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Middle East & Africa EMR 2021 Middle East & Africa EMR 2021
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Middle East & Africa EMR 2021
Vendor Performance and Market Energy

author - Everton Santos
Everton Santos
author - Jonathan Christensen
Jonathan Christensen
author - Sidney Tate
Sidney Tate
September 9, 2021 | Read Time: 9  minutes

Many healthcare organizations in the Middle East and some in Africa have made EMR purchase decisions over the last five years (2016–2020). In that time, KLAS has validated 86 EMR decisions—72 in the Middle East and 14 in Africa—impacting over 320 hospitals, with decisions made in 2018–2020 impacting (on average) at least twice as many facilities as decisions made in 2016–2017. This report will examine the customer satisfaction, market share, and recent wins and market energy of EMR vendors in the Middle East and Africa. Compared to KLAS’ previous report on EMRs in the Middle East (published in 2019), this study includes performance data on a significantly higher number of vendors, providing more expansive insights, particularly into the Middle East market.

Cerner Continues to Lead in Performance, with Customers Reporting Stronger Relationships

Cerner has had a constant presence in the Middle East for over a decade. Customers generally report a consistent product experience that meets expectations, and they feel Cerner has improved relationships, especially after the onset of COVID-19. Since 2019, Cerner’s overall score has increased 6 points (on a 100-point scale) thanks to more attentive support, quicker response times, and greater flexibility in meeting customers’ ever-changing needs. Purchases of Millennium PowerChart have slowed in recent years: of the six contracts signed 2016–2020, five were signed in 2016. Most organizations that would typically consider Millennium—i.e., larger health systems—already have an EMR in place, and smaller organizations find the platform too resource intensive. Uptake of Cerner’s lighter, less expensive platform (not yet rated) has grown in the region; it is marketed to smaller organizations and in countries where the Millennium platform is not offered.

overall performance score and net new contracts

Successful Migrations Greatly Boost Health Insights’ Customer Experience

Over the past two years, Health Insights has successfully migrated all customers to their new MEDiCACLOUDCARE platform. Customers view the web-based platform as a significant improvement over the previous platform, citing improved speed, documentation tools, ease of use, and accessibility. Respondents are optimistic about the changes that have been made to the platform and feel the vendor is well prepared to meet future needs. The majority of Health Insights’ customers (located in Saudi Arabia) work with a reseller and want improved responsiveness to various support requests. With the vendor’s focus on migrating their customer base, no new clients have signed with Health Insights since 2019.

Growing Pains Still a Challenge for InterSystems Customers Despite Improvements

Since 2019, InterSystems has worked to address customers’ concerns about support gaps by onboarding and training more internal staff members. Yet growing pains, which started with InterSystems’ large influx of customers in 2017, have lingered. While respondents have experienced better support structure and transparency, they feel it can still be difficult to find knowledgeable resources. Despite the concerns from current customers, InterSystems is widely considered in new deals because of their web-based platform, hosting options, and lower costs. InterSystems was chosen in three new contracts in 2020.

Regional Decisions Bolster Dedalus (DXC) & Cloud Solutions; Satisfaction High with Epic though Cost Is a Deterrent

middle east hospital wins 2016 through 2020Dedalus solutions have been chosen for the highest number of hospitals in the Middle East since 2016. This is thanks to the vendor’s April 2021 acquisition of DXC Technology, whose Enterprise Management solution was chosen for a large 2019 contract in Egypt (in partnership with Vodafone Egypt). Of the estimated six organizations live on Enterprise Management, KLAS has collected feedback from three. While the impact of the Dedalus acquisition is still to be seen, customer satisfaction has increased in recent years as DXC Technology has improved accessibility to knowledgeable support resources. Development is slower than customers would like. Cloud Solutions (the IT branch and subsidiary of Dr. Sulaiman Al-Habib Medical Group) has had success with their early commercial ventures in Saudi Arabia. Their VIDA solution was selected for greenfield hospitals in three health clusters: Al-Qassim, Jazan, and Najran. Early feedback from clients—who are typically 50-bed hospitals that previously used paper records—indicates successful deployments and high satisfaction driven by VIDA’s ease of use and clear dashboards. There are some hiccups, such as system slowness. Epic customers continue to report strong partnerships and high satisfaction with support, which increased during the COVID-19 pandemic in the form of virtual trainings and new dashboards. High satisfaction has not translated to significant growth, as many prospective clients view Epic as being beyond their price range. Two of Epic’s five clients in the Middle East have contracted in the last five years.

Middle East/Africa EMR Landscape

middle east africa emr landscape

Regional Summaries

For details about other Middle East countries, see the Vendor Insights section in the full report.

Kingdom of Saudi Arabia (KSA)

The Saudi Ministry of Health’s (MOH) Health Vision 2030 includes updating hospital IT infrastructures within each health cluster. This vision has benefitted Cloud Solutions and IQVIA (with three clusters each) and ALERT (with one cluster). Health Insights and OASIS—which historically have had large customer bases—have not been selected for any clusters. Health Insights has successfully migrated all Saudi Arabia clients to MEDiCACLOUDCARE, their web-based product. OASIS customers would like to adopt the web-based OASIS+ but are waiting for MOH approval. In addition, 11 other vendors have added 1–4 hospitals each across the public and private sectors in the last five years.

kingdom of saudi arabia hospital wins

United Arab Emirates (UAE)

Cerner Millennium has the largest market share in the UAE thanks to large, long-standing contracts with two public health authorities (SEHA and MOHAP). Growth on the Millennium platform has slowed down (only one new contract since 2016), with smaller private hospitals showing less interest. InterSystems has a midsize presence and has grown more rapidly than any vendor since 2016. Ohum Healthcare and MIMSYS have a midsize presence among private hospitals in the country. Epic has a contract with a public health authority (DHA) and a private client as well, though they have not signed any new clients in the country since 2016. In the UAE, six vendors each have between 1–5 hospitals using their EMR technology.

united arab emirates hospital wins


EMR purchasing has been slow in Africa, though there are pockets of energy in the continent’s eastern and southern regions. The vendors with the largest market presence have expansive contracts that cover a single health provider or region. Dedalus has contracts in South Africa (via their DXC Technology acquisition) with regional departments of health, and MEDITECH has a presence in five countries, including a contract with the MOH in Botswana. In 2018, Telekom Healthcare Solutions signed the most recent expansive contract with a private provider in South Africa. In recent years, few new contracts have been validated by KLAS. No vendor has significant mindshare in this region.

africa hospital wins

About This Report

Data for this report comes from two sources: (1) KLAS performance data and (2) KLAS market share data.

KLAS Performance Data

Each year, KLAS interviews thousands of healthcare professionals about the IT solutions and services their organizations use. For this report, interviews were conducted over the last 18 months using KLAS’ standard quantitative evaluation for healthcare software, which is composed of 16 numeric ratings questions and 4 yes/no questions, all weighted equally. Combined, the ratings for these questions make up the overall performance score, which is measured on a 100-point scale. The questions are organized into six customer experience pillars—culture, loyalty, operations, product, relationship, and value.

customer experience pillars software

Sample Sizes

Sample sizes displayed throughout this report (e.g., n=16) represent the total number of unique customer organizations interviewed for a given vendor or solution. However, it should be noted that to allow for the representation of differing perspectives within any one customer organization, samples may include surveys from different individuals at the same organization. Ratings from these individuals are aggregated in order to prevent any one organization’s feedback from disproportionately impacting a solution’s score. The table below shows the total number of unique organizations interviewed for each vendor or solution as well as the total number of individual respondents.

Some respondents choose not to answer particular questions, meaning the sample size for any given vendor or solution can change from question to question. When the number of unique organization responses for a particular question is less than 6, the score for that question is marked with an asterisk (*) or otherwise designated as “limited data.” If the sample size is less than 3, no score is shown. Note that when a vendor has a low number of reporting sites, the possibility exists for KLAS scores to change significantly as new surveys are collected.

about this report

KLAS Market Share Data

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 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.

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.

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 multiple contracts are signed with each participating entity because there was a single, collective decision-making and selection process.

Where Does Market Share Data Come From?

The market share data reported in this study is based on hospital EMR contracts that were in place (primarily) in Arabic-speaking countries in Western Asia and Egypt as of 31 December 2020. 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. 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 variation may result from lack of vendor transparency/participation.

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.”

author - Sarah Hanson
Sarah Hanson
author - Madison Moniz
Madison Moniz
author - Natalie Jamison
Project Manager
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.