Asia/Oceania EMR 2022
First In-Depth Look at Regional Market Share & Vendor Performance

Asia

IQVIA Growing Fast in Asia, with Improved Support & Delivery in South and Southeast Asia

IQVIA has one of the broadest market footprints in Asia. Customers span six countries in Southeast Asia and are also found in India and Sri Lanka. The customer base for IQVIA’s go-forward Arcus Air platform (acquired from Incarnus Technologies in 2019) has more than tripled in the last five years, with 19 organizations selecting it. The hosted cloud version has been adopted by customers in Cambodia, India, and Thailand. Support has improved since the acquisition, even through the pandemic. Clients describe strong partnership from IQVIA and say their representatives know the customer organization well and respond quickly. A recent product upgrade has led to some reports of system slowness, hurting client satisfaction slightly.

ezCaretech a Strong Performer in South Korea, Slow to Expand to Other Countries

ezCaretech has a significant presence in South Korea, where they are headquartered and where they have steadily grown in the last five years. They have the highest overall score of measured vendors in Asia, and clients—especially large academic hospitals, where the solution is widely used—report good development of BESTCare. Customers describe BESTCare as a high-quality solution with robust functionality and solid integration. Some want ezCaretech to provide faster development and better training. Recent employee turnover has resulted in slower responsiveness. ezCaretech’s new offering, EDGE&NEXT, is a smaller, cloud-based solution that has been adopted by some smaller hospitals in South Korea. ezCaretech was also selected by a hospital in Japan, their first Asia client outside South Korea.

InterSystems Delivers Solid Performance to Broad Customer Base

InterSystems has clients (mostly private hospital groups) across five different Asian countries and has the largest market presence in the region among the multiregional vendors KLAS monitors. The highly configurable TrakCare product generally meets expectations and is working well for clients in multiple countries. Respondents describe good relationships with InterSystems’ executives, strong support, and smooth implementations. Customers would like to see more proactive outreach from InterSystems in terms of adapting to local requirements, rather than reacting when clients initiate conversations. Clients also want more proactive communication about available training resources and newly released features; on a related note, clients feel usability for tools like CPOE could be improved.

Oceania

Oracle Health (Cerner) Has the Largest Existing Market Share in Oceania, Lowest Customer Satisfaction

Oracle Health, who acquired Cerner in June 2022, currently has the largest presence of any EMR vendor in Oceania, with several large, longstanding government contracts, including in New South Wales, Queensland, and Victoria. Over 200 hospitals have digitized various clinician and departmental workflows through the use of Oracle Health. However, in November 2022, New South Wales Health announced their selection of Epic for their Single Digital Patient Record program. In terms of the Oracle Health client experience, customers are increasingly frustrated, and customer satisfaction in the region is currently at the lowest point KLAS has measured. Respondents note that significant turnover has hurt support and customer relationships, and clients say they are left with inexperienced personnel and poor problem resolution. Hospitals that have retained the same vendor representatives report higher satisfaction and smoother experiences. The product itself generally meets customers’ needs and is a strength for Oracle Health. However, the slower pace of development has led to unmet promises for specific functionality. Customers are divided on their outlook following the acquisition: some are hopeful for technology improvements, while others are less optimistic and expect turnover issues to continue.

Epic (Limited Data) Stands Out for Relationships in Australia

At the time this research concluded, four organizations were live with Epic in Oceania (all in Melbourne, Australia), and all have achieved HIMSS Level 6; a fifth customer went live in late 2022. The three interviewed Epic clients report consistently high satisfaction, highlighting Epic’s strong partnership through the implementation and after go-live. Respondents appreciate Epic’s proactivity and strategic engagement when it comes to broad change management. Customers do feel training and product usability could improve.

Renewed Customer Focus from InterSystems & Telstra Have Led to Improvements

Following some challenges in Oceania, InterSystems restructured their team prior to the pandemic to better support the Australian market. Those efforts have helped some struggling clients make improvements and successfully go live. Today, customers remain somewhat dissatisfied with InterSystems: several upgrades (from heavily customized environments to InterSystems’ country-specific editions) had significant delays and challenges that were exacerbated by stretched resources and insufficient training. Going forward, most clients plan to stick with InterSystems, feeling that things will continue to improve. They cite enhancements like a long-awaited interface revamp (part of a new upgrade) aimed at better mobile device support.

KLAS does not have historical performance data on Telstra Health, but recently interviewed customers consistently note that while they struggled during implementation and in the early stages of using the product (five or more years ago), the vendor has recently made significant improvements to product stability and the user interface. Customers can deploy the solution in most departments and do most documentation electronically, though some still use paper forms or a third party for ePrescribing. Respondents feel Telstra Health has recommitted themselves to focusing on customer relationships and proactive service. Customers want Telstra to continue making positive strides in areas like integration and development.

A Look at Altera Digital Health (Asia/Oceania Combined): Clients Report Turnover, Slow Development

Altera Digital Health (formerly Allscripts) has a few clients using Sunrise Acute Care in Asia and Oceania, but KLAS was unable to interview enough unique clients for the vendor to be rated in the individual regions; this report shares their aggregate performance across both regions. Altera is used by a large number of hospitals in South Australia and by a few clients in Singapore and Guam; one organization in the Philippines is implementing. Customer satisfaction with the solution is at its lowest level since KLAS started measuring it in 2015. Most customers plan to stay because of the effort required to get the solution to its current state, but few would buy it again. Clients’ chief complaints are slow development, inexperienced staff, poor relationships, and unkept promises. It is too soon to tell the impact of the Harris Healthcare acquisition.

About This Report

Each year, KLAS interviews thousands of healthcare professionals about the IT solutions and services their organizations use. For this report, interviews were conducted over the last 12 months using KLAS’ standard quantitative evaluation for healthcare software, which is composed of 16 numeric ratings questions and 4 yes/no questions, all weighted equally. Combined, the ratings for these questions make up the overall performance score, which is measured on a 100-point scale. The questions are organized into six customer experience pillars—culture, loyalty, operations, product, relationship, and value.

This report also includes market share data as of 31 December 2021. Additional details about KLAS’ methodology for reporting on vendor market share globally are shared on subsequent pages.

Sample Sizes

How Does KLAS Measure EMR Market Share?

In this report, any given vendor’s EMR market share is defined as the total number of inpatient hospital facilities (as opposed to organizations, which may be comprised of multiple hospitals) whose most recent contract is with that vendor. For example, if a vendor signs a contract with a four-hospital organization, that vendor’s market share would increase by four. KLAS acknowledges that in some countries the term “hospital” may be used to refer to an organization with multiple inpatient facilities. However, in this report, “hospital” is used to refer to a single inpatient facility.

At any point in time, only one company is recognized as the most recently contracted vendor for a hospital. KLAS considers a change in a hospital’s most recently contracted EMR vendor a “win” for the new vendor and a “loss” for the incumbent vendor (if one existed). In this report, a win does not depend on the legal status of a contract or on whether a provider organization is a paying customer. Additionally, while KLAS tracks vendor losses, these losses are not charted in this research since many hospitals outside the United States are moving from paper or from a conglomeration of best-of-breed departmental systems to an enterprise platform. KLAS will comment on losses in geographies where relevant.

Hospitals that have contracted for a new EMR normally continue to use their previous system for one or more years before/after going live with a new one. During this time, the hospital might be considered a customer of both vendors, but only the most recently contracted vendor receives market share credit in this report. Likewise, there may be a space of time between when a previous vendor’s contract ends and a new contract is formalized. In these cases, the previously contracted vendor is recognized as the current vendor until the new agreement is formalized. However, provider organizations have the final say on their own status, so in rare cases when an organization has directly informed KLAS of a decision, a win might be counted before a contract is legally signed.

When measuring market share, KLAS counts any facility that offers inpatient services. Most of the contracts discussed in this report were made by general acute care hospitals, including community hospitals and facilities offering sub–acute or step-down care services (as long as those facilities have overnight inpatient beds). However, this research also includes some EMR decisions made by inpatient rehabilitation facilities, inpatient psychiatric hospitals, and specialty acute care facilities (e.g., for oncology, pediatrics, or ophthalmology). Outpatient facilities, urgent care centers, day hospitals, and residential treatment facilities are excluded.

In cases where two or more healthcare organizations join together to make an EMR purchase decision, KLAS regards the decision as a single contract even if multiple contracts are signed with each participating entity because there was a single, collective decision-making and selection process.

Where Does Market Share Data Come From?

The market share data reported in this study is based on hospital EMR purchasing as of 31 December 2021, as shared in the 2022 Global (Non-US) EMR Market Share report. (Market share data reflecting 2022 contracts will be shared in KLAS’ next report in this series, set to publish in mid-2023.) The data comes from multiple sources, including publicly available information and the numerous conversations KLAS has each year with provider organizations around the globe.

KLAS also provides vendors with the opportunity to report their annual hospital EMR wins. KLAS then validates this information with provider organizations through in-depth interviews, publicly available information, and other means.

In all cases, KLAS makes a best-effort attempt to use third-party sources and our vast network of provider contacts to independently validate all recently signed EMR contracts. While KLAS believes the data in this report is directionally correct, we acknowledge that some inaccuracies may result from lack of vendor transparency/participation.