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Global (non-US) EMR Market Share 2020
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Global (Non-US) EMR Market Share 2018
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Global (Non-US) EMR Market Share 2023 Global (Non-US) EMR Market Share 2023
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Global (Non-US) EMR Market Share 2023
Europe Continues to Lead, Energy Picking Up in Other Regions

author - Everton Santos
Author
Everton Santos
author - Jonathan Christensen
Author
Jonathan Christensen
 
June 8, 2023 | Read Time: 14  minutes

With the pandemic mostly past, healthcare organizations across the world are readdressing key technology priorities. EMR initiatives continue to be prioritized at most organizations. In 2022, KLAS validated 164 EMR purchase decisions impacting 532 hospitals and over 82,000 beds. 30 different vendors in 31 different countries were selected. While 2022 had the lowest validated EMR purchase activity of the last five years, certain markets remained highly active—specifically, Europe and Latin America and, to a lesser extent, Asia and the Middle East. Canada and Oceania, while relatively quiet in 2022, are poised for significant activity in 2023 due to major contracts on the horizon.

Dedalus, Oracle Health (Cerner), IQVIA Lead Multiregional Vendors in 2022 Wins

Dedalus has grown significantly through acquisitions in the last five years, and their platforms continue to be widely considered and selected (chosen across nine countries in 2022). Their 2022 acquisition of Lutech’s wHospital platform in Italy (34 hospitals) accompanied strong growth in DACHL and France. They were also selected for a health region in Morocco. Oracle Health (who acquired Cerner) had a strong year of EMR wins. They were contracted for the third-highest number of beds thanks to large multihospital decisions in their favor—for Millennium in Canada, the UK, and the UAE; for i.s.h.med in Germany. IQVIA had a strong year in Asia thanks to two large contracts in India, including a state health department deploying Arcus Air in the cloud to 16 hospitals. Another notable regional contract is NTT DATA’s selection by an Argentinian province, which chose to expand their existing ehCOS contract to an additional 75 hospitals and 550+ health centers.

2022 wins and migrations

Softway Medical Leads a Strong Year for Regional Vendors, Followed by CGM & System C in Europe, MV & Philips in Latin America

Europe continues to lead the global EMR activity, driven by increased funding and regional consolidation of public health systems. Softway Medical had another strong year, as groupements hospitaliers de territoire (GHTs) in France continued to favor Softway’s hosted EMR. Their HOPITAL MANAGER solution was also selected for the first time in Belgium. CompuGroup Medical (CGM) had a strong year in Central and Eastern Europe; their CLININET solution was selected by two large groups (a private healthcare group and a public health region) in Poland, and seven organizations chose CGM in the DACHL area. As of 2022, MV remains the most widely selected solution in Latin America across the last five years. Philips is the second most selected solution in the region, and TASY has been chosen by increasingly large organizations in the past three years. System C rounds out the top five regional vendors in 2022 selections, thanks to a contract with the UK’s largest private hospital group.

Europe

Regional Decisions Bolster Softway Medical, Dedalus & CGM

Western Europe
GHTs continue to drive the most EMR activity in Europe. KLAS validated eight decisions in 2022 that impacted a majority of a GHT’s hospitals. Softway Medical (with the largest EMR market share in France) was chosen in five GHT decisions. Also, two large private hospital groups selected Softway—one for HOPITAL MANAGER, the other extending MEDIBOARD to the rest of their hospitals. One GHT selected Dedalus DxCare as a precursor to the vendor’s Care4U platform (still under development); another large hospital selected Care4U directly. Dedalus has the second-largest hospital market share in France. One GHT chose to migrate to Maincare’s go-forward platform and extend it to their remaining hospitals, and another GHT selected SIB.

UK, Ireland, and Channel Islands
The largest EMR decision in the UK went to System C’s local solution, Careflow, which will roll out to about 50 private hospitals. The vendor was also selected by a specialist trust. A large public trust selected Oracle Health (Cerner) for their four hospitals. Two organizations will expand their instance of Epic: one to a neighboring trust and another to recently merged hospitals. Epic was also selected for the new children’s hospital in Ireland—the vendor’s first contract in the country. MEDITECH was chosen by a two-organization consortium in England, and an existing client (a private organization) will migrate to the Expanse platform. InterSystems was also chosen in Ireland for a public rehabilitation hospital and psychiatric hospital—the vendor’s first EMR clients in the country.

2022 regional breakdown europe

DACHL
KLAS validated 21 decisions in DACHL countries. Oracle Health (Cerner) was selected in two, which account for the most beds impacted, including a large private group extending i.s.h.med to 10 more hospitals. Dedalus and CGM were selected in seven decisions each. Dedalus was chosen by a multihospital rehab group in Switzerland, a standalone hospital in Austria, and five organizations (two new contracts, three extensions) in Germany. CGM was selected by seven organizations across the medico and CGM REHA platforms in Germany. CISTEC was chosen by a consortium of five organizations in Switzerland.

Other Areas
In Poland, CGM was selected by two large groups, adding to CLININET’s strong market presence in the country. EMR activity has slowed down in the Netherlands but ramped up in Belgium, where Softway Medical was selected by a health network in French-speaking Wallonia; this is the vendor’s first Belgian client. ChipSoft added a new client in Dutch-speaking Flanders. Dedalus, the market share leader in Italy, was selected there by a regional health provider, and they also finalized the acquisition of wHospital from Lutech Group.

Latin America

MV Leads in Brazil Decisions, Followed by Philips; NTT DATA Selected in Argentina

Brazil
In Brazil, EMR energy rebounded somewhat from 2021 (a five-year low). MV was selected in the most decisions (their sixth consecutive year with this designation) and continues to be widely considered by large and small organizations alike. Also a continuing trend, Philips was chosen the second most in the region. Over the last three years, the largest hospitals (by bed size) that have made EMR decisions in Brazil have chosen Philips. SPDATA and Pixeon continue to be selected primarily by small standalone hospitals (<80 beds).

Other Latin American Countries
KLAS validated two 2022 contracts in other Latin American countries. NTT DATA expanded their presence in Spanish-speaking countries through a contract with an Argentinian provincial ministry of health that chose to extend ehCOS to an additional 75 hospitals and 550+ health centers. MV was chosen by a private hospital in Guatemala (their first customer in the country).

2022 regional breakdown latin america

Middle East/Africa

Oracle Health (Cerner) Selections Boost Already Strong Presence, Dedalus Selected in Morocco

Middle East
In the Middle East, total 2022 EMR contracts were on par with previous years, though the number of beds impacted hit a five-year low due to smaller hospitals adopting EMRs. Among the several large contracts that finalized was Oracle Health’s (Cerner) selection by two public health providers in the UAE, adding eight more hospitals to their region-leading market share. Cloud Solutions was chosen by the largest individual hospital to purchase an EMR in the region, continuing the vendor’s strong, consistent growth in the area. CertaCure and IQVIA were the only other vendors selected by multiple providers in the Middle East. CertaCure’s contract in Kuwait is their first in the country, as is IQVIA’s contract in Lebanon.

Africa
The largest decision in Africa went to Dedalus: the ministry of health in Morocco chose to roll out DxCare to 10 hospitals in one health region. Egypt remains one of the most active markets in Africa for EMR purchasing. In 2022, two organizations selected i.s.h.med from Oracle Health (Cerner), and one selected CertaCure.

2022 regional breakdown middle east and africa

Asia/Oceania

IQVIA, InterSystems, ezCaretech Most Widely Selected as EMR Activity Rebounds

Asia
While the number of validated Asia contracts in 2022 was two-thirds of 2021’s total, impacted beds were closer to pre-pandemic levels. IQVIA was selected by five organizations in three countries, including a 16-hospital state health department in India and a migration of 14 hospitals to Arcus Air in the cloud. InterSystems also had a strong year, with four organizations selecting them across China, Indonesia, and Thailand. ezCaretech continued expanding in South Korea, where they are the most widely used vendor by large hospitals. Two university hospitals selected BESTCare, and three smaller hospitals selected EDGE&NEXT (cloud based). ezCaretech has had little growth in Asia outside South Korea. Dedalus, Kranium Healthcare Systems, and SRIT were selected by one large hospital apiece in India.

Oceania
Oceania’s only validated EMR contract in 2022 came from a newly built private hospital in Australia that selected Telstra Health. Australia is poised for high EMR purchase activity in the future; several statewide decisions are forecasted to finalize in coming years, and multiple private hospital groups are actively evaluating EMRs.

2022 regional breakdown asia and oceania

Canada

Oracle Health (Cerner) Selected in the Only 2022 Hospital EMR Decision

2022 was a slow year in Canada for EMR purchases, with one contract finalizing: a two-group consortium that chose Oracle Health (Cerner) Millennium for six hospitals, replacing their legacy MEDITECH environment. Across the last five years, a little over twice as many hospitals have chosen to stay with MEDITECH rather than leave for another vendor. Several large provincial decisions will likely finalize in 2023, along with one that already has (not included in this report).

2022 regional breakdown canada

About This Report

A Note about Terminology and What Counts as an EMR

Though the nomenclature used to describe the core patient record used throughout a hospital varies from region to region or language to language (e.g., EHR, EPR, EMR, EPD, EPJ, DPI, KIS, HCE, PEP, etc.), the term that will be used in this research is EMR (electronic medical record).

The EMR is the core record used by hospitals for day-to-day clinical tasks, such as clinical noting and documentation, ordering, results reporting, and ePrescribing. Some systems in this research may not include all of these clinical functions, but they are all viewed by their users as their core patient record. Solutions used solely for document management or scanning are excluded from this research even though they are the primary clinical system in use at some hospitals.

Additionally, the term “vendor” is used throughout this report to refer to the company supplying the EMR technology. KLAS recognizes that different countries may have different terminology, including “supplier.”

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, such as Spain and the Netherlands, 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. Below is a breakdown of 2022 EMR purchasing by hospital type.

2022 hospital wins and migrations by hospital type

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 separate contracts are signed with each participating entity because there was a single, collective decision-making and selection process. In 2022, decisions of this nature occurred in Belgium, Canada, France, Germany, Switzerland, and the UK.

Types of Wins

KLAS places newly contracted hospitals into various categories. Multihospital organizations and standalone hospital organizations that switch to a vendor not previously in use at the organization are counted as “net new” wins. “Add-on” wins occur when an organization extends their existing EMR contract to a new hospital. Often, these add-on wins come about as the result of acquisitions/mergers, newly constructed hospitals, or organizations consolidating from two or more EMRs to a single solution.

Contract changes in which an organization stays with their current EMR vendor but moves to another platform from that vendor as their go-forward solution (usually requiring sizable build/implementation effort) are noted where applicable but are not included in a vendor’s overall wins. Often, these decisions are complete platform migrations, though in some cases the organization may move forward with functionality from both platforms. For simplicity’s sake, KLAS refers to all such decisions as “migrations,” regardless of whether other vendors were also considered or how competitive that decision may have been. In this report, the following vendors all had at least one customer migration: CompuGroup Medical (KIMSYSTEM to CGM REHA), InterSystems (Clinicom to TrakCare), Maincare (M-CrossWay to Maincare-IC), MEDITECH (MAGIC or 6.x to Expanse), Meierhofer (M-KIS Akut to M-KIS Next), MV (MV2000 or Hospidata to SOUL MV), Nexus AG (from xmCare to Nexus EPD), and Philips Tasy (Delphi-based solution to HTML5 code base). Customers who upgrade their current system or re-sign with their current vendor to extend the length of their existing contract are also excluded from a vendor’s overall wins, though they are presented in the vendor’s market share counts in applicable markets.

Where Does Market Share Data Come From? 

The market share data reported in this study is based on hospital EMR purchasing activity (i.e., executed contracts) that occurred 1 January–31 December 2022. 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. The table to the right shows vendors’ levels of transparency and disclosure of their EMR wins for 2022.

In all cases, KLAS makes a best-effort attempt to use third-party sources and our vast provider network 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 or an inability to validate the status of a contract.

KLAS is confident that the decisions tracked in this report account for most EMR purchasing that occurred in 2022 in Canada, Europe (excluding Eastern/Southern Europe), Latin America, the Middle East, and Oceania. However, EMR purchasing in Asia involves a wide variety of vendors, many of which KLAS does not currently track, so KLAS acknowledges that the picture given for EMR purchasing in Asia is less complete. KLAS also has less transparency into EMR purchasing happening in Africa.

level of transparency and disclosure of emr contracts

KLAS’ historical global market share information is continually being updated as new information comes to light. In some cases, contracts are canceled, new vendors are chosen that were missed in previous years’ reports, hospitals close, or KLAS discovers that a contract previously recorded did not include EMR functionality. This review of the historical data necessarily results in some shifts in vendors’ overall market share numbers. In 2022, this ongoing data review resulted in notable shifts (+/- 10 or more hospitals) for Nexus and InterSystems (both adjusted down in Europe), Softway Medical (adjusted up in Europe), and Dedalus (adjusted up, mostly in Europe). In 2022, Oracle Health acquired Cerner’s software portfolio, resulting in the transfer of Cerner’s existing market share to Oracle Health. Similarly, Allscripts’ market share was transferred to Altera Digital Health after Harris Computer Corporation acquired Allscripts’ hospital and large physician practice business and rebranded it as Altera Digital Health. Dedalus also acquired the wHospital solution as part of their acquisition of Lutech Group’s healthcare portfolio, resulting in a 34-hospital increase in Dedalus’ overall market share. Additionally, this year is the first that KLAS has included market share and recent wins for Origin Integration Studios (Asia) and Ciberbit (Europe and Asia). Historical trending charts are updated accordingly as KLAS adjusts market share numbers, combines vendors’ market share based on M&A activity, or adds new vendors to the research. The trending charts in this year’s report supersede trending data given in previous iterations.

Geographic Regions

The geographic regions used in this report are based—with some variation—on the United Nations’ geographic regions. Since nearly all EMR purchases in Northern America in the past nine years have occurred in either Canada or the United States (the one exception being in Saint Pierre and Miquelon, a French overseas territory) and since this report excludes US market share data, the UN’s designation of Northern America has been replaced with the KLAS region of Canada (with Saint Pierre and Miquelon being grouped in). Similarly, EMR purchases that occur in a country’s overseas territories are discussed in the sections for their respective geographic regions (as defined by the UN) and are not grouped into counts for the overarching country (e.g., American Samoa, Puerto Rico, Guam, Virgin Islands for the US; British Virgin Islands, Falkland Islands [Isla Malvinas], and other British Overseas Territories for the UK; French Guiana, Guadeloupe, Martinique, Mayotte, Réunion, and Saint Pierre and Miquelon for France; Curaçao for the Netherlands; etc.). For more details on the US EMR market, please refer to KLAS’ annual US hospital EMR market share report.

Vendors that are widely considered by provider organizations in multiple regions and have a significant number of validated customers in at least two regions are labeled as “multiregional.” Vendors whose customer base is heavily skewed toward a single region are designated as “regional” and grouped by region. These designations are re-evaluated annually.

author - Amanda Wind
Writer
Amanda Wind
author - Natalie Jamison
Designer
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. © 2025 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.

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