Global EMR Performance 2017
Keeping Pace with a Transforming Market

1. InterSystems, Cerner, and Allscripts Experience Differs by Region; Epic Consistent among Smaller Base

Self-reported EMR usage levels closely mirror EMR vendors’ levels of strategic interaction. Most multiregional vendors have highly differing levels of strategic partnerships by region. Providers report InterSystems is a phenomenal partner in the Middle East, strategically helping customers do more. However, in Europe (France and UK) customers report delayed implementations, unkept promises, and inadequate support resources. Allscripts is regarded in Canada for deeper strategic relationships, something not as commonly reported by customers in other regions. Of these 3, Cerner's performance differs least by region. However, strategic relationships are more varied. In most regions, about a quarter feel Cerner is highly involved, though no Canadian customers said Cerner was highly strategic. Epic’s small and growing customer base consistently reports strong guidance and highly strategic relationships, leading to deep organizational adoption. MEDITECH has helped many legacy customers migrate to and get deeper adoption of 6.x in Canada.

2. InterSystems Gets High Marks for Nurses; Epic Strong Thus Far for Clinicians

InterSystems’ organization and user interface make it easy for nurses to navigate and find the information they need. For physicians, the interface isn’t quite as intuitive and requires too many clicks. Epic’s highly prescriptive implementations have largely resulted in quality deployments, and customers give the system high marks for meeting clinicians’ needs. With highly customizable EMRs, Cerner and Allscripts are meeting clinicians’ needs overall with few exceptions. However, as guidance is variable, some customers note challenges with suboptimal builds and workflows years after implementation. MEDITECH’s 6.x platform offers a dramatic improvement over legacy platforms, though MEDITECH recommends using a third-party firm to help through the implementation. Several regional solutions like MV SOUL and ChipSoft have proven very strong for meeting clinicians’ needs.

Regional Briefs

Both Epic and Allscripts are on the rise in Europe through different approaches. Epic’s prescriptive guidance has helped all customers deploy Epic’s functionality both broadly and deeply in their hospitals from day one in English and non-English speaking countries. Allscripts customers (primarily in England) like the open architecture and report success tying together disparate applications into their Allscripts portfolio. Allscripts supports customers’ adoption efforts, but the relationship is not considered an equal partnership. ChipSoft is strong in the Netherlands and has branched out into Belgium. They offer strong technology but don’t foster strong relationships. Cerner meets needs and works closely with customers; most say it’s up to the customer to be proactive in the relationship. Stronger localization of Millennium is still a want voiced by customers. InterSystems continues to struggle in Europe—resource issues have delayed implementations, upgrades, and localization requests in the UK and France. Agfa HealthCare has a strong solution for the DACH with their first HIMSS Stage 6 customer in the region. Overall development is slow. Adoption of DXC Technology Lorenzo in the UK as a full-blown EPR is still light, hampered by immature functionality (ePrescribing, maternity, theatre), slow system performance, and subpar service.

Canada has light to moderate EMR adoption, though both Cerner and MEDITECH have deeply adopted customers (i.e., HIMSS Stage 6). Offering strong value, MEDITECH 6.x’s enhancements remove previous barriers to clinician documentation in legacy versions. Cerner meets most needs, though Cerner’s understanding of the region and customer partnerships can improve; most adoption efforts are driven by customers. Allscripts has few deeply adopted customers in the region; Allscripts is available to strategize and has helped customers achieve moderate levels of adoption, but customers say those engagements cost extra. Epic’s first live customer hit HIMSS Stage 6 shortly after the go-live in 2017.

InterSystems is a highly rated partner in the region, making them the top-performing vendor for private and public hospitals alike. InterSystems works closely and proactively with customers to drive success and deeper adoption of the product. To date, not all customers feel they have deep usage across their entire organization. Cerner is also a strong option in the Middle East and is viewed as having a comprehensive system that allows for deep departmental usage. Only half of interviewed customers feel Cerner has partnered to help drive this deep adoption. In addition to Cerner and InterSystems, Epic also has two live customers in the region.

No vendor excels in client satisfaction in Latin America—each has challenges. MV (mostly Brazil) migrations to SOUL have been rocky, and overall support is often slow or unable to answer questions. Once live, the system is intuitive and easy for clinicians to learn. Customers also have strong relationships with upper-level executives. Philips (mostly Brazil) migrations from Delphi to Java have been more problematic, and the Java version has poor usability stemming from an overly complex and option-heavy UI. Philips has helped customers get deeper adoption of the new platform, and customer support is a strength as customers work through glitches. everis (Mexico) and InterSystems (mostly Chile) customers report inadequate support/implementation resources. Cerner has about 5 Millennium customers in the region. Outside Brazil, they favor deploying i.s.h.med via SAP.

EMR adoption continues to progress, especially in Australia. InterSystems customers enjoy good support, and recent releases have brought welcome updates. Customers say most adoption has been driven internally but InterSystems will help if asked. Cerner has the largest EMR footprint in the region, primarily in Australia. Organizations outside New South Wales report improving partnerships and implementations, and the NSW rollout continues to improve as more functionality is deployed. Allscripts has a capable system, and customers have achieved moderate levels of adoption driven primarily by the customers who are striving towards deeper adoption. Epic has two live customers in the region with deep adoption.