Epic’s EMR is based on the same database technology used by MEDITECH, but it has far out-paced it’s cousin in industry growth.

The system has an integrate ambulatory component, which has allowed it to displace many standalone acute and outpatient EHR systems.

However, the upfront and ongoing costs are out of reach for smaller hospitals and independent clinics. The company is now seeing some growth in the smaller site sector, as their current clients are implementing in the CAH and small site space, as extensions of the larger health system.

Time will tell whether Epic will be able to continue to dominate and grow with the same trajectory. MEDITECH now has an integrated solution available, and athenahealth is quickly spinning up an acute competitor.

iSolved Time – Quest and TimeForce Profile

iSolved Time is a product out of QQuest and TimeForce, giving them a launch with over 60,000 employers and two million users.


Infinisource is the company that owns and offers iSolved. While they provide human capital management solutions, iSolved is specifically focused on capturing time and attendance data.


The tools in their iSolved platform include the ability to track from mobile devices, standard time clocks, and web portals. The basic features are similar to any other time and attendance company – for example, employees can view accruals, request time off, and view their pay stubs.
This is a cloud-based service, which can help you be up and running quicker with less IT work required upfront. The company manages the servers, upgrades and patches, etc., and the employer can manage policies, schedules, and time approval from an online access portal.

Kronos Workforce Management Software

The Kronos Workforce Management system is one of the widest-adapted time and attendance systems in the world. The company boasts over 20,000 customers.


Kronos was founded in 1977. They created the first microprocessor-based time clock, in 1979, and reached $1 billion in annual revenue in 2014.


The company has continued to innovate, offering time clocks that broadcast videos to employees when they punch in for the day.


The labor management software offers powerful analytics, including costing information and employee oversight tools. Kronos supports HR and payroll functions as well, making it one of the more-rounded Time and Attendance systems available.

TSheets Time Tracking Software

TSheets provides current-world solutions for time tracking. If you’re looking for system that go beyond clock-punch, you may like their offerings.


This time and attendance company offers apps for multiple mobile platforms, supporting GPS location tracking. An employer can view who’s working and where in real time, which can be valuable managing employees in the field.


Additional options for clocking in and out include phone systems, SMS messaging, and a web portal you can access via a browser.


The TSheets system integrates with accounting and payroll systems as you would expect. The company is based in Idaho, and was started in 2006. The emphasis on current technology for labor tracking has led to fast growth for TSheets.

TimeClock Plus Labor Tracking

One of the longstanding Time and Attendance companies, TimeClock Plus has been providing attendance tracking systems since 1988.


TimeClock Manager is their administration module, providing the labor management tools. The system was designed to be affordable and yet powerful enough to manage workforces of 10,000 employees and more.


The backend of the system is a Microsoft SQL database. The front end options include web portals or various models of time clock hardware. They offer over 100 payroll interfaces.


This system has not been extended to provide HR administration or payroll processing. The company makes strategic partnerships where needed to meet business needs.

TimeClock Plus is not one of the flashier systems but its strong functionality has won it high marks in many reviews.

e-MDs EHR and PM Software Review

e-MDs is an ambulatory Electronic Health Record system, with Practice Management functionality as well.  


It was developed in 1996 in Austin, TX.


e-MDs has received accolades from AAFP, and favorable reports from KLAS. While the consolidating marketplace has decreased the number of independent practices, e-MDs has grown to over 50,000 users.


Their EHR solution has been developed with the intention of truly support provider workflows, generating readable notes, and capturing the needed data as efficiently as possible.
Like Athena, their system was built to be web-based, and compares favorably to much older technologies driving Epic, MEDITECH and others.

Athenahealth EHR Software Review

Athenahealth’s EHR has been a disruptive force in the health care IT industry, with an appealing payment structure, and new cloud-based technology.


The company is based in Boston, and headed by Jonathan Bush.


Athena will typically take over billing and collections for their clients, in addition to providing charting and other practice management features.


Their providers pay a percentage of net collections, which seems to indicate that athena has skin in the game. The more the practice makes, the more the vendor makes.


The unique EHR model allows athena to manage systems efficiently, when one upgrade updates all customers. It can also mean that providers get less flexibility, and any custom requests can be slow to be completed.
Athena’s largest disadvantage may be that they are a specialized product in a consolidating marketplace. As an ambulatory-only solution, they have been replaced in some clients by Epic or Cerner’s all-inclusive products. In response, athena does have an inpatient solution in development.


Meditech is an EHR company based in Boston.


One of the widest-adopted HIS system in the US, MEDITECH competes head-to-head with Cerner and often Epic.


The biggest strategic disadvantage was arguably the lack of an outpatient offering.


Until last year, MEDITECH offered acute system only. They were leaving money on the table as hospitals were forced to find secondary systems for their clinics. As of last year, MEDITECH began selling an Ambulatory module as part of their 6.1 system.


If the early adopters are successful and word-of-mouth builds, this could help MEDITECH square off more successfully with the other HIS system leaders. At very least, this can help them protect their market as they profit off the upgrades to 6.1.


eClinicalWorks Medical Record Software

eClinicalWorks offers a hosted EHR that has been widely adopted in the US.


The company is based in Massachusetts. They boast over 100,000 physicians using their system.


eClnicalWorks is focused on outpatient services only, not currently offering an acute system. They have had success selling into hospitals, offering interfaces between the inpatient and outpatient systems.


While they continue to grow, this could prove to be a weakness for them. Many hospitals systems are electing to implement systems with inpatient and outpatient capabilities, such as Epic or Cerner.


eCW leveraged their standardized pricing and efficient implementation processes in a deal with Sam’s Club. They offered their system for providers, paired with Dell equipment for a fixed price.
The emphasis on a best-of-breed ambulatory product has paid off with many FQHCs and standalone clinics signing with them. Even the NFL announced in 2012 that they were using eClincialWorks for their move from paper to EHR.

GE Centricity Practice Solution EHR

GE’s offerings are an assortment of EHR systems, purchased and rebranded under the Centricity name. There is no inpatient option, so this system makes the most sense for independent practices.

GE has a robust practice management and charting system. Their forms include everything needed to meet Meaningful Use requirements.

Centricity uses HTML and MEL-based forms. The freedom to create your own forms has historically been a strength. However, some of that advantage is lost as clinics work to meet PQRS and MU standards. They have to standardize forms to ensure data collection leads to populating the right fields for GE’s proprietary CQR reporting registry.

Easy EHR customization may be more of a limitation today than a feature.

The CQR reporting platform makes reporting to CMS easy, once the system has been configured to collect data in the correct fields.

The Oracle version (Centricity Physician Office) continues to receive version updates and service packs, but appears to be on life support.

The SQL platform (Centricity Practice Solution) has an updated user interface, and appears to be their preferred platform going forward. The PM and EMR integration is only available on this platform.