With support from California Health Care Foundation, earlier this year (2016) Health 2.0 surveyed over 100 small health tech companies to ask their experiences integrating with specific EMR vendors.

1. report generated by:
API Survey Results

2. generated report for
Q1: How vital is it for your product/service to integrate with an EMR?
Sample size represents number of verified respondents that began the survey, but not all 108 completed the survey in its entirety. There was significant drop off
following question five, which was the last question on one page before respondents moved on to a long and difficult page of questions involving specific vendors.
Where possible, we've presented the largest sample size of data for any given question, though we also compared the larger sample size to the group of 75 respondents
that completed the survey in full. Overall, the smaller sample of respondents that completed the survey reflected a similar distribution when compared to the
corresponding larger sample sizes.
Total Respondents: 108
Vital Nice to have Optional Unncessary
37%
40
2%
2
13%
14
48%
52

3. Yes! We’ve Intergrated. No. We haven’t.
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Q2: Has your company attempted an integration with an EMR vendor?
Again, this sample size represents the number of verified respondents that began the survey. Respondents who began the survey but
did not complete it were contacted and given an opportunity to finish the survey; some did, others did not.
Total Respondents: 108
30%
No: 32
70%
Yes: 76

4. Yes! We’ve Intergrated. No. We haven’t.
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5. Yes! We’ve Intergrated. No. We haven’t.
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Q3: We define four levels of integration. Please select one of the following that best
describes the extent of your integration attempt(s).
Sample size represents number of verified respondents that began the survey, indicated they had experience
integrating with EMRs, but not all completed the survey.
Total Respondents: 73
8% (6) 33% (24) 27% (20) 32% (23)
Extracting data from the EMR for a proprietary application (i.e. read)
Extracting data from the EMR and inserting data back into the EMR (i.e. read and write)
Extract data, insert data back into the EMR, and make a change within the vendor system (i.e. read, write, and change)
Bring in your own external data & combine it with data generated by vendor system, manipulate/analyze it and make a change

6. Yes! We’ve Intergrated. No. We haven’t.
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Q4: How many integrations has your company attempted?
Total Respondents: 73
1 - 5 5 - 10 10 - 15 15 - 20 20+
63% (46)
18% (13)
1% (1)
3% (2)
15% (11)

7. Yes! We’ve Intergrated. No. We haven’t.
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Q5: Which EMR vendors have you integrated with?
49% 20% 19%
12% 39%33%
Respondents: 34
Respondents: 23
49%
Respondents: 34
Respondents: 14
Respondents: 8
17%
Respondents: 12
Respondents: 13
Respondents: 27
20%
Respondents: 14
Total Respondents: 69
Note that respondents were able to select more than one vendor. The mean number of integrations per respondent is 2.5,
while the median number of integrations is 3.
Other: Greenway, Practice Fusion, drchrono, Care Cloud, QRS, PointClickCare

8. Yes! We’ve Intergrated. No. We haven’t.
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Q6: How did you integrate?
Respondents: 26 Respondents: 16 Respondents: 25 Respondents: 8 Respondents: 24 Respondents: 13
Total Respondents: 46
Accessed Vendor API Used 3rd Party Integration Engine Used Batch or Non-API Data Exchange Used Direct or Other Protocol
19%
(5)
19%
(5)
19%
(5)
42%
(11)
25%
(4)
25%
(4)
19%
(3)
31%
(5)
16%
(4)
8%
(2)
4%
(1)
72%
(18)
38%
(5)
23%
(3)
15%
(2)
23%
(3)
17%
(4)
4%
(1)
4%
(1)
75%
(18)
25%
(2)
50%
(4)
25%
(2)
Respondents: 12 Respondents: 6 Respondents: 14
33%
(4)
17%
(2)
33%
(4)
17%
(2)
33%
(2)
17%
(1)
33%
(2)
17%
(1)
29%
(4)
36%
(5)
14%
(2)
21%
(3)

9. Yes! We’ve Intergrated. No. We haven’t.
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Q7: Was a large provider client necessary to engage a vendor in a conversation about accessing data?
30% 70%
59%
69%
41%
31%
46% 54%
46% 54%
56% 44%
53% 47%
80% 20%
74% 26%
Respondents: 27 | No: 8 // Yes: 19
Respondents: 17 | No: 10 // Yes: 7
Respondents: 26 | No: 18 // Yes: 8
YesNo
Respondents: 13 | No: 6 // Yes: 7
Respondents: 9 | No: 5 // Yes: 4
Respondents: 15 | No: 8 // Yes: 7
Respondents: 10 | No: 8 // Yes: 2
Respondents: 23 | No: 17 // Yes: 6
Respondents: 13 | No: 6 // Yes: 7

10. Yes! We’ve Intergrated. No. We haven’t.
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30% 70%
59%41%
69%31%
Respondents: 27 | Yes: 10 // No: 17
Respondents: 16 | Yes: 5 // No: 11
Respondents: 26 | Yes: 20 // No: 6
Yes No
Respondents: 17 | Yes: 3 // No: 14
Respondents: 9 | Yes: 1 // No: 8
Respondents: 16 | Yes: 6 // No: 10
Respondents: 10 | Yes: 3 // No: 7
Respondents: 24 | Yes: 18 // No: 6
Respondents: 17 | Yes: 7 // No: 10
Q8: Would you say vendors were generally supportive of your integration efforts?
63%37%
23%77%
25%75%
18% 82%
13% 87%
38% 62%

11. Yes! We’ve Intergrated. No. We haven’t.
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Q9: Was there a fee associated with accessing a vendor API?
67% 33%
64% 36%
46% 54%
54% 46%
77% 23%71% 29%
Respondents: 24 | No: 16 // Yes: 8
Respondents: 14 | No: 9 // Yes: 5
Respondents: 24 | No: 11 // Yes: 13
YesNo
Respondents: 10 | No: 5 // Yes: 5
Respondents: 8 | No: 6 // Yes: 2
Respondents: 14 | No: 10 // Yes: 4
Respondents: 8 | No: 6 // Yes: 2
Respondents: 24 | No: 13 // Yes: 11
Respondents: 13 | No: 10 // Yes: 3
75% 25%
75% 25%
50% 50%
In a subsequent question, respondents were asked about the specific dollar amount of any associated fees. Where there was a fee, respondents
indicated it was usually less than $25,000. However some respondents claimed that for Epic, Cerner, GE, athenahealth, and Allscripts sometimes
the fee was upward of $50,000. It is also worth noting that respondents mentioned many vendors sought some type of revenue share agreement
and that CommonWell fees were around $50,000, which in theory should connect startups to many vendors in the space.

12. Yes! We’ve Intergrated. No. We haven’t.
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Q10: Overall, would you say EMR vendors helped or hindered the integration process?
22%
52%48% 65%35% 29%71%
14%86%
57%43%
40%60%
41%59%
53%47%
78%
Respondents: 27 | Helped: 13 // Hindered: 14 Respondents: 17 | Helped: 6 // Hindered: 11 Respondents: 7 | Helped: 5 // Hindered: 2
Respondents: 15 | Helped: 7 // Hindered: 8 Respondents: 5 | Helped: 3 // Hindered: 2
Respondents: 17 | Helped: 10 // Hindered: 7 Respondents: 14 | Helped: 6 // Hindered: 8Respondents: 23 | Helped: 18 // Hindered: 5
Helped Hindered
Respondents: 23 | Helped: 19 // Hindered: 3

13. Yes! We’ve Intergrated. No. We haven’t.
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Q11: How would you rate the ease of access to any partner programs provided by EMR vendors?
Respondents: 27
Respondents: 15
Respondents: 27
Respondents: 14
Respondents: 7
Respondents: 16
Respondents: 9
Respondents: 23
Respondents: 13
Program exists; easy to understand Program exists; enrolling somewhat complicated Non-existent programs; difficult to enroll
52%
(14)
15%
(4)
33%
(9)
64%
(9)
14%
(2)
21%
(3) 56%
(5)
11%
(1)
33%
(3)
9%
(2)
43%
(10)
48%
(11)
62%
(8)
15%
(2)
23%
(3)
57%
(4)
14%
(1)
29%
(2)
44%
(7)
25%
(4)
31%
(5)
47%
(7)
13%
(2)
40%
(6)
11%
(3)
44%
(12)
48%
(13)

14. Yes! We’ve Intergrated. No. We haven’t.
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Q12: How would you rate the quality of any vendor APIs you gained access to in the course
of the integration process?
Respondents: 25
Respondents: 11
Respondents: 24
Respondents: 10
Respondents: 6
Respondents: 13
Respondents: 7
Respondents: 25
Respondents: 11
High technical quality, relatively easy to work with Not great, but workable Poorly designed APIs
24%
(6)
28%
(7)
48%
(12)
50%
(5)
10%
(1)
40%
(4)
14%
(1) 14%
(1)
71%
(5)
8%
(2)
60%
(15)
32%
(8)
36%
(4)
18%
(2)
45%
(5)
33%
(2)
17%
(1)
50%
(3)
38%
(5)
23%
(3)
38%
(5)
27%
(3)
27%
(3)
45%
(5)
8%
(2)
25%
(6)
67%
(16)

15. Yes! We’ve Intergrated. No. We haven’t.
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16. Yes! We’ve Intergrated. No. We haven’t.
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Please describe why you haven’t integrated with an EMR.
Total Respondents: 29
48% (14)
21% (6)
7% (2)
41% (12)
Application does not need integration to add value
Have attempted to integrate, but process was too difficult
Other integration engine means direct integration is not necessary
Too costly
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17. Yes! We’ve Intergrated. No. We haven’t.
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Is there other medical data stored in an EMR that could enrich this application or
improve the user experience?
Yes No
10%90%
Respondants: 29 | Yes: 26 // No: 3
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18. Yes! We’ve Intergrated. No. We haven’t.
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Would the patient benefit from his/her professional care team receiving data from this application via
(or in combination with) the EMR?
10%90%
Respondants: 29 | Yes: 26 // No: 3
Yes No
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19. Yes! We’ve Intergrated. No. We haven’t.
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Are there other crucial functionalities that could be added via an EMR integration
(i.e. scheduling, notifications, messaging)?
Yes No
10%90%
Respondants: 29 | Yes: 26 // No: 3
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