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Global (Non-US) EMR Market Share 2018 Global (Non-US) EMR Market Share 2018
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Global (Non-US) EMR Market Share 2018

author - Eder Lagemann
Eder Lagemann
author - Jonathan Christensen
Jonathan Christensen
June 29, 2018 | Read Time: 5  minutes

In 2017, larger public healthcare organizations in highly developed countries continued to favor top-tier EMR platforms with analytics and population health management offerings. Smaller, private organizations and those in developing countries focused on platforms with broad functionality. Who are provider organizations choosing? Which vendors have sustained global momentum over the past five years? And which vendors are most relevant regionally? This report—KLAS’ sixth on EMR market share outside the US—examines these questions in depth.

Big Year for Epic Headlined by Contract with Alberta Health Services

Gaining over 16,000 beds across six contracts, Epic more than doubled their small but growing non-US market share in 2017. They were selected by Alberta Health Services in one of the largest EMR contracts ever finalized outside the US in terms of both value and scale (it encompasses all care settings and over 100 hospitals). Preferred by clinicians during the demo and sales process, Epic has been selected over the past five years in many larger, multihospital or regional decisions and in most deals in Canada. In the UK, public concerns over early issues with the Cambridge implementation have dissipated; two UK organizations signed with Epic in 2017. Epic entered new markets in Belgium and Switzerland, their first French- and German-language installations. Epic’s successful year came despite EMR decisions cooling down in the Netherlands, Epic’s biggest market outside the US.

2017 new hospital wins by contract type and number of beds
new hospital wins 2012 2017 multiregional vendors

InterSystems Continues Rapid Growth; Cerner Consistent

A contract with the Northern Territory, Australia, underscored another strong year for InterSystems, who has had significant growth in the past five years, especially among smaller, multihospital private organizations. Resulting resource constraints have led to a number of missed implementation timelines in the past three to four years (most acutely in Europe). In comparison, Cerner Millennium had moderate growth in 2017, headlined by Monash Health’s selection in Victoria, Australia. Over the past five years, Millennium has not grown as quickly as its primary competitors. Cerner has slowed Millennium’s growth by limiting it to targeted markets, offering in additional markets around the globe, and marketing their non-EMR platforms (like HealtheIntent). Those who do choose Millennium like its broad functionality and flexibility.


EUROPE: In UK, Epic Sees First Wins in Four Years; In Mainland Europe, Local Solutions Seeing Success Notwithstanding Stiff Competition from Cerner and Epic

With money tight and the Global Digital Exemplar program still taking off, only four new contracts were signed in the UK—two with Epic, one with System C, and one with Allscripts. Local solutions IMS MAXIMS and DXC Technology Lorenzo were not chosen; nor was Cerner, despite a strong UK presence. Contracts in mainland Europe continued to favor regional solutions, though Epic and Cerner made inroads. Both signed their first customer in Belgium, and Epic, their first in Switzerland. In the DACH, most contracts were add-ons with Agfa HealthCare or Meierhofer. Millennium is no longer marketed in the DACH, in favor of (which had no new contracts) and medico. In Italy, two organizations selected Dedalus; none chose InterSystems (their primary competitor). Dutch-speaking selections in Belgium favored Cerner; ChipSoft also signed one new customer in Belgium. One contract was finalized in the Netherlands (DXC Technology). No new contracts were finalized in Spain, Portugal, or the Nordics.

2017 regional breakdown europe


In Brazil, large organizations continue to favor MV—the average size of MV’s new customers is nearly twice that of closest competitor Philips. Chosen by 22 organizations in 2017, Philips has bounced back after struggling with platform migrations for several years. Less robust options SPDATA, Pixeon, and TOTVS are more ideally suited for small hospitals. SPDATA’s EMR business grew rapidly in 2017, primarily among very small hospitals, many of which already had SPDATA’s nonclinical systems. Pixeon is strong for small specialty hospitals, especially ophthalmology. Their largest customer left for MV in 2017. TOTVS, who entered healthcare through their ERP, was selected by three organizations for their EMR. Outside of Brazil, buying energy in Latin America resides with private organizations, who continue to select numerous vendors. Philips, Cerner (, everis, and DXC Technology had the most energy in 2017. In the Caribbean, MEDITECH expanded their strong presence as new customers signed in Puerto Rico and the Virgin Islands.

2017 regional breakdown latin america

CANADA: Epic Preferred in New EMR Selections; Many MEDITECH Customers Migrating to Expanse

The biggest EMR news in Canada in 2017 was Alberta Health Services’ choice of Epic for their province-wide EMR. Even excluding the Alberta contract, Epic has been chosen by more organizations in Canada over the past five years than any other vendor. Cerner is a distant second in recent selections. Numerous MEDITECH customers chose to migrate to Expanse; MEDITECH is chosen less often outside their existing customer base. Allscripts has a large footprint in the country, but no organizations have selected them in the last five years, and three have chosen to replace them.

2017 regional breakdown canada

MIDDLE EAST & AFRICA: InterSystems Builds on Strong Regional Performance

In the Middle East, private organizations in the UAE continue to prefer InterSystems thanks to the vendor’s strong performance and sizable regional presence. Cerner, strongest with public hospitals, was selected by one hospital in the Middle East. Numerous other solutions were also selected: Advanced Technology Company, DXC Technology, ezCaretech (resold by the Saudi National Guard), Medasys, and Napier Healthcare. No hospitals chose Epic.

2017 regional breakdown middle east africa

ASIA & OCEANIA: Landscape Competitive in Asia; InterSystems wins NT in Australia

In Australia, InterSystems won a sizable contract for the Northern Territory. Several public organizations selected Cerner, expanding Cerner’s market lead among public hospitals. BOSSnet (acquired by Allscripts in 2016) was selected in Western Australia, and Sunrise Clinical Manager was selected for the first time outside of South Australia (migration by a BOSSnet customer). In Asia, most purchasing is made by private healthcare groups; they favor vendors with broad functionality, a lower cost, and a regional presence, such as InterSystems, DXC Technology, and Cerner (

2017 regional breakdown asia oceania
author - Elizabeth Pew
Elizabeth Pew
author - Natalie Jamison
Natalie Jamison
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.