- With both Cerner and Epic Systems either netting more acute care hospitals as customers or not losing any EHR customers, the two vendors combined for just over half of the US acute care hospital market share, according to recent KLAS research.
Cerner saw the most acute care hospitals wins out of all vendors and accounted for 24.8 percent of the total market share, the US Hospital EMR Market Share 2018 report found. Epic had fewer wins but did not lose customers, accounting for 26.7 percent of the acute care hospital market.
MEDITECH came in third with 17 percent of the total market, followed by CPSI (10.3 percent) and Allscripts (7.2 percent).
KLAS considered “wins” when a single standalone hospital opted for a new EHR system or a hospital within an IDN purchased one separately from the rest of the organization. Additionally, a win could occur with a new IDN customer or when “an organization using a go-forward EMR that implements that product in newly acquired hospitals or decides to roll out the EMR to additional hospitals within their organization who were not yet live.”
Losses happened when an organization goes through an EHR replacement process or when a hospital system with multiple EHRs opts to consolidate into one system.
“Epic’s strong integration and consistent development are major reasons that their market share remains more stable and that they are chosen by larger health systems and hospitals,” report authors explained. “Cerner’s long-time patient accounting challenges continue to be a primary factor when large organizations choose not to go with Cerner.”
For smaller hospitals though, Cerner outpaced Epic. This is likely due to Epic’s initial cost and lack of direct contracting, and that Cerner has more flexible price models, researchers stated.
Smaller acute care hospitals – one to 200 beds – accounted for 80 percent of the decisions for contracting a new EHR, KLAS found. Over half of the hospitals that signed a new EHR contract in 2017 opted for a less expensive or less resource-intensive platform. This included athenahealth, MEDITECH, and the community deployment models from Cerner and Epic.
“athenahealth’s inpatient solution continued to gain traction, garnering more contract wins among small hospitals than any other solution,” researchers wrote. “The cloud-based platform is particularly attractive to the smallest hospitals, who require minimal IT footprints and up-front costs.”
MEDITECH had a net increase in the US hospital EMR market share for the first time in three years, due in large part to its web-based platform Expanse, the report explained. Fifty-eight percent of MEDITECH’s legacy customers that opted for a new solution in 2017 chose Expanse, while 42 percent chose another vendor.
“Historically, MEDITECH’s systems have not generated significant consideration outside of the existing MEDITECH base, but Expanse is changing that,” researchers stated. “Some community hospitals (1–200 beds) using other vendors’ legacy solutions chose in 2017 to switch to Expanse.”
Allscripts also doubled its acute care EMR customer base with the acquisition of McKesson’s Paragon and Horizon EMR. The research team did note before the Allscripts acquisition, that many Horizon and Paragon customers who left in 2017 had already made decisions to switch to other vendors.
“More notable are the losses sustained by Sunrise Clinical Manager (SCM), Allscripts’ go-forward solution for larger organizations. SCM’s market share had been relatively stable for a number of years, but in 2017, two large multihospital organizations switched their SCM hospitals to Epic, looking to simplify their IT infrastructure and consolidate to an integrated solution,” the researchers wrote.
Healthcare interoperability was also a key factor behind many EHR implementations decisions in 2017, the report explained. This is also why Cerner and Epic were leaders in EHR adoption because of Cerner’s work with Commonwell and with “the Epic-to-Epic sharing made possible by Care Everywhere.”
“Traditionally, barriers such as initial cost outlay, infrastructure costs, and support and maintenance costs have prevented many smaller hospitals from being able to switch systems or leave a legacy product, but cloud-based technology (such as the solutions from athenahealth and MEDITECH) and alternative deployment models (such as the community deployment models offered by Cerner and Epic) are reducing these barriers,” researchers wrote.