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市场调查报告书
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全球门诊电子健康记录(EHR) 市场：预测至 2032 年 - 按组件、部署方式、诊所规模、专科、最终用户和地区进行分析

Ambulatory EHR Market Forecasts to 2032 - Global Analysis By Component (Software, and Services), Deployment Mode, Practice Size, Specialty, End User and By Geography
出版日期: | 出版商: Stratistics Market Research Consulting | 英文 | 商品交期: 2-3个工作天内

价格

根据 Stratistics MRC 的一项研究，全球门诊电子健康记录(EHR) 市场预计将在 2025 年达到 98 亿美元，并在 2032 年达到 170.1 亿美元，在预测期内以 8.2% 的复合年增长率增长。

门诊电子健康记录)是一个用于收集、整理和管理门诊病患健康记录的电子平台。它将诊断、检查、处方笺和病程记录等详细资讯整合到一个无缝的数位系统中。透过减少行政工作并提供对最新资讯的即时访问，EMR 提高了临床准确性和沟通效率。门诊电子健康记录解决方案还包括线上处方笺、预约管理、计费辅助和病人参与工具等功能，帮助医疗机构在院外提供更快、更协调、更可靠的医疗服务。

向基于价值的医疗（VBC）转型

医疗机构越来越需要展现高品质的医疗成果，而数位化工具对于追踪指标和报告绩效至关重要。门诊电子健康记录平台能够帮助临床医生管理人群健康、降低不必要的成本并改善医疗协调。增强的分析和互通性功能有助于根据基于价值的医疗（VBC）要求做出更明智的决策。随着报销模式不断从按量付费转向按价值付费，对高级电子健康记录功能的需求也不断增长。这种转变促使成熟市场和新兴市场的医疗机构对其数位基础设施进行现代化改造。

医生抵制和工作流程中断

许多临床医师认为电子病历（EHR）介面复杂，并担心会扰乱现有的工作流程。学习曲线和资料输入所需的时间常常导致挫折感和职业倦怠。工作流程的重组也可能在过渡期内造成暂时的效率低落。由于缺乏专门的IT支援来协助系统采用，小规模诊所面临的挑战更大。因此，临床人员的抵触情绪持续阻碍门诊机构电子病历的整合进程。

整合远端医疗和远端患者监护（RPM）

数位平台的设计正日益融合远距医疗、远距离诊断和持续健康监测。这种融合使临床医生即使在传统临床环境之外也能更有效地追踪患者的病情进展。云端基础的系统支援跨装置、患者和护理团队的无缝资料交换。不断扩展的远端医疗报销模式进一步推动了电子健康记录-远距病患管理（EHR-RPM）的普及。随着混合医疗模式的成为主流，对整合式门诊电子健康记录解决方案的需求预计将快速成长。

监管和合规的复杂性日益增加

与资料隐私、互通性和安全性相关的要求正在加重医疗机构的营运负担。诸如 HIPAA、ONC 指南和国际资料保护法等框架的频繁更新进一步加剧了系统管理的复杂性。持续的审核和认证需求推高了供应商和使用者的成本。违规的风险可能导致经济处罚和业务中断。因此，监管的复杂性仍对市场扩张构成重大威胁。

新冠疫情的影响：

新冠疫情显着加速了门诊医疗的数位转型，并增加了对电子病历系统的需求。医疗机构迅速部署了远端医疗功能和数位化文件工作流程，以维持医疗服务的连续性。许多诊所整合了自动预约系统、电子处方笺和远端存取工具，以减少面对面接触。疫情也凸显了互通性数据系统对于协调公共卫生应对措施的重要性。随着医疗机构适应后疫情时代的模式，门诊电子健康记录的采用率持续上升。

在预测期内，软体领域将占据最大的市场份额。

由于门诊护理领域对先进数位化工具的需求不断增长，预计在预测期内，软体领域将占据最大的市场份额。全面的电子病历 (EHR) 软体能够实现无缝的文件记录、日程安排、患者管理和临床决策支援。云端基础方案因其扩充性和较低的前期成本而备受中小诊所青睐。与计费系统和分析平台的整合能够提高整个工作流程的效率。供应商不断创新，致力于提升人工智慧功能、互通性并开发行动友善介面。

在预测期内，独立医疗中心细分市场将实现最高的复合年增长率。

预计在预测期内，独立医疗中心领域将实现最高成长率，因为它们正在增加对数位化的投资。这些机构正在寻求灵活且经济高效的电子病历（EHR）系统，以简化营运并提高病人参与。不断增长的患者数量和对更快服务交付的需求正促使各中心采用自动化工作流程。云端对应平臺有助于减轻管理负担并提高临床效率。许多独立诊所也在实施整合远距远端医疗和远端患者监护（RPM）模组，以扩展其服务范围。

占比最大的地区：

由于北美拥有强大的数位医疗基础设施，预计该地区将在预测期内占据最大的市场份额。门诊医疗机构对先进临床IT系统的广泛采用进一步增强了该地区的优势。积极的政府政策和激励措施不断推动系统升级和互通性。主要的电子病历供应商在美国和加拿大拥有广泛的业务，从而提高了其市场渗透率。对基于价值的医疗（VBC）和社区医疗保健的日益重视，进一步强化了对强大的门诊电子健康记录平台的需求。

预计年复合成长率最高的地区：

亚太地区预计将在预测期内实现最高的复合年增长率，这主要得益于医疗保健行业的快速数位化。该地区各国正大力投资现代化门诊基础设施和电子健康系统。不断增长的患者群体和日益壮大的中产阶级推动了对高效数位化工作流程的需求。各国政府正透过国家数位医疗计画和监管改革来支持医疗资讯科技的应用。云端基础电子健康记录解决方案的日益普及，使得即使是小规模的诊所也能以经济高效的方式实施相关方案。

免费客製化服务：

订阅本报告的用户可从以下免费自订选项中选择一项：

  • 公司简介
    • 对最多三家其他公司进行全面分析
    • 对主要企业进行SWOT分析（最多3家公司）
  • 区域分类
    • 根据客户兴趣对主要国家进行市场估算、预测和复合年增长率分析（註：基于可行性检查）
  • 竞争基准化分析
    • 基于产品系列、地域覆盖和策略联盟对主要企业基准化分析

目录

第一章执行摘要

第二章 引言

  • 概述
  • 相关利益者
  • 分析范围
  • 分析方法
  • 分析材料

第三章 市场趋势分析

  • 司机
  • 抑制因素
  • 机会
  • 威胁
  • 终端用户分析
  • 新兴市场
  • 新冠疫情的影响

第四章 波特五力分析

  • 供应商的议价能力
  • 买方议价能力
  • 替代产品的威胁
  • 新进入者的威胁
  • 竞争对手之间的竞争

5. 全球门诊电子健康记录市场（依组件划分）

  • 软体
    • 临床解决方案
    • 管理解决方案
    • 电子处方笺
    • 病人参与工具
    • 分析与报告
  • 服务
    • 介绍
    • 培训和支持
    • 咨询
    • 託管服务

6. 全球门诊电子健康记录市场依部署方式划分

  • 云端基础的
  • 本地部署
  • 杂交种

7. 全球门诊电子健康记录市场（依诊所规模划分）

  • 私人医疗
  • 小规模练习
  • 大型团体诊所

第八章 全球门诊电子健康记录市场（依专科划分）

  • 基层医疗
  • 小儿科
  • 整形外科
  • 心臟病学
  • 皮肤科
  • 综合诊所

9. 全球门诊电子健康记录）

  • 门诊部
  • 医生
  • 门诊部
  • 门诊手术中心
  • 其他最终用户

第十章 全球门诊电子健康记录市场（依地区划分）

  • 北美洲
    • 美国
    • 加拿大
    • 墨西哥
  • 欧洲
    • 德国
    • 英国
    • 义大利
    • 法国
    • 西班牙
    • 其他欧洲
  • 亚太地区
    • 日本
    • 中国
    • 印度
    • 澳洲
    • 纽西兰
    • 韩国
    • 亚太其他地区
  • 南美洲
    • 阿根廷
    • 巴西
    • 智利
    • 其他南美国家
  • 中东和非洲
    • 沙乌地阿拉伯
    • 阿拉伯聯合大公国
    • 卡达
    • 南非
    • 其他中东和非洲地区

第十一章：主要趋势

  • 合约、商业伙伴关係和合资企业
  • 企业合併（M&A）
  • 新产品上市
  • 业务拓展
  • 其他关键策略

第十二章：公司简介

  • Epic Systems Corporation
  • MEDHOST
  • Oracle Health
  • TruBridge
  • MEDITECH
  • Nextech Systems
  • eClinicalWorks
  • DrChrono
  • athenahealth
  • Kareo
  • NextGen Healthcare
  • AdvancedMD
  • Allscripts Healthcare Solutions/Veradigm
  • Modernizing Medicine
  • Greenway Health
Product Code: SMRC32666

According to Stratistics MRC, the Global Ambulatory EHR Market is accounted for $9.80 billion in 2025 and is expected to reach $17.01 billion by 2032 growing at a CAGR of 8.2% during the forecast period. An Ambulatory EHR refers to an electronic platform used in outpatient clinics to capture, organize, and maintain patient health records. It unifies details such as diagnoses, tests, prescriptions, and progress notes into a seamless digital system. By reducing administrative effort and offering immediate access to updated information, it strengthens clinical accuracy and communication. Ambulatory EHR solutions also include features like online prescriptions, appointment management, billing assistance, and patient engagement tools, helping providers deliver faster, coordinated, and more reliable care outside hospitals.

Market Dynamics:

Driver:

Shift to value-based care (VBC)

Providers are increasingly required to demonstrate quality outcomes, making digital tools essential for tracking metrics and reporting performance. Ambulatory EHR platforms help clinicians manage population health, reduce unnecessary costs, and improve care coordination. Enhanced analytics and interoperability features support better decision-making aligned with VBC requirements. As reimbursement models continue transitioning from volume to value, demand for advanced EHR functionalities is rising. This shift is motivating healthcare organizations in both mature and emerging markets to modernize their digital infrastructure.

Restraint:

Physician resistance & workflow disruption

Many clinicians find EHR interfaces complex and fear disruptions to their established workflows. The learning curve and time required for data entry often contribute to dissatisfaction and burnout. Workflow restructuring can also create temporary inefficiencies during the transition period. Smaller practices struggle more, as they lack dedicated IT support to ease the adoption process. As a result, resistance from clinical staff continues to slow the pace of EHR integration in ambulatory settings.

Opportunity:

Telehealth and remote patient monitoring (RPM) integration

Digital platforms are increasingly designed to incorporate virtual consultations, remote diagnostics, and continuous health monitoring. This convergence enables clinicians to track patient progress more effectively outside traditional clinical environments. Cloud-based systems support seamless data exchange between devices, patients, and care teams. Expanding reimbursement models for telehealth are further driving EHR-RPM adoption. As hybrid care models become mainstream, demand for integrated ambulatory EHR solutions is expected to rise rapidly.

Threat:

Intense regulatory and compliance complexity

Requirements tied to data privacy, interoperability, and security increase the operational burden on healthcare organizations. Frequent updates to frameworks such as HIPAA, ONC guidelines, and international data protection laws further complicate system management. The need for continuous audits and certification raises costs for vendors and users alike. Non-compliance risks can lead to financial penalties and operational disruptions. Consequently, regulatory complexity continues to act as a major threat to market expansion.

Covid-19 Impact:

COVID-19 significantly accelerated digital transformation within ambulatory care, boosting demand for EHR systems. Providers rapidly adopted telehealth features and digital documentation workflows to maintain continuity of care. Many clinics integrated automated scheduling, e-prescribing, and remote access tools to reduce physical interactions. The pandemic also highlighted the importance of interoperable data systems for coordinating public health responses. As healthcare facilities adapt to post-pandemic models, ambulatory EHR adoption remains on an upward trajectory.

The software segment is expected to be the largest during the forecast period

The software segment is expected to account for the largest market share during the forecast period, due to rising demand for advanced digital tools in outpatient care. Comprehensive EHR software enables seamless documentation, scheduling, patient management, and clinical decision support. Cloud-based solutions offer scalability and lower upfront costs, making them attractive for small and medium-sized practices. Integration with billing systems and analytics platforms enhances overall workflow efficiency. Vendors are continuously innovating with AI features, interoperability upgrades, and mobile-friendly interfaces.

The independent centers segment is expected to have the highest CAGR during the forecast period

Over the forecast period, the independent centers segment is predicted to witness the highest growth rate, as they increasingly invest in digital modernization. These facilities seek flexible and cost-effective EHR systems that streamline operations and improve patient engagement. Higher patient volumes and demand for fast turnaround services are pushing centers to adopt automated workflows. Cloud-enabled platforms are helping them reduce administrative overhead and enhance clinical productivity. Many independent practices are adopting integrated telehealth and RPM modules to expand service offerings.

Region with largest share:

During the forecast period, the North America region is expected to hold the largest market share, due to strong digital health infrastructure. The region benefits from high adoption of advanced clinical IT systems among outpatient providers. Favorable government initiatives and incentives continue to fuel system upgrades and interoperability efforts. Major EHR vendors operate extensively across the U.S. and Canada, strengthening market penetration. Growing focus on VBC and population health is reinforcing the need for robust ambulatory EHR platforms.

Region with highest CAGR:

Over the forecast period, the Asia Pacific region is anticipated to exhibit the highest CAGR, driven by rapid healthcare digitization. Countries across the region are investing heavily in modern outpatient infrastructure and electronic health systems. Rising patient loads and expanding middle-class populations are pushing demand for efficient digital workflows. Governments are supporting health IT adoption through national digital health missions and regulatory reforms. Increasing availability of cloud-based EHR solutions is enabling cost-effective deployment for smaller practices.

Key players in the market

Some of the key players in Ambulatory EHR Market include Epic Systems, MEDHOST, Oracle Heal, TruBridge, MEDITECH, Nextech S, eClinicalW, DrChrono, athenahea, Kareo, NextGen H, Advanced, Allscripts, Moderniz, and Greenway.

Key Developments:

In October 2025, Oracle announced collaboration with Microsoft to develop an integration blueprint to help manufacturers improve supply chain efficiency and responsiveness. The blueprint will enable organizations using Oracle Fusion Cloud Supply Chain & Manufacturing (SCM) to improve data-driven decision making and automate key supply chain processes by capturing live insights from factory equipment and sensors through Azure IoT Operations and Microsoft Fabric.

In September 2025, TruBridge, Inc. announced an agreement with Java Medical Group for expansion of TruBridge technology and services at its Russellville Hospital in Russellville, Alabama. The partnership is part of a broader effort to standardize Java Medical Group's other managed hospitals using the TruBridge nTrust offering that includes the EHR, business office outsourcing and the full suite of financial health software.

Components Covered:

  • Software
  • Services

Deployment Modes Covered:

  • Cloud-based
  • On-Premise
  • Hybrid

Practice Sizes Covered:

  • Solo Practices
  • Small Group Practices
  • Large Group Practices

Specialties Covered:

  • Primary Care
  • Pediatrics
  • Orthopedics
  • Cardiology
  • Dermatology
  • Multi-specialty Clinics

End Users Covered:

  • Ambulatory Clinics
  • Physicians
  • Outpatient Departments
  • Ambulatory Surgical Centers
  • Other End Users

Regions Covered:

  • North America
    • US
    • Canada
    • Mexico
  • Europe
    • Germany
    • UK
    • Italy
    • France
    • Spain
    • Rest of Europe
  • Asia Pacific
    • Japan
    • China
    • India
    • Australia
    • New Zealand
    • South Korea
    • Rest of Asia Pacific
  • South America
    • Argentina
    • Brazil
    • Chile
    • Rest of South America
  • Middle East & Africa
    • Saudi Arabia
    • UAE
    • Qatar
    • South Africa
    • Rest of Middle East & Africa

What our report offers:

  • Market share assessments for the regional and country-level segments
  • Strategic recommendations for the new entrants
  • Covers Market data for the years 2024, 2025, 2026, 2028, and 2032
  • Market Trends (Drivers, Constraints, Opportunities, Threats, Challenges, Investment Opportunities, and recommendations)
  • Strategic recommendations in key business segments based on the market estimations
  • Competitive landscaping mapping the key common trends
  • Company profiling with detailed strategies, financials, and recent developments
  • Supply chain trends mapping the latest technological advancements

Free Customization Offerings:

All the customers of this report will be entitled to receive one of the following free customization options:

  • Company Profiling
    • Comprehensive profiling of additional market players (up to 3)
    • SWOT Analysis of key players (up to 3)
  • Regional Segmentation
    • Market estimations, Forecasts and CAGR of any prominent country as per the client's interest (Note: Depends on feasibility check)
  • Competitive Benchmarking
    • Benchmarking of key players based on product portfolio, geographical presence, and strategic alliances

Table of Contents

1 Executive Summary

2 Preface

  • 2.1 Abstract
  • 2.2 Stake Holders
  • 2.3 Research Scope
  • 2.4 Research Methodology
    • 2.4.1 Data Mining
    • 2.4.2 Data Analysis
    • 2.4.3 Data Validation
    • 2.4.4 Research Approach
  • 2.5 Research Sources
    • 2.5.1 Primary Research Sources
    • 2.5.2 Secondary Research Sources
    • 2.5.3 Assumptions

3 Market Trend Analysis

  • 3.1 Introduction
  • 3.2 Drivers
  • 3.3 Restraints
  • 3.4 Opportunities
  • 3.5 Threats
  • 3.6 End User Analysis
  • 3.7 Emerging Markets
  • 3.8 Impact of Covid-19

4 Porters Five Force Analysis

  • 4.1 Bargaining power of suppliers
  • 4.2 Bargaining power of buyers
  • 4.3 Threat of substitutes
  • 4.4 Threat of new entrants
  • 4.5 Competitive rivalry

5 Global Ambulatory EHR Market, By Component

  • 5.1 Introduction
  • 5.2 Software
    • 5.2.1 Clinical Solutions
    • 5.2.2 Administrative Solutions
    • 5.2.3 e-Prescribing
    • 5.2.4 Patient Engagement Tools
    • 5.2.5 Analytics & Reporting
  • 5.3 Services
    • 5.3.1 Implementation
    • 5.3.2 Training & Support
    • 5.3.3 Consulting
    • 5.3.4 Managed Services

6 Global Ambulatory EHR Market, By Deployment Mode

  • 6.1 Introduction
  • 6.2 Cloud-based
  • 6.3 On-Premise
  • 6.4 Hybrid

7 Global Ambulatory EHR Market, By Practice Size

  • 7.1 Introduction
  • 7.2 Solo Practices
  • 7.3 Small Group Practices
  • 7.4 Large Group Practices

8 Global Ambulatory EHR Market, By Specialty

  • 8.1 Introduction
  • 8.2 Primary Care
  • 8.3 Pediatrics
  • 8.4 Orthopedics
  • 8.5 Cardiology
  • 8.6 Dermatology
  • 8.7 Multi-specialty Clinics

9 Global Ambulatory EHR Market, By End User

  • 9.1 Introduction
  • 9.2 Ambulatory Clinics
  • 9.3 Physicians
  • 9.4 Outpatient Departments
  • 9.5 Ambulatory Surgical Centers
  • 9.6 Other End Users

10 Global Ambulatory EHR Market, By Geography

  • 10.1 Introduction
  • 10.2 North America
    • 10.2.1 US
    • 10.2.2 Canada
    • 10.2.3 Mexico
  • 10.3 Europe
    • 10.3.1 Germany
    • 10.3.2 UK
    • 10.3.3 Italy
    • 10.3.4 France
    • 10.3.5 Spain
    • 10.3.6 Rest of Europe
  • 10.4 Asia Pacific
    • 10.4.1 Japan
    • 10.4.2 China
    • 10.4.3 India
    • 10.4.4 Australia
    • 10.4.5 New Zealand
    • 10.4.6 South Korea
    • 10.4.7 Rest of Asia Pacific
  • 10.5 South America
    • 10.5.1 Argentina
    • 10.5.2 Brazil
    • 10.5.3 Chile
    • 10.5.4 Rest of South America
  • 10.6 Middle East & Africa
    • 10.6.1 Saudi Arabia
    • 10.6.2 UAE
    • 10.6.3 Qatar
    • 10.6.4 South Africa
    • 10.6.5 Rest of Middle East & Africa

11 Key Developments

  • 11.1 Agreements, Partnerships, Collaborations and Joint Ventures
  • 11.2 Acquisitions & Mergers
  • 11.3 New Product Launch
  • 11.4 Expansions
  • 11.5 Other Key Strategies

12 Company Profiling

  • 12.1 Epic Systems Corporation
  • 12.2 MEDHOST
  • 12.3 Oracle Health
  • 12.4 TruBridge
  • 12.5 MEDITECH
  • 12.6 Nextech Systems
  • 12.7 eClinicalWorks
  • 12.8 DrChrono
  • 12.9 athenahealth
  • 12.10 Kareo
  • 12.11 NextGen Healthcare
  • 12.12 AdvancedMD
  • 12.13 Allscripts Healthcare Solutions / Veradigm
  • 12.14 Modernizing Medicine
  • 12.15 Greenway Health

List of Tables

  • Table 1 Global Ambulatory EHR Market Outlook, By Region (2024-2032) ($MN)
  • Table 2 Global Ambulatory EHR Market Outlook, By Component (2024-2032) ($MN)
  • Table 3 Global Ambulatory EHR Market Outlook, By Software (2024-2032) ($MN)
  • Table 4 Global Ambulatory EHR Market Outlook, By Clinical Solutions (2024-2032) ($MN)
  • Table 5 Global Ambulatory EHR Market Outlook, By Administrative Solutions (2024-2032) ($MN)
  • Table 6 Global Ambulatory EHR Market Outlook, By e-Prescribing (2024-2032) ($MN)
  • Table 7 Global Ambulatory EHR Market Outlook, By Patient Engagement Tools (2024-2032) ($MN)
  • Table 8 Global Ambulatory EHR Market Outlook, By Analytics & Reporting (2024-2032) ($MN)
  • Table 9 Global Ambulatory EHR Market Outlook, By Services (2024-2032) ($MN)
  • Table 10 Global Ambulatory EHR Market Outlook, By Implementation (2024-2032) ($MN)
  • Table 11 Global Ambulatory EHR Market Outlook, By Training & Support (2024-2032) ($MN)
  • Table 12 Global Ambulatory EHR Market Outlook, By Consulting (2024-2032) ($MN)
  • Table 13 Global Ambulatory EHR Market Outlook, By Managed Services (2024-2032) ($MN)
  • Table 14 Global Ambulatory EHR Market Outlook, By Deployment Mode (2024-2032) ($MN)
  • Table 15 Global Ambulatory EHR Market Outlook, By Cloud-based (2024-2032) ($MN)
  • Table 16 Global Ambulatory EHR Market Outlook, By On-Premise (2024-2032) ($MN)
  • Table 17 Global Ambulatory EHR Market Outlook, By Hybrid (2024-2032) ($MN)
  • Table 18 Global Ambulatory EHR Market Outlook, By Practice Size (2024-2032) ($MN)
  • Table 19 Global Ambulatory EHR Market Outlook, By Solo Practices (2024-2032) ($MN)
  • Table 20 Global Ambulatory EHR Market Outlook, By Small Group Practices (2024-2032) ($MN)
  • Table 21 Global Ambulatory EHR Market Outlook, By Large Group Practices (2024-2032) ($MN)
  • Table 22 Global Ambulatory EHR Market Outlook, By Specialty (2024-2032) ($MN)
  • Table 23 Global Ambulatory EHR Market Outlook, By Primary Care (2024-2032) ($MN)
  • Table 24 Global Ambulatory EHR Market Outlook, By Pediatrics (2024-2032) ($MN)
  • Table 25 Global Ambulatory EHR Market Outlook, By Orthopedics (2024-2032) ($MN)
  • Table 26 Global Ambulatory EHR Market Outlook, By Cardiology (2024-2032) ($MN)
  • Table 27 Global Ambulatory EHR Market Outlook, By Dermatology (2024-2032) ($MN)
  • Table 28 Global Ambulatory EHR Market Outlook, By Multi-specialty Clinics (2024-2032) ($MN)
  • Table 29 Global Ambulatory EHR Market Outlook, By End User (2024-2032) ($MN)
  • Table 30 Global Ambulatory EHR Market Outlook, By Ambulatory Clinics (2024-2032) ($MN)
  • Table 31 Global Ambulatory EHR Market Outlook, By Physicians (2024-2032) ($MN)
  • Table 32 Global Ambulatory EHR Market Outlook, By Outpatient Departments (2024-2032) ($MN)
  • Table 33 Global Ambulatory EHR Market Outlook, By Ambulatory Surgical Centers (2024-2032) ($MN)
  • Table 34 Global Ambulatory EHR Market Outlook, By Other End Users (2024-2032) ($MN)

Note: Tables for North America, Europe, APAC, South America, and Middle East & Africa Regions are also represented in the same manner as above.