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Epic Systems Corp. still dominates the market for big healthcare system EHRs by a wide margin, but Cerner Corp., after its $1.3 billion acquisition of Siemens AG's Soarian EHR unit, is narrowing the gap, according to a new EHR purchasing plans survey from KLAS Enterprises LLC.
Meanwhile, the survey found a dramatically consolidated market for acute care EHR systems, with only three other major players challenging Epic and Cerner when hospital officials make buying decisions: Allscripts Healthcare Solutions Inc., Medical Information Technology Inc. (MEDITECH), and McKesson Corp.
KLAS found that healthcare providers considering new EHR systems from Epic or Cerner, whether as upgrades or replacements, still lean 2-to-1 toward Epic, even though Cerner technically has more market share when Soarian users are added to Cerner's share. The survey of some 400 users consisted of in-depth interviews.
"A key finding we had this year was decisions [to go with Epic or Cerner] are becoming more competitive," Coray Tate, KLAS vice president of clinical research, told SearchHealthIT. "Those leaning toward Epic over Cerner are down from 3-to-1 last year."
Those interested in buying the proprietary 134-page report can find it here. SearchHealthIT was provided with a two-page executive summary of the report after it was released last month.
Epic still ahead in market share, but…
Coray Tatevice president of clinical research, KLAS
In this more competitive market, Epic is still projected this year to hold a 25% market share (as opposed to 36% last year) among those providers who have already selected or are leaning toward a vendor, according to KLAS. Cerner, meanmwhile, retains the 14% share it had in 2014, the report said.
After Epic and Cerner, the KLAS researchers found at the time of the report that some 41% of the inpatient market was still "up for grabs," with 1,200 providers running legacy systems and seeking to upgrade, according to Tate.
Of those 1,200 providers, 14% of prospective buyers are considering MEDITECH's 6.0 platform, followed by 5% looking at McKesson's Paragon EHR, and 1% weighing a new Allscripts system.
Meaningful use still inspires EHR decisions
Tate said meaningful use has been and remains a big driver for EHR buys, and stage 3 of meaningful use -- for which CMS released a proposed rule on March 20 -- will be even more focused on clinical processes and outcomes than the previous two stages. This will likely spur those still running legacy systems to consider making a change, he said.
The survey did not look at the prospects for EHR vendors serving the ambulatory and small hospital sectors, nor did it distinguish between cloud-oriented versus enterprise systems.
However, Tate said that while it is possible that the inpatient field now dominated by just five vendors could be challenged by others with cloud or other technologies, it is not likely that a "me too" competitor could break in with the same kind of clinically oriented system sold by the big five.
Allscripts struggles despite product improvements
Other notable findings in the survey included that McKesson, even with its recent Paragon system, has dropped in popularity from 2014, with 5% considering it now as opposed to 12% last year.
And while Allscripts is down to 1%, from 2% last year, the vendor may be an "overlooked option" because "users have reported significant improvement in their experience over the past two years and that a new management team and population health strategy are energizing current customers," according to the KLAS executive summary.
Allscripts went through a period of financial turbulence several years ago, but customers have been reassured over the last two years, according to the report.
"Allscripts has a more complete and robust offering now, yet they're being excluded," Tate said.
As for MEDITECH, the veteran company that has been around since 1969 -- a decade before Epic and Cerner were founded -- the report summary said many MEDITECH customers reported feeling "stuck." For those MEDITECH customers, Epic was the EHR of choice, but was financially out of reach.
Tate said MEDITECH has a reputation for delivering what it promises and that has earned it loyalty.
And the KLAS survey found that users of McKesson's Paragon system had the highest tendency to look elsewhere, with nearly 30% of its user base considering a change, compared to 18% last year, when KLAS did a similar report.
On the up side for McKesson, KLAS found that many of those restless McKesson customers are delaying decisions in the hopes that McKesson will deliver what they need, and most Paragon users would not switch even if they could.
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