Global EMR Performance 2018
Spotlight on Regional Performance

Across Limited Customer Base, Epic Delivers High Performance and Consistency; Cerner Steady; InterSystems Stretched

Epic is a relative newcomer in many regions yet performs best in providing a consistently positive experience across regions thanks to strong partnerships and strategic guidance throughout the implementation process. 75% of responding organization leaders report high overall satisfaction, and none are dissatisfied. Cerner is the only vendor with customers in every region and comes next in global performance and consistency. While overall satisfaction is above average, customers say they have largely driven their own success. Cerner is willing to engage strategically, though generally not proactively and often at an extra cost. MEDITECH performs above average in Canada and the UK & Ireland thanks to more strategic engagements in recent years. However, slow growth and relatively slow development have caused some concern. No Allscripts organizations in any region report high satisfaction. While some customers have achieved deep adoption, they often feel they drove their implementation themselves. InterSystems’ performance has declined significantly over the past two years due to an inability to provide adequate staff to meet increasing regional demands. European customers report delayed implementations and stretched vendor resources, and customers in the Middle East and Australia experience similar challenges with new implementations and transitions to new country-specific EMR editions.

Vendor performance in Europe is more varied than in any other region outside the US. Customers praise Epic’s commitment to the region and strong executive relationships; no customers feel forgotten. However, a notably dissatisfied customer in Denmark has struggled to get buy-in, and Epic can miss market nuances, potentially slowing their regional growth. Cerner has improved strategic interactions with Millennium customers, engendering high confidence in their R&D. In some cases, Cerner struggles to nimbly respond to region-specific change requests. For over two years, InterSystems’ rapid growth in Europe has been creating development and implementation issues. Compared to other regional vendors, Agfa HealthCare, Cambio, ChipSoft, and Dedalus (Medasys) garner higher customer confidence in their R&D and regional dedication. Each has challenges hampering customer satisfaction: respondents say Agfa HealthCare lacks sufficient resource expertise, Cambio’s ongoing development is slow, ChipSoft offers weaker relationships, and Dedalus’ (Medasys) support is reactive and slow. DXC Technology and Tieto have struggled to deliver a consistent experience, and their customers are increasingly worried about these vendors’ long-term footing in their respective markets.

MV and Philips, the largest vendors in the region, have diverged in performance since last year’s report. MV’s ratings have improved slightly thanks to their easy-to-use product and ongoing investment in R&D. MV offers strong executive relationships and guidance, but lower-level support is weak. Conversely, Philips’ scores have decreased. While the product itself has improved, specifically in stability, Philips’ efforts to grow outside of Brazil—where their Latin American customer base has historically been centered—have left Brazilian customers feeling forgotten. Vendor support and attention in Brazil have declined, especially from executives, several of whom have left the country to support Philips’ expansion elsewhere. Other vendors with smaller market share include everis, Cerner, and InterSystems. everis has several large clients; they say everis has oversold product functionality and delivered slow implementations. InterSystems has few clients in the region and primarily focuses their marketing efforts elsewhere, as does Cerner, who primarily markets i.s.h.med (via resellers) rather than Millennium. KLAS does not yet measure i.s.h.med’s performance.

InterSystems led vendor performance in the Middle East in previous years, but multiple concurrent implementations in the UAE have suffered from stretched resources, as have established customers to a lesser extent. In contrast, Cerner, who has the largest regional market share, has demonstrated stable performance thanks to robust functionality and strong integration. Some respondents feel Cerner could be more in tune with regional needs; region-specific requests are routed through Kansas City, and customers have limited access to Cerner’s full portfolio (e.g., cloud products). Relationships are strong overall, though they could be more strategic. Leadership from Epic’s three live customers express high satisfaction but also want to see a greater regional presence and improved regional expertise.

MEDITECH, a longstanding vendor in Canada, is generally praised for recognizing and delivering solutions for Canada-specific needs. Success with the new Expanse platform will be critical for long-term customers on legacy platforms, who need updated technology to meet market demands. Cerner’s overall performance in Canada is not poor, though Canada is their least satisfied region. Customers feel they receive US-focused rather than Canada-specific functionality. Strategic relationships and regional expertise could also be stronger. Customers say that following Allscripts’ recent losses in Canada, the vendor has reaffirmed their commitment to the region and is working on more localized functionality. Customers also report improved strategic engagement, although it can feel sales driven and result in recommendations to purchase Allscripts’ tools. KLAS interviewed all four live Epic customers in the region. Early feedback shows deep initial adoption, a willingness to meet regional needs, and strategic implementation support that includes go-live-readiness assessments.

Vendor regional commitment is perceived to be lower in Asia/Oceania than in other regions. Cerner has steadily improved across the region in past years due to deepening adoption and the cloud functionality they recently made available in the region. This year Cerner saw a slight decline in overall score. Access to executives is good, but customers want deeper strategic relationships. InterSystems’ performance has declined substantially due to delivery challenges in Oceania; in particular, Australian customers implementing or deploying their country-specific system edition say InterSystems’ attention and resources have been diverted to the Northern Territory implementation. InterSystems customers in Asia, especially China and Thailand, are generally pleased. Allscripts customers want better responsiveness and deeper strategic relationships. Overall confidence in Allscripts’ R&D is very low; Allscripts’ strategy of acquiring rather than developing new solutions does not resonate with customers.