The difficulty isn't the product itself, but all the integrations.
Every small clinic wants special custom formats. Insurance eligibility providers will lie about their abilities. Some insurance companies don't integrate with any eligibility check software. Sending health info anywhere requires yet more interchange formats.
The actual note taking bit isn't too bad, and can be easily modeled with most flexible CMSs even. The problem is that you can either gamble on a startup offering everything that a company that has been in business since before you were born and actually being able to follow through, or you can just go with the established company like everyone else does.
Having seen several startups trying to break into the space, it's no surprise that epic still dominates. The regulatory hurdles alone are not trivial; clinics that take Medicaid are usually required to use an EMR with a CEHRT certification which can cost tens of thousands of dollars to obtain.
Every small clinic wants special custom formats. Insurance eligibility providers will lie about their abilities. Some insurance companies don't integrate with any eligibility check software. Sending health info anywhere requires yet more interchange formats.
The actual note taking bit isn't too bad, and can be easily modeled with most flexible CMSs even. The problem is that you can either gamble on a startup offering everything that a company that has been in business since before you were born and actually being able to follow through, or you can just go with the established company like everyone else does.
Having seen several startups trying to break into the space, it's no surprise that epic still dominates. The regulatory hurdles alone are not trivial; clinics that take Medicaid are usually required to use an EMR with a CEHRT certification which can cost tens of thousands of dollars to obtain.