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US Hospital EMR Market Share 2020
Shifting Perspectives Among Large and Small Hospitals
Author
Coray Tate
Author
Paul Warburton
In 2019, EMR purchase decisions in the private sector had a dramatic impact on Cerner, MEDITECH, and the small-hospital market, with Epic continuing to amass market share.
MEDITECH’s Market Share Expands with Expanse
The Expanse platform is expanding MEDITECH’s appeal, drawing interest and purchases from organizations outside MEDITECH’s legacy customer bases and from types of organizations that haven’t typically considered MEDITECH in the past. All this has resulted in net market share growth for MEDITECH in two of the last three years. Most of the organizations that contracted for Expanse in 2019 are community hospitals (26–200 beds), but one large organization (400+ beds) also chose to consolidate to Expanse, creating the opportunity for the market to assess how Expanse scales to more complex environments. Continued ancillary development and plans for a revised nurse workflow also generate interest outside MEDITECH’s existing customer base. About half of the legacy MEDITECH customers who made a go-forward decision in 2019 chose to migrate to Expanse (a similar percentage as in previous years). Almost half of MEDITECH’s 2019 losses came from standardization and provider M&A activity.
Cerner Sees Net Decrease in Market Share for First Time
Historically, Cerner has been the only vendor besides Epic to add hospital market share each year. However, in 2019, four large organizations left Cerner, and with no government contracts to make up the loss, Cerner saw a net decrease in market share for the first time since KLAS began tracking losses in 2010. This decrease is especially notable in terms of number of beds. The two largest drivers for organizations leaving Cerner are standardization to Epic and Cerner’s lack of tangible improvements to the revenue cycle solution. Cerner won the most standalone facilities in 2019; most of these organizations are smaller organizations that value Cerner’s robust clinical system and ability to scale to the needs of smaller hospitals. In 2019, no legacy Siemens customers migrated to Millennium.
Epic Continues to Grow Market Share across All Segments of the Private Sector
To date, Epic is the only vendor to have reliably delivered full acute/ambulatory care integration and a complete clinical/revenue cycle solution to large, complex customers, for whom they have become the vendor of choice. Epic’s market share continued to grow across organizations of all sizes in 2019—it now accounts for just under 40% of the acute care beds in the United States. Just over half of Epic’s wins were competitive decisions; the remainder were the result of standardization and acquisition. Seven small hospitals chose Epic’s Community Connect offering. The Community Connect customer experience can vary greatly depending on the host organization, and Epic is still trying to figure out how to raise the Community Connect experience to match that of their direct customers.
athenahealth’s Acute Care Exit Leaves Void in Small Standalone Market
To date, no other vendor has been able to generate the excitement and energy that athenahealth created among small standalone hospitals. Cerner CommunityWorks and MEDITECH Expanse come the closest as organizations in this market hope for a budget price point, SaaS technology, and a direct vendor relationship. To appeal to these organizations, MEDITECH developed MaaS (a cloud hosted option), Allscripts is in the process of releasing a more standardized version of Sunrise Clinical Manager, and both MEDHOST and CPSI are working to update their clinician workflows. Prior to announcing their exit from the acute care market in late 2019, athenahealth had amassed a customer base of 120+ small hospitals. Many of these organizations will likely be looking to make a go-forward EMR decision in coming years.
Allscripts Continues to Lose Market Share across All Platforms
Allscripts continues to steadily lose market share across both of their go-forward platforms. Paragon customers hoped that Allscripts would deliver improvements promised by McKesson, and while Allscripts has developed an integrated ambulatory solution, customers note that the vendor’s recent efforts feel more like maintenance than true product investment and development. Only about 25% of Paragon customers who made a purchase decision in 2019 chose to migrate to Sunrise Clinical Manager (SCM). The first customer for Sunrise Community Care (SCC), a cloud hosted version of SCM, is slated to go live in summer 2020. It remains to be seen whether SCC will convince more Paragon customers to stay with Allscripts.
For more information about the EMR decisions and purchase drivers of acute care organizations, please see KLAS’ Decision Insights research:
Writer
Elizabeth Pew
Designer
Jess Wallace-Simpson
Project Manager
Robert Ellis
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.