Epic Systems Dominates 2020 EHR Implementation Market Share

Only Epic Systems and Azalea Health had a positive net change in EHR implementation market share during 2020.

Nearly 150 hospitals implemented Epic Systems EHR throughout 2020, which further contributed to Epic’s stronghold on the EHR implementation market share, according to a recent KLAS report.

Additionally, EHR adoption was up in 2020 despite COVID-19. KLAS revealed large organizations fueled EHR purchasing, along with standalone community hospitals.

“Contracting naturally took a back seat as COVID-19 cases ramped up and the country went into lockdown,” KLAS explained. 

“It rebounded some in Q3 and then spiked in Q4 as organizations reinstated budgets and revived tabled HIT initiatives. Decisions by large organizations (>10 hospitals) often take several years, and most of those that were paused in 2020 are back in full swing, with Epic, Cerner, and MEDITECH leading in consideration.”

Although Epic did not grow as much as it did in 2015 when it added 144 hospitals to its resume, the EHR vendor giant outpaced its competition in 2020 by a more significant margin than ever before.

Large healthcare organizations said the vendor’s deep integration and stability were key reasons to make the switch. Epic added 46 hospitals amounting to over 15,000 beds from larger organizations with over ten hospitals. Most of those hospitals switched from Allscripts, Cerner, and MEDITECH.

According to the report, over the last five years, Epic averaged 90 hospital additions. In 2020 Q1 alone, the vendor added 37 hospitals and slightly under 7,000 beds in one significant win.

Azalea Health was the only other EHR vendor to have a net positive change in hospital market share with a four-hospital increase. Allscripts lost one hospital, MEDITECH lost nine hospitals, CPSI and MEDHOST both lost 12 hospitals, while Cerner lost 19 hospitals.

This marked the second year that Cerner decreased its market share and large healthcare organizations expressed concern over Cerner’s revenue cycle functionality. For instance, a 37-hospital healthcare organization chose Epic, and 31 of those hospitals were Cerner customers. This loss accounted for over half of the vendor’s 2020 hospital losses, KLAS noted. Since 2015, Cerner has lost seven large customers.

On the other hand, Cerner added 19 small, standalone hospitals, coming in as the vendor with the most additions in that market. Community hospitals tapped the vendor twice as often as its next closest competitor and raved about Cerner’s CommunityWorks model and Millennium EHR platform.

“A global market share leader, Cerner’s sights are set on meeting the ever-changing needs of our clients and developments in healthcare,” wrote Cerner in an emailed statement. “The company’s industry-leading efforts are providing data-driven insights that are and will continue advancing medicine. On the heels of a strong first quarter, Cerner’s global market share continues to lead the way for the future and position it for growth centered around client success.” 

Every hospital MEDITECH added in 2020 was a small hospital under 100 beds, and roughly 75 percent were under 25 beds. However, the vendor lost 62 percent of its legacy customers that were up for a new contract in 2020.

“A quarter of the legacy customers that moved to another vendor in 2020 did so as the result of M&A activity,” KLAS explained. “The remainder were competitive decisions that opted not to migrate to Expanse (almost all went to Epic); not all of these decisions involved a full RFP.”

After leading EHR vendors in EHR satisfaction among small hospitals, MEDITECH added nine small hospitals with fewer than 200 beds. Meanwhile, seven hospitals adopted CPSI, four small hospitals chose Epic, and two selected Azalea Health.

“Epic is typically cost prohibitive for this group, but some standalone hospitals looking to improve collaboration with referral partners chose Epic’s Community Connect model,” explained KLAS.

“Azalea Health, who is working to modernize the former Prognosis solution, was chosen by a couple of small standalone hospitals in 2020. Though Allscripts had no wins among small standalone organizations in 2020, they have announced a streamlined version of the Sunrise platform intended for community hospitals.”

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