Epic Dominates EMR Market Share Wars; Cerner Loses Ground

Only two vendors experienced significant gains during 2019: Epic and MEDITECH.

Electronic medical record (EMR) company Epic muscled a greater share of the U.S. acute care market EMR market during 2019, while its closest competitor, Cerner, lost ground, according to the 2020 U.S. Hospital EMR Market Share Report from KLAS. MEDITECH was the only other vendor demonstrating positive gains, growing its market share by 29 facilities over the previous year. CPSI, MEDHOST, and Allscripts all recorded losses.

"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," according to the report.

EMRs are one of the most expensive investments made by hospitals and healthcare systems, and decisions about what vendor to use impact a broad range of operations. As health systems merge and consolidate, EMRs can play a key role in streamlining operations and creating greater efficiencies.

KLAS, a Salt Lake City-based research and insights firm, reports market share among the top EMR companies serving 5,457 acute care hospitals as follows:

• Epic 29%
   
• Cerner 26%
   
• MEDITECH 17%
   
• CSPI 9%
   
• Allscripts 6%
   
• MEDHOST 4%
   
• None/Other 9%

The report also captured EMR company's account gains and losses during 2019:

• Epic gained 55 facilities
   
• MEDITECH gained 29 organizations
   
• CSPI lost five hospitals
   
• Cerner lost nine accounts
   
• MEDHOST lost 10 facilities
   
• Allscripts lost 29 accounts

The battle between Cerner and Epic has been close in recent years as each vies for market dominance. Last year Epic had a slight edge over Cerner in terms of overall market share—with 28% and 26%, respectively, as reported by KLAS.

"Historically, Cerner has been the only vendor besides Epic to add hospital market share each year," according to the report. "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. The decrease is especially notable in terms of number of beds." When examining market share by the 881,315 beds in acute care multi-specialty hospitals, Cerner has a 29% market share compared to Epic's 39%.

KLAS indicates the primary reasons organizations left Cerner were to standardize to Epic, as well as Cerner’s "lack of tangible improvements to the revenue cycle solution." While Cerner lost overall market share, KLAS reports that the company won the most standalone facilities in 2019 because most of these smaller organizations "value Cerner’s robust clinical system and ability to scale to the needs of smaller hospitals."

MEDITECH was the only other strong performer during 2019. "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," according to KLAS. "All this has resulted in net market share growth for MEDITECH in two of the last three years."

The KLAS report is based on acute care EMR executed contracts that occurred in the United States from January 1–December 31, 2019. The data comes from multiple sources, including publicly available information, thousands of conversations KLAS has with provider organizations, and vendors. The full report is available for download on the KLAS website.