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, according to a recent KLAS report. EMR purchasing by smaller hospitals is being driven primarily by these organizations’ need to exchange information with surrounding hospitals and desire for vendors that offer newer, more innovative technology and more flexible financial options.
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.
The KLAS report investigates reveals five small hospital EMR market trends impacted buying energy in 2018:
1. 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.
2. MEDITECH Has First Market Share Increase in Three Years
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.
3. Allscripts 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. KLAS notes that both solutions have been losing customers for years and 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; however, in 2017, two large multihospital organizations switched their SCM hospitals to Epic, looking to simplify their IT infrastructure and consolidate to an integrated solution.
4. Cerner Garnered the Most Acute Care Wins
Cerner saw the most acute care wins out of all vendors; however, Cerner lost 25 hospitals, due to customer standardization. The report notes that Cerner’s long-time patient accounting challenges continue to be a primary driver for healthcare organizations choosing not to select Cerner. On the positive note, Cerner offers the most flexible pricing model and direct contracting.
5. Epic Sees the Largest Net Growth in Acute Care Market
Epic had fewer wins but sustained no losses, giving Epic the highest net market share growth. Key drivers of positive market share growth include Epic’s strong integration and consistent development making them an attractive choice for larger health systems and hospitals. The report did cite initial cost and lack of direct contracting in Epic’s community model as a potential concerns for customers.