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US Hospital EMR Market Share 2018

US Hospital EMR Market Share 2018
Small Hospitals Hungry for New Technology

Authored by: Erik Bermudez & Paul Warburton May 24, 2018 | Read Time: 4  minutes

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In 2017, 216 acute care hospitals contracted for a new EMR, with 1–200 bed hospitals accounting for the vast majority (80%) of these decisions. These smaller hospitals are hungry for new technology but often resource poor; over half that signed a new contract in 2017 chose a less expensive or less resource-intensive platform—namely, athenahealth, MEDITECH, and the community deployment models from Cerner and Epic. This report investigates this and other shifts that impacted buying energy in 2017.

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athenahealth Capitalizes on Smaller Hospitals’ Hunger for New Technology


athenahealth’s inpatient solution continued to gain traction, garnering more contract wins among small hospitals than any other solution. The cloud-based platform is particularly attractive to the smallest hospitals, who require minimal IT footprints and up-front costs. Indeed, athenahealth’s 2017 wins occurred solely among hospitals with under 50 beds. Questions regarding the solution’s maturity are a concern for some—in 2017, 13 contracted customers backed out before going live, returning to previous vendors, primarily CPSI. MEDITECH’s new cloud-based technology (Expanse) also generated buying energy among smaller hospitals (details below). Smaller hospitals have expressed initial interest in eClinicalWorks’ cloud-based inpatient solution (10i); to date, very few contracts have been signed.


cloud based and community specific platform deployment purchases

MEDITECH Has First Market Share Increase in Three Years Thanks to Energy around Cloud-Based Solution


2017 marked the first time in three years that MEDITECH saw a net increase in US hospital EMR market share. These early signs of renewed energy are driven primarily by Expanse, MEDITECH’s newly christened web-based platform. Expanse has been in development for many years, with ambulatory integration and enhanced usability as key goals, and it has created increased migration activity among MEDITECH’s legacy customers—58% of those who made a go-forward decision in 2017 chose Expanse, while 42% went with other vendors. In some recent years, MEDITECH’s systems have not generated significant consideration outside of the existing MEDITECH base, but Expanse is changing that. Some community hospitals (1–200 beds) using other vendors’ legacy solutions chose in 2017 to switch to Expanse.


net change in acute care hospital market share 2013 to 2017

Allscripts Acquires McKesson EIS, Sustains Losses across All Three Inpatient Platforms

In 2017, Allscripts nearly doubled their acute care EMR customer base with the acquisition of McKesson’s Paragon and Horizon EMRs. Both solutions have been losing customers for years, and 2017 was no different. It should be noted that many Horizon and Paragon customers who left in 2017 had already made decisions to switch to other vendors prior to being acquired by Allscripts. These losses are no surprise given Horizon’s sunset status and McKesson’s consistent underdevelopment of Paragon, most significantly their inability to deliver an integrated ambulatory solution. More notable are the losses sustained by Sunrise Clinical Manager (SCM), Allscripts’ go-forward solution for larger organizations. SCM’s market share had been relatively stable for a number of years, but in 2017, two large multihospital organizations switched their SCM hospitals to Epic, looking to simplify their IT infrastructure and consolidate to an integrated solution.


2017 acute care hospital losses by platform deployment model

Cerner Achieves the Most Acute Care Wins; Epic Sees the Largest Net Growth

For years, Cerner and Epic have been the most considered EMR vendors across all hospital sizes. In competitive decisions by large organizations, they are almost the only vendors considered. In 2017, Cerner saw the most acute care hospitals wins out of all vendors. Epic had fewer wins but sustained no losses, giving Epic the highest net market share growth. Cerner lost 25 hospitals, 15 due to customer standardization. Epic’s strong integration and consistent development are major reasons that their market share remains more stable and that they are chosen by larger health systems and hospitals; Cerner’s long-time patient accounting challenges continue to be a primary factor when large organizations choose not to go with Cerner. Cerner’s and Epic’s alternative deployment models for smaller hospitals both saw significant wins. In this space, Cerner outpaced Epic—for these hospitals, the initial cost and lack of direct contracting in Epic’s community model can be a concern; Cerner offers more flexible pricing models and direct contracting.


2017 us acute care hospital market share

2017 us acute care hospital wins and losses

MEDHOST Remains Stable; CPSI Loses Significant Market Share

Organizations using CPSI (Healthland and Evident), MEDHOST, Cerner Soarian, and MEDITECH’s MAGIC, C/S, or 6.x solutions make up over one-third of all hospital contracts in the United States. Many of these traditional small-hospital platforms are seeing high rates of replacement as provider organizations consolidate and as customers switch to more attractive deployment models. MEDHOST’s customer base remained stable in 2017 thanks to improved relationship efforts and the release of a new hosted option. CPSI Evident sustained the highest losses of any platform in 2017, with customers turning to other vendors in search of things like innovative technology, responsive support, and consistent upgrades. CPSI’s Healthland customers are in a similar situation. Cerner’s legacy Soarian customers are leaving but more slowly than in previous years.

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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. © 2020 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.