records to store or retrieve. There will be fewer prescription error due to our e-prescribing, easier retrieval of labs, x-ray results which allow you to track and auto correct any prescription errors entered. The System will save your business a huge amount on medical storage for files and allow your business to thrive and grow at the same time. Our product will be there from start to finish, every step of the process to help guide the facility into the superior world of EHR systems. We will facilitate in helping convert paper documentation into the system while abiding to all HIPAA requirements. As well as making sure the facility is aware of all documents that must still be kept in physical copy form, and for how long. 2.2 Mission Statement Synergy MD mission is to provide the healthcare industry and Medical facilities with cost-effective solutions and easy transitioning from paper to electronic records by means of Webbased, digital transcription, along with customer service that is priceless and out of this world. All this in addition to our state of the art PRE & POST installation support services. 2.0 Product or Service Description A fully featured E.H.R. system that allows for the transition of a medical office from paper dependency to a more organized and secure computer system. Founded in 2007 our company has been revolutionizing medical facilities since its inception. We make it possible for an office to convert all paper documents into a computerized system as well as the ability to add new documents directly into the system as well. This allows a facility to make use of the paperwork they already have as well as organize it efficiently along with any new files. Our software can either be downloaded directly from our website, packaged in a variety of bundles. 3.1 Product Description The suite we recommend would vary on the type of facility we are servicing, with some including all of our software's, while other may not need the full package. We have scheduling, note taking, e-prescribing, and medical history apps that work as long as an internet connection is handy. Technology harnessed by the cloud allows us to constantly improve our software by pushing updates to all of our clients as soon as they are ready. This minimizes any security issues that could occur and ensures that our users are always up to date with the newest, most efficient, and especially most secures software. We have also figured out a great system of setting up reminders for doctors so that none of their credentials can expire without ample reminders from the E.H.R. system. 3.2 Business Concept As the name suggests, the basic concept of Synergy MD is a central software that connects all aspects of the medical office operation. We want to make sure that the system is simple, clear, and organized and those three features are our hallmarks, in addition to our handson approach. We promote the downloading of our software through online purchase, and activation through a unique serial number. We then invite the consumer to input the type of facility they operate and configure the EHR system to best serve the facility's needs. Each patient will be given his or her own compartment in the system that will essentially act as their \"file\". All diagnoses as well as notes, or any other information will be documented in these files. All field will be customizable to even better fit each unique facility's needs. Any field can be taken away, and there are many choices of substitute fields to add which are based on extensive facility research. The major idea, or \"concept\" here is that we want to simplify the process even further than any EHR has in the past by allowing a simplified and smooth flow of documents around the office, accuracy and speed both improve. We believe any chance a business has to improve both those things is one worth investing in. 3.0 Industry / Market Analysis EHR implementation has doubled from 2007 to 2012, growing from 34.8 percent to more than 71 percent, according to the Centers for Disease Control and Prevention. In the past, medical records were only stored on paper, this made it difficult for health care providers to share patient's information. Between 2001 and 2011, the number of doctors using an EHR system grew significantly about 57%, this made it easier for all doctors to coordinate patient's care, while reducing the chance of medical errors. Facilities who implement an EHR system will have access through the authorization of 2009's federal HITECH legislation to fund financial incentives of as much as $25 billion. The money will be paid to those providers who implement and use EHRs. This newfound wealth for EHR vendors is the result of the multi-billion dollar incentives contained in the American Recovery and Reinvestment Act of 2008 (ARRA). Better known as the economic stimulus legislation. 4.1 Market Analysis (size, growth, trends) In 2007, only 17% of physicians used basic EHRs, according to the Centers for Disease Control and Prevention. Now about 70% of physicians are using one of the hundreds EHR systems currently on the market. Government incentives for EHR usage in 2009 caused a race in the healthcare information technology community to develop and market the next big EHR system. \"Patients and providers are expecting up-to-the-minute access to healthcare data and the government is interested in leveraging this data to improve patient outcomes and to encourage better communication across the healthcare spectrum. EHR has moved from being a simple concept of a computer-generated text file replacing handwritten chart data to a complex ecosystem of clinical data, patient education, and patient engagement tools which will increasingly require cross-platform interoperability.\" A big shift in the EHR industry will be from server-based systems that require hardware or software to be installed on office computers to web- and cloud-based systems that can be available in the office or on mobile devices. According to the Practice Profitability Index released in May 2013 by Care Cloud and Quantia MD, more than 40% of physicians say they will be implementing new EHR systems in 2014. Half of the physicians surveyed want to improve operational performance in billings and collection, while 31% want to improve their technology overall. Physicians are facing pressures to adopt and use EHRs in order to remain compliant with various healthcare reform efforts and demonstrate Meaningful Use. It's clear there is a growing number of providers and groups that signed up for their first EHR in haste and are now entering the market again, wiser about what they need in a clinical system. The other benefits to an EHR Implementation include poor penmanship of physicians, paper can be expensive to store and transport, easy to destroy e.g. fires, flood, and ink disappears after time and would be gone forever. Paper doesn't give you enough room to write as and is not environmentally friendly. Below is a list of pertinent information that were missing from paper charts. Table 4.1: Types and frequencies of missing information Information Missing during Patients Visit by % Visits Pathology results 15% History and physical exams 27% Radiology results 28% Letters/dictations 39% Lab results 0% 45% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 4.2 Consumer Analysis (needs, wants, behavior etc.) The typical consumer in the medical industry has already transitioned over to an EMR or EHR system of some kind. The consumers in this industry though, do not think twice before switching the provider of their service when they feel wronged. Generally there is a trend of miscommunication and just plain bad customer service from our larger competitors. Synergy MD knows that the typical medical office needs a reliable, friendly, and fully supported system to make them fully satisfied with the state of their EHR situation. We also recognize that an entire population of medical facilities of all types still exist which have not made the plunge over to a computerized office as of yet. These facilities are the hardest to sell on a system which they feel they missed out understanding, and are often now even more hesitant to take on the drastic change. For this reason, we are marketing are product as a fully supported one. We will address any questions or needs and provide proper tools to help staff get trained with our system so that transitioning does not have to be so scary. Facilities like this need a simple, clear system to help them enter the paperless realm. 4.3 Competition There are several companies in this industry. Take and compare Allscripts, Cerner, and Athena health's they each serve hospitals and smaller physician (ambulatory) practices in different capacities. Privately held Epic is the market leader in both categories, and reaches over half of U.S. patients. Below is a list of the top 5 EHR companies and their earnings. Figure 4.3 A Top 5 EHR companies and their earnings Annual Compan Certificati certified Priva on (as of Revenue Company c or y # Publi MU2 te EHR System Name Website 9/27/13) X Cerner Power Chart Ambulatory EHR 1 $2.67 billion* Cerner Corporation Public CCHIT (modular cerner.com only) Epic Care Epic Systems 2 $1.50 Privat billion* e $1.45 Public Ambulatory - Core Corporation CCHIT X epic.com CCHIT X allscripts.com EMR 3 All scripts All scripts Professional EHR" billion NextGen Ambulatory $429.8 EHR million NextGen Healthcare 4 Information Systems Public CCHIT X nextgen.com Inc.* Sure scripts $422.3 5 Athena health Athena Clinical athenahealth.c Public LLC / million X om CCHIT According to the Office of the National Coordinator for Health IT, the cost of purchasing and installing an EHR can vary from $15,000 to $70,000 (per provider). The primary difference in both depends mostly on whether you select on-site EHR deployment which involves extra set up and maintenance costs or a web-based EHR deployment known as Software as a Service (SaaS) this involves a monthly fee. Figure 4.3 B Graph of Estimated Average Cost in Office Esti mated Average Cost In offi ce vs (SaaS) $70,000 $60,000 $50,000 $40,000 $30,000 $20,000 $10,000 $0 Estimated Average Cost (In-Office) Upfront Cost Estimated Average Cost Yearly Cost (SaaS) 5 Year TCO In addition below is a comparison of what it would cost a small practice of one versus a practice of 5 physicians. Figure 4.3 C Chart Cost of EMR Adoption 4.4 SWOT Analysis Strength 1. Excellent staff with strong knowledge of Synergy MD, excellent internal communications. 2. Models, profiles and other work products are expressed in easily readable terms and is easily understandable to clinical, business, and healthcare communities. 3. Synergy MD has obtained commitments from all funding partners. 4. Reliable and easy to use system. 5. Compatible with almost any other E.H.R or Medical Office system. Weakness 1. High Adoption Cost 2. Limitation on Interoperability 3. Software package variations 4. Varying forms of pressure from clients/physicians Opportunities The ability to expand the use of work products worldwide through our affiliates and associate organization agreements. The ability to influence Health Information Technology (HIT) public policy and market forces. The current EHR systems are not as reliable as Synergy MD and cost a lot more. Figure 4.4 Cost Analysis Threats 1. Global economy and rising costs affecting attendance/participation in meetings. 2. Competitive pressure / Market 3. Competitor with similar products 4. Security Concerns 4.5 Keys to Success The keys to Success for Synergy MD is that we will remain at the forefront of technology and software implementation. We will ensure that we have the right leadership and the right personnel working for us. Our stakeholder will have the same overall vision for the company. Patient safety and protecting healthcare information will continue to be a top priority for our organization. Our goals will be clearly defined and we set realistic time frames for systems implementation and training. We will ensure that we have the right resources available to us and be adequately financed so that our business can thrive. Synergy MD will have adequately trained employees on hand that will get the job done while maintaining a positive relationship with our vendor and partners. These methods will only add to Synergy's success 4.0 Marketing & Sales Since beginning operations in 2016 Synergy MD has seen sales increase in virtually every quarter since. At first our product was an online-only purchase sold through a few online marketplaces. Since then we have expanded rapidly offering our software through more merchants, and in 2016 introducing a physical version because of the many requests we have received from clients. After a small local marketing push in the New York City area in 2016 we saw our biggest jump in sales. We sold just about 600 copies of our software up until the marketing push. After the local marketing as finished we had sold an additional 600 copies in under 6 months, doubling our overall sales. Synergy MD hopes to sell between 800-1200 copies in the following year which would be another year of record growth. There has been a small profit posted in the final quarter of 2015 which amounted to about $50,000. We plan to re-invest this into another marketing push in Q2 of 2016. Though we have operated at a small loss in previous years we have has small investors who believe in the eventual growth of our product in the mainstream E.H.R market. Thankfully this is finally in sight. As of 2013 the E.H.R market is worth over 23 billion dollars, and this number is expected to grow fast in the coming years. 5.1 Marketing objectives Synergy MD started from literally scratch when in debuted on the digital marketplace in 2016. Since then we have grown in healthy leaps and bound and finally took a .1% share in 2016. Since then that number has grown by comparison to just over .6 percent of the E.H.R market in 2016 and we hope to reach a 1% share in the next 8 months. Our lower price to our closest counterparts has garnered some attention online and in conversation between medical offices. In order to get our market share where we want it we need to raise money for a major media push which would hopefully allow us to break into the E.H.R conversation. Figure 5.1 Growth in the Industry 0.90% 0.80% 0.70% 0.60% 0.50% 0.40% 0.30% 0.20% 0.10% 0.00% Q1 210 Q4 2010 Synerg yMD Q1 2013 S ens eAI Q4 2013 G loopyHealth As can be seen by the above chart there are a few competitors of similar size to Synergy MD. They both had early success but have recently fallen from their growth. We all offer similar products though Similar MD has decided to price competitively compared to SenseAI and Gloopy which recently closed its doors. Many people are of the view that the electronic health data program will compromise their privacy by revealing what should be confidential information. The marketing department will make it a priority to disseminate information on the way the new products function. This will make consumers understand better the product on sale hence reducing their resistance. Awareness will be achieved through detailed advertisement, seminars and use of doctors whose opinion on the product is positive. The ultimate goals of the Synergy MD is to increase company sales by 45 percent on average every year, achieve a customer satisfaction rate of 80-87 percent and to be recognized globally. Synergy MD e-business will have the following marketing objectives as it strives to undertake its core duties increase sales by 10% each year Build brand awareness and acceptance among the customers Grow market share by 5% each financial year Launch new products and services as it expands. Target new customers. Enter new markets internationally and locally. Improve stakeholder relations. Enhance customer relationships. 5.2 Target market Synergy MD e-business targets medical facilities, physicians and businesses who do not have an EHR systems to date. These are the type of customers who are looking for a way to provide efficiency to their business. The current customers of the Synergy MD are facilities who use paper record for their health data and are looking to transition to an EHR system. The company will as well seek to enhance data retrieval and storage of people who use online system to store their information. The following factors will influence them into choosing Synergy MD products; i. Synergy MD e-business will provide high quality products than their competitors ii. Synergy MD e-business will sell its products at relatively lower prices iii. The products will be of variety and convenient to the final customer As of 2015 the top 10 E.H.R firms command about 90% of the overall space. According to Becker's Hospital review these 10 major brands are: Spic Systems Corporation which controls almost 20% and is the big wig in this group, Meditech, Computer Program & Systems Inc., Cerner, Mckesson, and a few others. Synergy MD is about taking the time to find out what each of our clients need and specially designing a product that will work for them. While our competitors work in volume and quickly move on to the next facility, we want to offer a service that appreciates why facilities have taken this long to make the switch. We believe that our customer is the office that has been intimidated by the switch to a paperless system, and we want to offer them the peace of mind of knowing that they will have full hand on support to make sure the transition goes as smoothly as possible. Our existing customers enjoy our support and understand that the real value in our suite is not that it is simple and it just works, but that we are always there to make it right when nit doesn't. 5.3 Value Proposition and Positioning The company prides itself in the provision of best EHR systems which will reduce paper work and save time for other health services. The product will ensure minimization of medical errors by using rationalized patient data for e-prescription. Our company offers unique products which will allow ease access of data and overall change in the medical spectrum. Synergy MD business is focused on automation of pharmaceutical services that will help with scheduling, reduction in medical error, improved safety and overall administrative efficiency and work flow of your business. By continuously conducting market research, we will have the ability to quickly adapt to address the needs of our target region. Below is a chart of the top requested functionality based on percentages that every business is looking for in an EHR system all of which Synergy MD offers. Figure 5.3 Top requested functionality based on percentages Synergy MD system services are not limited to but will include the following: Appointment Scheduling E-Prescribing Coding Appointment Reminders Orders and Result Patient Portal and Results E-Learning Patient Profiles Clinical Alerts Clinical Decision Support Device Connectivity Meaningful Use Dashboard Templates Library Support (e-ticket) Onsite Training At Synergy MD we will provide all the services that our competitors offer but at a much more cheaper price and we will ensure that we are meeting the need of our customer which seem to be the number one complaint from physician. Buyer are looking for a system that is efficient and productive. They want a system that is able to manage patient's information and offer a smooth work flow to their practices. The system need to offer intelligence in the ability to run their practices and that is exactly what Synergy MD offers. Chart showing the percentage of replacement EHR Software and Paper Let's take a closer look at a few of the services that will be included. Coding - ensuring that physicians are capturing all codes for visits is crucial. Outdated codes means the business is losing revenue and is at compliance risk. E-Prescribing- there are so many prescription being rewritten on a weekly basis because of illegible handwriting and because a medication is not covered by the patient insurance. Medication error according to The Institute of Medicine are responsible for majority of avoidable errors in health care. Synergy MD will be able to check drug to drug interactions, allergies and no more illegible handwritings. Synergy MD will help to track health maintenance for patients with chronic illnesses e.g. sending out reminders to patient who are diabetic for follow up care and appointments. Lastly patient satisfaction the biggest, patient want to leave a doctor's office feeling confident and with a better understanding of their health conditions and furthermore know that they can get in touch with their doctors to make appointment our electronic appointment scheduler will cut down on long phone wait times and give receptionist a better view at opening well in advance. Physicians can spent more time providing care to their patients and less time handling complaints. Sample view of Scheduling Screens 5.4 Pricing strategy Synergy MD is a new company and does not have a price history but based on research an EHR system can run anywhere from 15,000 to 70,000 per provider. Other companies currently in the market charge anywhere from 200 -700 monthly with a onetime service fee ranging from 2,000 -5,000 per provider. The chart below gives you an idea of what three current competitors are currently charging monthly in comparison to what Synergy MD will charge for the same services on a monthly basis. Figure 5.4 Monthly Cost Monthly Cost Synerg y MD 230 Cure MD 295 Companies Care Cloud 379 Amazing Charts 250 0 50 100 150 200 250 300 350 400 The level of the prices will depend on: i. Product demand - if demand increases, prices will increase relatively over a period of ii. time Competitors prices - if competitors raise prices, Synergy MD will either remain constant or increase at relatively lower rate than those of competitors iii. At 10% market share, Synergy MD will operate under lower prices so as to increase its market share 5.5 Distribution strategy Since 2016 Synergy MD has been offering our software online, as well as part of a physical package. We also offer full-service installation that would include heading up a project to set up your facility from scratch. For a fee (dependent on the size of the facility and amount of work stations involved). This full-service install would include the facilities choice of hardware as well as full installation and training if needed. We sell through most online retailers with whom we have great working relationships. Currently we have transitioned to a more in-person, full service installation approach and no longer offer direct downloads of the software anywhere on the web. This is part of the concentration on the support side of the product. In the past we offered additional services dealing with interoffice communication and operations but have since decided to shift our focus on developing the best E.H.R. option available on the market. Since refocusing our resources to focus on our marquee product we have seen sales rise steadily every year and have received positive feedback from our clients. 5.6 Promotion/IMC Strategy Physicians are skeptical about transitioning their offices over to Electronic method they are worried that it may be a long process and might end up being a bigger headache than its worth. Here at Synergy we will make the process a lot easier and by making ourselves available from start to finish during the transition process. We will over training and support to aid with a quick and smooth software transition leaving our customers satisfied and happy. We will market our business through the web, where we will offer a free demonstration of our services. We are available 24hr for any questions you might have in regards to our services. We can even arrange and in house demonstration if necessary. We offer the added services of backing up all medical records during the first three months as added security and comfort. We will also advertise using social media outlet such as Facebook and Instagram. As a strategy we will use phrases that when anyone is googling or doing research on an EHR system our company will automatically show up in their search. We offer a guide book on how to easily change from Paper to EHR. In addition we will over a checklist to physician that will outline all the things they should be looking for in a system. Doctor and patients who have had positive opinions on the products will be used in the promotion campaigns. We will be doing billboards and sending our sales reps out to physicians who have not already made that transition to give them a better look at our services. 5.7 Sales Forecast first 36 months Since beginning operations in 2007 Synergy MD has seen sales increase in virtually every quarter since. At first our product was an online-only purchase sold through a few online marketplaces. Figure 5.7 Synergy MD Sales per copies Syne rg yMD Sale s (pe r 10 0 copie s ) SynergyMD Sales (per 100 copies) 14 12 10 8 6 4 2 0 Sa l e s 2 0 0 7 Sa l e s 2 01 0 Sa l e s 2 0 1 3 Sa l e s 2 0 1 5 Since then we have expanded rapidly offering our software through more merchants, and in 2012 introducing a physical version because of the many requests we have received from clients. After a small local marketing push in the New York City area in 2014 we saw our biggest jump in sales. We sold just about 600 copies of our software up until the marketing push. After the local marketing as finished we had sold an additional 600 copies in under 6 months, doubling our overall sales. Synergy MD hopes to sell between 800-1200 copies in the following year which would be another year of record growth. There has been a small profit posted in the final quarter of 2015 which amounted to about $50,000. We plan to re-invest this into another marketing push in Q2 of 2016. Though we have operated at a small loss in previous years we have has small investors who believe in the eventual growth of our product in the mainstream E.H.R market. Thankfully this is finally in sight. As of 2013 the E.H.R market is worth over 23 billion dollars, and this number is expected to grow fast in the coming years. 5.0 Finance Management Synergy MD will effectively manage all funds related to the business. In order to accomplish the objectives and goals of the business. We will plan and implement a sound capital structure and ensure adequate return to our shareholders. 6.1 Minimum start up Requirement The Minimum startup cost for Synergy would be roughly 300,000. This will cover all overhead cost. These include equipment advertising, employees, training and any other cost involved. Figure 6.1 Yearly Performance cash Flow 6.2 Important Assumptions The important assumptions for Synergy include the need for our services and product. We already know that there is a strong need for EHR System. There is also the fact that research shows there is a strong consumer base for Electronic health care systems. Based on market research EHR systems are profitable. By keeping our prices low and managing our overhead cost so that we ensure that we pay off our startup cost we should so really well. We have ensured that we have sufficient capitalization and fund to run the business until we reach our breakeven point and start to make a profit 6.3 Break Even Analysis Average percent changes in a clinic's operational efficiency and financial performance between the pre-EHR and post-EHR periods. Figure 6.3 Monthly Break Even Analysis 7.0 References Electronic Health Record (EHR) Infographic by HealthIT.Gov. (n.d.). Retrieved January 29, 2016, from http://www.openhealthnews.com/blogs/groenpj/2013-01-03/electronic-healthrecord-ehr-infographic-healthitgov EMR market surpasses $23 billion.(2014). Retrieved February 07, 2016, from http://www.healthcareitnews.comews/emr-market-surpasses-23-billion HIPAA Privacy Rule and Its Impacts on Research. (n.d.). Retrieved February 07, 2016, from https://privacyruleandresearch.nih.gov/ How Medical Laboratories Help Physicians Overcome the Failure of Many EHR Systems to Support Effective Lab Test Ordering and Lab Result Reporting. (n.d.). Retrieved January 29, 2016, from http://www.darkdaily.com/how-medical-laboratories-help-physiciansovercome-the-failure-of-many-ehr-systems-to-support-effective-lab-test-ordering-andlab-result-reporting-330#axzz3yfkymGf6 How to Budget and Fund EHR Projects. (n.d.). Retrieved January 29, 2016, from http://www.hrsa.gov/healthit/toolbox/healthitimplementation/implementationtopics/planb udgetsecurefunding/planbudgetsecurefunding_6.html JP Medved. (2014, February 27). What Does EMR Software Cost? Retrieved February 07, 2016, from http://blog.capterra.com/emr-software-cost/ The top 100 EHR companies (Part 1 of 4). (n.d.). Retrieved January 29, 2016, from http://medicaleconomics.modernmedicine.com/medicaleconomics/content/tags/top100ehr s/top-100-ehr-companies-part-1-4 Top 10 Rankings of EHR Market Share Put Epic First as Hospitals, Physicians, and Clinical Laboratories Make Progress on Interoperability. (n.d.). Retrieved February 07, 2016, from http://www.darkdaily.com/top-10-rankings-of-ehr-market-share-put-epic-first-ashospitals-physicians-and-clinical-laboratories-make-progress-on-interoperability829#axzz3zWxUx3Xt