A Look at the Global (Non-US) EMR Market Share in 2019
When it comes to the global landscape, KLAS measures 5 different regions outside of the US: Asia/Oceania, Canada, Europe, Latin America, and the Middle East/Africa. In 2018, we found that 377 hospitals across those five regions were affected by EMR purchases. 303 hospitals signed new contracts, and a surprising 74 hospitals migrated to new systems.
The Global (non-US) EMR Market Share 2019 report is a way for us and providers to understand where other healthcare organizations throughout the world are making their investments in terms of HIT spending trends. The data can often be surprising, as it was this past year with major migrations from older legacy platforms to newer versions.
It is important for us to understand which vendors have the highest energy in the market. We want to know year over year which vendors are being considered and why. That information is crucial to the healthcare provider community as they make their investments and buying decisions.
A Change from the Past
We publish a Global (non-US) EMR Market Share report every year, so we are able to see what is changing from year to year. In 2018, we saw a few changes from the past.
We measure both multiregional vendors and regional vendors throughout the 5 non-US regions. While regional vendors only have customers in a certain region, multiregional vendors have customers spread throughout two or more regions.
In 2018, we found that multiregional vendors were able to scale their product to larger organizations, especially public tenders. Public tenders essentially shaped the 2018 global EMR landscape. These state- and province-wide decisions represented only 5% of the total contracts signed in 2018, yet they accounted for over a quarter of the hospitals that were impacted.
The public tenders we measured made huge decisions that impacted hundreds of providers. We saw multiregional vendors scale their product for large state- and province-wide decisions in 3 of the 5 international regions that we measure.
We anticipate that in the Global (non-US) EMR Market Share 2020 report, we will see even more state- and province-wide decisions being made. We are keeping an eye on that in particular to see whether our expectations from preliminary provider conversations come to fruition.
More Migrations Than Expected
Another big change from years past is related to migrations. This past year, we were better able to measure migrations for certain vendors, and the high number surprised me. In total, we collected data on 74 migrations. Because of the magnitude and scope of the migrations, we wanted to highlight that data in the report.
Four major vendors experienced migrations, and one of those vendors was Cerner. Cerner had 30 migrations alone in Sweden; an entire province switched from the older Siemens platform to the Millennium platform.
MV and Philips, regional vendors in Latin America, also had a number of migrations. MV far surpassed all other regional vendors when it came to the number of contracts signed, both in terms of migrations and new wins. They also expanded their contracts outside of Brazil, where approximately 90% of their market is, and signed with their first customer in Ecuador in 2018.
The Challenges of Expanding into New Regions
The deployment of EMRs looks different in every country, so each country and region comes with its own deployment complexities. Region-specific regulations, currency exchange, culture, and language barriers can all be significant challenges for vendors.
For example, one vendor who was working with a prospective client in a different region had to translate a few hundred pages of the tender contract documentation into the prospective client’s native language. Conditions like that are costly and risky, and when that prospective client ultimately didn’t select the vendor, the vendor’s efforts ended up being a waste of time and money.
To avoid these and other issues when working with outside regions, vendors sometimes set up a kind of partner network so they can have local distributers in a new country. Those distributers can then represent the vendor.
To learn more about EMR deployment, KLAS will be publishing a global EMR implementation report in July 2019. Be on the lookout for that report to learn more about how vendors are successfully implementing EMRs outside of the US.
Which Vendors are Doing Well?
Some vendors successfully gained new contracts in 2018. For example, Epic and Cerner are slowly but surely gaining more ground internationally. Cerner has a lot of experience internationally; they have been in the international arena much longer than Epic has. But Epic is still doing pretty well for themselves, despite their perceived high price point. They contracted more new beds than any other multiregional or regional vendor.
Among the multiregional vendors, Dedalus, Agfa HealthCare, and InterSystems were successful in that they landed contracts in several different regions. Among the regional vendors, everis—a vendor based in Spain that sells to Latin America—signed the second largest contract in any region with a large Argentinian province.
On the flip side, MEDITECH did not win a lot of new deals in the last year. In one particular region, they won a new contract but lost another one. Providers are finding that there are more options in the market, and although MEDITECH is investing a lot of time and effort into their new Expanse product, the functionality and robustness are yet to be proven.
Finding the Best Fit
Overall, many vendors are seeing a lot of success as they gain more customers and grow into new countries and regions. The hope is that providers can use this report to discover where there is energy in the market, which vendors are selling the most/least and why, and which vendors would work best for certain providers.
To see more data and details, check out the report.
   Photo cred: Shutterstock, Alex Mit