Clinical Market Share 2013
More Than Meaningful Use

WORTH KNOWING

As Stage 2 Begins There Are Still Many Decisions to Be Made—Since HITECH’s introduction, 405 out of nearly 1,500 hospitals over 200 beds have selected a new, currently marketed EMR. Still, another 443 are running legacy systems or have no EMR at all and will face decisions in coming years—a majority of these hospitals are running McKesson Horizon or MEDITECH MAGIC. Even currently marketed products will not be immune to turnover as 39% of multihospital systems have heterogeneous environments and may eventually follow peers in standardizing on a single EMR.

Cerner Narrows Gap in Shifting Market—Continuing a multiyear trend, Cerner and Epic combined drew more than three-fourths of new hospitals in 2012. Epic’s 2-to-1 lead over Cerner in new hospitals represents a narrowing gap from 5-to-1 in 2010. Both vendors appeal to IDNs looking to standardize patchwork quilts of EMRs, but the market for IDNs with large hospitals, which have leaned toward Epic, is shrinking. The remaining decisions are much more diverse, and the future may not be as lopsided.

Horizon Customers Betting on Paragon—McKesson signed the third-most hospitals for Paragon, christened McKesson’s go-forward CIS in late 2011. Paragon’s appeal to 200+ bed hospitals is mostly limited to existing Horizon customers wanting to continue their McKesson relationship. While only 1 out of 12 hospitals switched to Paragon from a competitor’s solution in 2012, McKesson has significant opportunity with 130 hospitals that have yet to make a post-Horizon decision.

Allscripts, MEDITECH, and Siemens Being Squeezed Out—None gained enough new hospitals in 2012 to suggest a market share rebound, and each lost more hospitals than the handful they gained. For the first time since KLAS has tracked market share, Allscripts gained no hospitals in the 200+ bed space. A lack of strong, integrated ambulatory solutions has been a challenge for all.

Bottom Line On Vendors

Allscripts–Failure to deliver promised acute-ambulatory integration with Allscripts Enterprise and Professional discourages both current customers and new prospects. No 200+ bed wins in 2012 and three losses. Leadership change a cause for optimism. Bumpy upgrades to v.5.x. Appeals to physicians more than IT. Recent dbMotion and Jardogs acquisitions seen as visionary.

Cerner–Continues upward trend with second-most new hospitals (23). Eleven hospitals lost mainly to providers standardizing on Epic. Status as an enabling partner growing, but reputation for bottom-line focus remains. Rising satisfaction scores stalled in last year. Usability challenges solvable with significant provider effort.

Epic–Has most new hospitals (47) for the fifth year in a row, including many prominent health systems. Considered “safe bet” for consistent delivery and most complete integration. Prescriptive implementations a source of discomfort but also success. Data sharing outside of Epic perceived as challenging. Never uninstalled.

McKesson–Third-most new hospitals (12); no Paragon losses. Little attention from non-Horizon customers concerned about Paragon’s readiness for large hospitals. Scores from 200+ bed customers lag on implementation and usability challenges. Customers optimistic that pending upgrades will help address issues. Integrated ambulatory EMR and full-featured EDIS in development.

Meditech–Six new contracts for 6.0, four of which are migrating from MAGIC and C/S. The 6.0 scores have tumbled due to difficult MAGIC upgrades, but recent feedback indicates a possible turnaround. New and improved implementation methodology said to be around the corner. Many legacy customers await 6.1 before considering a migration.

Siemens–Four new hospitals, but 16 losses included 6 Soarian sites. Seven-point drop in KLAS scores over the last two years. Customers praise Siemens’ relationship focus but lament slow development, including an ambulatory EMR in beta and ED functionality that is still maturing. Adoption of Soarian Clinical Workflow hindered by providers’ lack of resources to develop.