The recent announcement by TELUS regarding their acquisition of KinLogix, a cloud-based provider of EMR systems in Quebec, further consolidates the EMR market in Canada. Quebec has tended to function as an independent market for EMR systems. Four additional EMRs are commonly used in Quebec, namely Info-Data, Soft Informatique, Purkinje, and Omnimed. Other than Purkinje, which has a contract with the Canadian Armed Forces to provide Electronic Medical Records, none of the other EMRs are sold outside of Quebec.
As a result, TELUS’ strategy makes perfect sense in that it adds a new market for EMR systems to the TELUS Health family of products that is complementary to Wolf Medical, a product that TELUS acquired in February 2012. Additionally, both divisions (Wolf Medical and Kinlogix) are led by physicians, namely Dr. Brendan Byrne and Dr. Michel Hébert. The only gap for TELUS at this time is an EMR presence in Ontario and, with the acquisition of two cloud-based EMR systems to date, I would not be surprised to learn of the acquisition of a third cloud-based EMR system in Ontario at a future date. This would provide TELUS Health with virtually coast-to-coast EMR presence and the ability to link EMR systems through the cloud, plus the ability to offer a French or English version of their product in markets such as New Brunswick and Manitoba, each of which have pockets of dominantly French-speaking populations.
The other consolidation story playing itself out in the Canadian market is that of QHR Technologies, a company led by Al Hildebrandt, President and CEO. In rapid succession, QHR Technologies acquired EMIS Inc.’s assets in Canada in August 2011, followed by Healthscreen Solutions Inc. in October 2011. Two years prior, in November 2009, QHR Technologies acquired Clinicare Corporation, a Calgary-based company that developed one of Canada’s first comprehensive EMR systems. The QHR family of EMR products provides solutions for family practictioners as well as specialists with the Accuro EMR solution used by a wide range of specialties across English speaking Canada. What QHR currently lacks is an EMR product for the French-speaking market.
This story is one of a maturing marketplace for EMRs. Smaller EMR companies that do not have the resources or expertise to compete are being bought out by larger, more established companies with deeper pockets and a broader market presence.
Is this good for the EMR market in Canada? Yes, I believe so. Most mature EMR markets (UK, New Zealand) have a small number of dominant EMR products and a number of smaller companies that serve specialty niches or markets. This provides needed choice in the market and competition amongst vendors, which encourages improvements in the products over time. As with any growth-by-acquisition strategy, the biggest challenge that any company faces is retaining and supporting existing customers and simplifying the management of one’s products, particularly if there are multiple different versions in the marketplace. With cloud-based systems, this is easier, as there is one central version of the EMR that is updated centrally as new changes and enhancements are applied. It is certainly more challenging with local servers in individual physician offices.
The EMR consolidation story in Canada is just in the process of being written. Watch for future updates on CanadianEMR as the market continues to mature.
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