- A new KLAS report on the small hospital EHR adoption landscape shows that organizations under 200 beds are scooping up electronic health records from Epic, Cerner, and athenahealth at a rapid rate.
According to the report, hospitals with fewer than 200 beds accounted for 78% of EHR purchasing decisions in 2016.
Researchers attribute this trend to the emergence of microhospitals, or short-term acute care facilities with fewer than 15 inpatient beds, and an increase in EHR purchasing decisions by standalone hospitals.
“This market movement was fueled by continued growth of the community-specific platforms from Cerner and Epic, the acquisition and EMR-standardization activity of larger organizations, and smaller hospitals’ increased interest in athenahealth’s new hospital offering,” noted KLAS researchers in the report.
While 2016 was a big year for Epic, Cerner, and athenahealth, other vendors including MEDITECH and McKesson had a harder time maintaining their footing among small hospitals.
Epic continued to hold the lion’s share of the market in 2016
Epic sustained its six-year streak this year as the leading vendor among acute care hospitals by controlling 25.8 percent of the market.
Helping Epic’s reputation among small hospitals is their spotless record of zero reported voluntary customer uninstallments.
“No Epic customers voluntarily signed with a competing EMR vendor in 2016—of the two that did leave, one was acquired by another organization, and the other was spun off from a larger health system,” stated KLAS researchers.
Cerner earns highest number of critical access hospitals
Cerner trailed close behind Epic with 24.6 percent of the market.
Despite holding the second slot overall, Cerner provided EHR technology for the highest number of critical access hospitals in 2016.
“Cerner CommunityWorks is a large draw for small hospitals due to its breadth of functionality and integration, though provider satisfaction is middle of the road,” wrote researchers.
KLAS also attributed some of Cerner’s spike in new small hospital clients to its acquisition of Siemens.
“For many Siemens customers, Cerner’s acquisition acted as a catalyst, accelerating their time frame for making a new EMR decision,” stated the report. “While many of these provider organizations made a decision in 2015 (migrating to either Cerner Millennium or another vendor’s system), many others made decisions in 2016 made by Siemens legacy customers will continue to affect EMR purchasing trends into 2017 and beyond.”
While Cerner and Epic both appeal to small hospitals due to the variety of services the vendors’ EHR systems offer, small hospitals report a lack of flexibility preventing them from tailoring the technology to their specific organizational needs.
“One pain point reported by community customers of both Cerner and Epic is a lack of customization capabilities,” researchers stated.
athenahealth doubles its small hospital client base
While EHR giants Epic and Cerner maintained their status as top performers in the market, athenahealth also grew significantly, more than doubling their number of acute care hospital implementations in 2016.
Thirty-three percent of athenahealth’s gains were in hospitals with more than 25 beds.
“Providers are drawn to the vendor’s web-based platform, unique cost structure (percent of collections), and inpatient/outpatient integration,” wrote KLAS researchers.
Despite these successes, athenahealth also suffered migration losses.
“Perceived functionality gaps in ancillary departments cause some customers to leave and some potential customers to choose other options,” researchers noted. “With sales energy high, KLAS will be looking to validate athenahealth’s ability to scale and perform consistently for hospitals.”
MEDITECH, McKesson, and CPSI suffer multi-year net losses
MEDITECH, McKesson, and CPSI suffered the largest net losses in 2016.
[UPDATE: a previous version of this article stated MEDITECH lost half of its legacy customers to competitors in 2016, when in fact MEDITECH only lost half the legacy customers that made decisions to competitors in 2016.]
While MEDITECH still maintains a hold over 16.6 percent of the overall market, the vendor lost just over half of the legacy customers that made decisions to competitors in 2016.
“The majority of customers leaving MEDITECH report insufficient development and skepticism that the vendor will be able to meet future needs,” noted researchers.
“Most of the legacy MEDITECH customers who moved to another vendor in 2016 moved to Epic or Cerner, hoping for improved usability and not wanting to wait to see how MEDITECH’s web-based version will play out,” the report added.
McKesson’s losses stem primarily from the prevalent opinion among users that McKesson Paragon does not meet their organization’s needs.
Hospitals leaving CPSI often attributed their dissatisfaction to poor usability, development, and support, and instead switched over to athenahealth.
While CPSI suffered more overall losses than wins in 2016, more hospitals left McKesson than any other vendor.
Overall, EHR purchasing decisions among small hospitals went to vendors capable of providing a variety of functionalities that demonstrate the ability to accommodate future changes in the ever-developing world of health IT.
Additionally, small hospital mergers and acquisitions, as well as an increased interest in improved EHR integration between inpatient and outpatient settings across organizations, impacted EHR adoption.
Despite some shifts in EHR vendor client acquisitions, market trends show Epic and Cerner will likely continue to dominate the industry in the coming years.