Global EMR Market Share 2017

1. InterSystems and Epic Pull Ahead of Other Multiregional Vendors

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. 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. 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. Hospitals in the UK, Australia, and the Middle East chose Cerner in new and add-on contracts, though in an up year for hospital decisions overall, fewer new hospitals contracted with higher-cost Cerner than in the past. Selections by UK providers of the Lorenzo platform from DXC Technology (CSC) partially offset numerous recent losses to the vendor’s legacy platforms in other countries. Several language-specific vendors continued recent expansions outside their home regions: Medasys (from France) into North Africa and Lebanon, everis (Spain) into Latin America, and Dedalus (Italy) into Spain and Spanish-speaking Latin American countries.

2. MV, Agfa HealthCare, ChipSoft Holding Steady Against Multiregional Vendors

Expanding outside of Brazil and chosen frequently in Latin America, MV led among a group of expanding regional vendors. In Europe, where hospitals tend to be larger, Agfa HealthCare and ChipSoft staved off the potential encroachment of multiregional vendors by continuing to grow their leading market share footprints in DACH countries and the Netherlands, respectively. MIMSYS, a newer vendor based in India, is a compelling option for small, private hospitals in the Middle East looking for a low-cost solution. Philips signed a customer in Germany—their first outside Latin America. KLAS did not validate any 2016 wins for several regional vendors covered in previous reports, including QuadraMed, ALERT, Cambio, and STG (System C).

3. EUROPE: Lower-Cost DXC Technology (CSC), InterSystems Winning in the UK; Epic Expanding in Nordics

With the push to get hospitals digital by 2020, the UK is still fertile ground for EMR selections post NPfIT. However, money is not readily available due to NHS England’s tightened purse strings. Lower-cost suppliers DXC Technology (CSC) and InterSystems are compelling offerings to both public and private organizations, and one trust is reducing costs by deploying Cerner in a shared environment with a neighboring trust. In Finland, Epic was selected for an ambitious regional contract, strengthening Epic’s foothold in the Nordics (Epic’s first Danish hospitals went live in 2016). Providers in mainland Europe mostly opt for local vendors who understand local regulations and language—e.g., Agfa HealthCare (DACH countries), Dedalus (Italy), and Medasys (France). In the Netherlands, organizations selected lower-cost ChipSoft more often than Epic, and this energy has spilled into Dutch-speaking Belgium.

4. MIDDLE EAST: Public Hospitals Entrenched with Cerner; Private Hospitals Have More Options Than Ever

Cerner is the most-used EMR by public hospitals in the Middle East. The United Arab Emirates (UAE) Ministry of Health expanded their Cerner footprint, even helping a separate hospital that had selected Epic to pivot and deploy Cerner, who was able to quickly implement their product in time for the hospital’s opening.

Private hospitals were more varied in their decisions, selecting some solutions newer to the region: MIMSYS was selected by some small private hospitals in the UAE, Qatar, and South Africa, and in Lebanon, four organizations will deploy Medasys through a reseller. Cerner also expanded in Qatar and the UAE and for the first time into Kuwait. A small hospital group in the UAE selected InterSystems. The largest private hospital (~400 beds) to make a decision in the region was the only organization to choose Epic.

5. LATIN AMERICA: MV Successfully Migrating and Expanding; Philips Struggling with Conversion

In the last three years, numerous providers have selected MV, and existing customers have reported a smooth transition as they have migrated to the latest platform. Philips customers, on the other hand, report many more challenges with the Delphi to Java conversion. As Philips has focused on these challenges and their expansion into other regions, like Europe and the Middle East, fewer hospitals in Brazil or other Latin American countries have selected them.

Private hospital groups in other countries in South America have looked to MV, in addition to everis, Dedalus, Philips, and DXC Technology’s xHIS platform. In the Caribbean, Allscripts was selected in the Bahamas, and MEDITECH expanded their existing presence in Puerto Rico.

6. Epic Up and Coming in Canada, InterSystems Expanding in Asia, Oceania Quiet in 2016

In Canada, the two organizations (both in Ontario) that finalized a new vendor contract both chose Epic. Three of the five Canadian organizations that have signed with new vendors since 2014 chose Epic, with the other two selecting Cerner. While new vendor decisions are rare, six hospitals chose to migrate to MEDITECH’s new Web platform in 2016, continuing an ongoing trend in the region.

Relatively few of the decisions made in Asia impacted vendors in this research: InterSystems added a new customer to their existing presence in both China and Thailand, and Allscripts did the same in Singapore. Napier was selected in the Philippines and Malaysia.

Few decisions were finalized in Oceania in 2016—one hospital was added to a Cerner contract in Queensland, Australia. Allscripts also acquired local solution BOSSnet.