US Hospital EMR Market Share 2017
Decision Energy Shifts to the Small Market

1. Cerner Sees Greatest Increase in Small-Hospital Market Share

Small hospitals moved to Cerner more than any other vendor in 2016, accounting for the vast majority of Cerner’s growth. Cerner CommunityWorks is a large draw for small hospitals due to its breadth of functionality and integration, though provider satisfaction is middle of the road. Looking for greater interoperability with nearby Epic hospitals at a feasible price point, small standalone hospitals also contracted for Epic Community Connect. One pain point reported by community customers of both Cerner and Epic is a lack of customization capabilities.

2. athenahealth’s Expansion Disrupts Small Market

The number of hospitals that contracted with athenahealth more than doubled in 2016. One-third were hospitals with over 25 beds. Providers are drawn to the vendor’s web-based platform, unique cost structure (percent of collections), and inpatient/outpatient integration. Perceived functionality gaps in ancillary departments cause some customers to leave and some potential customers to choose other options. With sales energy high, KLAS will be looking to validate athenahealth’s ability to scale and perform consistently for hospitals.

3. Multiyear Net Losses for MEDITECH, McKesson, and CPSI

Customers leaving MEDITECH do so due to insufficient development, skepticism that the vendor will be able to meet future needs, and the desire to reduce the number of EMRs used in an organization. However, there are early indications that the release of MEDITECH’s integrated ambulatory offering and new development on the inpatient side are changing the market’s perception of MEDITECH. McKesson Paragon saw high losses, and no new wins were reported to KLAS. Many users feel Paragon does not meet their needs, and many are uncertain about its future due to McKesson’s plans to sell it. About half of the hospitals that left CPSI (both Evident and Healthland platforms) switched to athenahealth, citing CPSI’s poor usability, development, and support.

4. Epic Continues to Widen Gap in Large Market

Epic’s integration and track record of customer-to-vendor trust continue to drive loyalty and market growth, particularly among larger organizations and IDNs (multihospital organizations). Over 50% of IDN contracts (13 of 23) went to Epic. The two hospitals that left Epic in 2016 did so involuntarily as a result of being spun off or acquired. About 25% of IDNs (6) chose Cerner in 2016, drawn to Millennium’s integration and flexibility for customization. One of these IDN contracts was for an organization of 30 microhospitals (1–15 beds). Providers who chose Allscripts in 2016 often had a prior relationship with the vendor and were hoping to standardize to a single EMR across their healthcare organization.

Allscripts

Retention and wins gave Allscripts a net gain in 2016. Providers indicate that Allscripts offers strong functionality with some gaps.

athenahealth

Has maintained significant energy since entering acute care market in 2015. Most wins came in the community space (1–200 beds); about two-thirds were in the critical access range. Questions about ancillary-functionality development remain.

Cerner

Second-highest net acute care hospital growth bolstered by most wins in small hospital space, including one large microhospital contract. 24 hospital losses—16 from legacy Siemens customers, 8 from Millennium.

CPSI (Evident and Healthland)

Little consideration among community hospitals. Low customer satisfaction and high losses among Evident customers; CPSI has continued to develop Centriq. CPSI did not share with KLAS a list of 2016 contract wins for validation.

eClinicalWorks

Had some early success with new inpatient product in 2015, but KLAS validated very little movement in 2016. Lost key inpatient development customer in 2016. eClinicalWorks did not share with KLAS a list of 2016 contract wins for validation.

Epic

Six-year leader in net acute care hospital growth; continued to increase lead in overall acute care hospital market share. Two noncompetitive losses (due to M&A). To date, KLAS has never validated a customer voluntarily uninstalling Epic.

McKesson

Significant decline in Paragon market share. No Horizon customers migrated to Paragon in 2016. Many current Paragon users not satisfied with functionality or still struggling to adopt all the functionality available.

MEDHOST

Slight decrease in overall acute care market share; little consideration among small standalone hospitals. Four acute care wins, and four specialty-hospital wins. Many providers’ needs still unmet by recent improvements.

MEDITECH

17 new hospitals. Interest in MEDITECH Web starting to expand beyond MEDITECH legacy customer base, mainly among community hospitals. Just over half of MEDITECH legacy customers that made a decision contracted elsewhere.