EHR Attestations Revisited

About a year ago, I posted a visualization of EMR/EHR attestation numbers from data provided by CMS and the ONC. Almost 16 months later, the attestation landscape hasn’t changed very much. From a geographical perspective, highly populated states continue to have the highest overall percentage attesting organizations (EPs and hospitals). However, keep in mind that these numbers are not adjusted for population size or number of total practices/hospitals per state. The maps below simply portray the yearly proportions of attestations coming from each state (so for each year, we would expect 100% total when adding up all states).

Trends in State Attestation (interactive)

Overall (2011-June 2013), California-based EPs and hospitals have sent in the most number of attestations at 6.83% of the entire set, followed by Florida and Texas at 5.59% and 5.55%. Of the continental states, Alaska, Wyoming and Vermont rank lowest at 0.07%, 0.11% and 0.17% respectively. A notable mention goes to Utah that saw a significant increase in successful attestations, going from 1.36% of total 2012 attestations to 7.77% of total 2013 attestations.

Popular Vendors

There are clear winners (as expected) in terms of user base and attestations submitted. Take a look at the top 5 table below. The top two spots seem to be secured by Epic & Allscripts, with some shift in 3rd-5th place.

For a complete list of EHR vendors, number of attestations per vendor and proportion of attestations from the vendor per year, please click here.

There are some interesting remarks to be made in regards to EHR vendors and attestations throughout 2011-2013:

  • There were over 600 (603) EHR vendors that were used to attest for MU through 2013.
  • The top 5 EHRs on the market own almost 50% of the attestations (48.02).
  • There are close to 300 (288) EHR vendors which had less than 20 EPs/hospitals attest for MU through 2013.

As the market continues to consolidate and smaller companies exit the market, the top EHRs will grow in market share. What does this mean for competition?

Specialty Breakdown

Attestation Breakdown

Family practice and internal medicine continue to lead the pack in EHR adoption & attestation applications, very similar to the proportions I calculated in the initial MU Visualized post. Of course, this is due to the fact that there are more general practitioners than specialists and these proportions have not been adjusted accordingly.

Have more data? Interested in doing some further research? Send me a tweet: @bogdanrau!

Leave a Reply


  1. This is a great post.

    We are looking forward to seeing the landscape change when MU stage two kicks in — and Summative usability testing will abound!

    • Bogdan

      I wonder how many of the hundreds of EHR companies do any type of usability testing…especially expert usability testing.

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