- EHR vendors are experiencing an upsurge in client acquisitions as EHR adoption and implementation continue throughout the healthcare industry, most notably in the form of EHR replacement.
While hundreds of technology vendors and solutions remain on the market, a select few repeatedly rise to the top each year as the most popular vendors among healthcare organizations.
Specificity and range of functionality
Recent market share reports show hospitals of different sizes, specialties, and regions have different priorities when choosing an EHR system that best fits their practice.
For small hospitals, that means specificity.
A recent KLAS report on small hospital EHR adoption in 2016 showed organizations under 200 beds gravitated most toward Epic Systems, Cerner, and athenahealth. Researchers stated these vendors were successful for their ability to present unique, specific platforms tailored to certain hospital types and communities.
“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.
Another top priority among small hospitals last year was finding a vendor with a broad range of functionalities — a need larger vendors such as Cerner and Epic were able to meet.
“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.
Meanwhile, athenahealth’s success in 2016 signaled the increasing importance of web-based platforms.
READ MORE: Top Inpatient EHR Companies by Hospitals
“Providers are drawn to the vendor’s web-based platform, unique cost structure (percent of collections), and inpatient/outpatient integration,” wrote KLAS researchers.
By and large, the KLAS report on small hospital EHR purchasing decisions reflects provider interest in vendors capable of accommodating future changes in an ever-evolving technological landscape.
Another KLAS report took the pulse of the global EHR market and found Epic and InterSystems to have gained more clients than any other EHR companies worldwide over the past year.
Similarly, scope of functionalities was a determining factor among providers for many global purchasing decisions last year.
Other factors driving global purchasing decisions were cost and usability.
While Epic was shown to be the second most popular EHR vendor in the world, InterSystems took the top slot.
“Broad functionality and a light IT footprint have led to InterSystems being deployed by more hospitals over the past four years than any other solution,” wrote researchers in the report. “InterSystems’ strong 2016 across Europe, Asia, and the Middle East — which included new contracts with several multihospital organizations in the UK and China —was driven by an all-in cost lower than Cerner’s and Epic’s.”
The widespread popularity of the Massachusetts-based vendor’s technology represents the importance of cost-effectiveness and flexibility in the global market.
On the other hand, Epic’s success reflects the industry’s need for optimal usability and strong clinical functionalities.
“With new contracts across Canada, the Netherlands, and Finland (a first), Epic was the most frequently selected higher-cost solution, due to robust clinical functionality and strong usability,” wrote researchers.
InterSystems and Epic lead the market by a significant amount with 56 and 31 multiregional contract wins, respectively.
Innovation and flexibility
These KLAS reports demonstrate that Epic, Cerner, and a handful of other vendors consistently hold the majority of the market in almost all areas of the industry.
However, a recent Kalorama Information Report shows some characteristics of the market in 2017 present opportunities for smaller vendors to claim their stake.
Frustrated physicians, dissatisfied hospitals hopping from vendor to vendor, and shifts in government and healthcare policy open the door for smaller, more niche vendors to acquire clients.
Further, while reports such as those recently published by KLAS seem to paint the industry as relatively black and white with clear winners and losers, Kalorama contends the market is much more nuanced than that.
"A few companies have more than half the market, but it's still true to say no company, not even the largest healthcare IT firms, have even a fifth of this market," said Publisher of Kalorama Information Bruce Carlson. "We think that is because there's still usability, vendor-switching, lack of mindshare in the market and customers are aching for better. Healthcare still involves a lot of local markets and then with EMR there is a web opportunity to sell direct to smaller hospitals and physicians."
According to Kalorama, innovation is the key to staying one step ahead of the competition.
Cerner, the top vendor in the US for 2017 according to Kalorama’s research, will likely encounter success because of its proven ability to develop new services in line with the ever-changing health IT environment.
CernerITWorks and Cerner RevWorks, two new offerings in Cerner’s arsenal as of 2017, are designed to meet the burgeoning demands of hospitals in IT and revenue cycle management.
In part, Cerner’s propensity to innovate ahead of the curve comes as the logical conclusion to its 2015 acquisition of Siemens IT.
Kalorama also published a report outlining what EHR vendors need to keep in mind as they gear up to satisfy a tumultuous 2018 market in the throes of policy changes, physician burnout, and cybercrime.
While usability will remain a priority, other mounting challenges will begin to change what determines vendor success.
"Small trends that in the past were noted but not addressed, like usability and interoperability, the removal of incentives and lack of market share leadership have bubbled up we believe, to where they are no longer side issues," said Carlson. "A few policy, industry and medical practice changes will change how the revenue grows or who earns it, and what the EMR market looks like in 2018."
Adaptable technology will win out over more inflexible models, according to Kalorama researchers.
Additionally, increased instances of ransomware attacks and cybersecurity threats will necessitate technology promising top-of-the-line security.
Advanced infrastructure will also be important, with dashboarding, blockchain, and other developing innovations becoming more and more popular among users.
Overall, technology geared toward optimizing flexibility, usability, specificity, and innovation propel the most successful EHR vendors forward in today’s healthcare industry.
For vendors such as Epic, Cerner, and InterSystems, securing the top spot for the foreseeable future will require consistent updates to product packages tailored to suit all kinds of healthcare organizations.
Meanwhile, smaller vendors looking to make a mark in the industry will benefit from offering low cost, highly customizable solutions fitting into niche markets.
While the healthcare industry is evolving at a breakneck pace, one thing remains certain: EHR adoption will only increase as time goes on.