In terms of EMR purchasing, 2018 was the busiest of the past three years. This energy impacted every market sector, with the US government finalizing contracts, three large health systems changing EMRs, and the small-hospital market continuing to see churn, according to a new KLAS Report.
The KLAS annual report, “US Hospital EMR Market Share 2019,” is based on acute care EMR purchasing activity (i.e., executed contracts) that occurred in the United States from January 1–December 31, 2018. KLAS reveals that while the majority of all organizations that made go-forward decisions in 2018—regardless of size or type—chose Cerner or Epic, this does not tell the whole story.
Here six key findings from the latest KLAS US Hospital EMR Market Share in 2019 report:
1. Large (500+ Beds) and health systems almost exclusively choose Epic, switching from Allscripts or Cerner
In today’s EMR market, most large organizations have invested heavily in implementing a single, go-forward solution across all of their hospitals, so future purchases in the large market will be highly contested and require a significant rip and replace. KLAS reports only four key vendors remain in the large provider market space—Epic (with 163 hospitals), Cerner (77 hospitals), Allscripts (16 hospitals), and MEDITECH (12 hospitals).
2. Cerner signed the highest number of new hospitals but came in second due to customer attrition.
Cerner cornered the market on the US government contracts, finalizing the VA deal and giving Cerner their biggest net gain of any year KLAS has measured, accounting for 76% of Cerner’s hospital wins. On the flip side, Cerner was chosen by fewer organizations in the private sector with the majority being smaller hospitals. A total of 65 hospitals left Cerner Millennium (52 of those hospitals came from two health systems) with the vast majority switching to Epic.
3. MEDITECH Expanse EHR Generating Energy and Competition
For the second year in a row, a number of organizations outside of MEDITECH’s base—mostly small to midsize hospitals—chose Expanse. KLAS notes that 19 legacy hospitals have migrated to the Expanse EHR platform out of 53 MEDITECH hospitals. MEDITECH market in 2018 decreased due to M&A activity among its customers.
4. Allscripts Continues Trends of Sunrise & Paragon Losses
In 2018, 14 hospitals—9 of which came from one large organization—left the Sunrise Clinical Manager (SCM) platform; all switched to Epic. 16 hospitals left the Paragon platform, moving to Cerner, Epic, MEDITECH, or CPSI. Allscripts had a total of 33 hospital losses in 2018, 15% of those were due to customer consolidation.
5. athenahealth’s Growth Slows as They Pause Acute Care Sales; Still No Live eClinicalWorks Customers
Critical access hospitals (CAH) have chosen athenahealth in recent years with selections tapering off significantly in the latter half of 2018, with organizations reporting that athenahealth has paused sales and stopped responding to RFPs. KLAS was unable to validate any new contracts for eClinicalWorks in 2018 (and the vendor did not share a list).
6. Acute Care EMR Decisions Today Based Less on Functionality and More on M&A Activity and Regional Affiliates
Mergers, acquisitions, and decisions to standardize to a single EMR continue to be a significant contributor to organizations’ EMR purchases. Since 2014, 20% of acute care hospitals that have switched EMR vendors have done so as a result of M&A activity, and over 50% have done so as part of a broader organization decision.
