I've been working on EMR and similar tech for 15 years. As an entrepreneur I look for opportunity where I can find it and I think there will be opportunities fo

I've been working on EMR and similar tech for 15 years. As an entrepreneur I look for opportunity where I can find it and I think there will be opportunities for scrappy startups once ACA rolls out. It might be a "Boom" for some vendors, but I think it will be harder for the small startup to get traction implementing innovative solutions in the EMR space, because it appears there are more artificial impediments to implementation with the new government intervention in healthcare. I think you'll see monolithic software vendors like GE Health[1] with their Centricity EMR get the lion's share of government investment. They'll use their clout to impose more 'certification' on small vendors, raising the bar for participation and market entry. It's already begun with groups like CCHIT[2]. A non profit certification body that apparently works in concert with the above mentioned large software vendors to create an expensive hurdle for small companies in terms of cost and compliance. The hammer to get provider participation? Providers will have their future medicaid/medicare reimbursement rates cut if they don't use a certified EMR. With Obamacare/ACA - reimbursement is likely going to be a much bigger portion of the average doctor's revenue. There is some incentive for 'meaningful use'[3] which is a cash reimbursement for adoption of the certified, monolithic software, but it's not clear if it completely offsets the cost of acquisition, training and support. [1] http://www.gehealthcare.com/centricity/ http://www.gehealthcare.com/centricity/ [2] http://www.cchit.org/ http://www.cchit.org/ [3] http://healthit.hhs.gov/portal/server.pt?open=512&objID=2996&mode=2 http://healthit.hhs.gov/portal/server.pt?open=512&objID=...