The new U.S. Acute Care EHR Market Share 2024 report from KLAS shows one electronic health record vendor pulling well ahead of the pack as it continues to add new hospital and health system clients. And it probably won't surprise you who it is.

WHY IT MATTERS
Verona, Wisconsin-based Epic Systems saw a significant net market share increase this past year – and in fact was the only EHR vendor to achieve one, according to KLAS. It didn't lose any clients either.

In adding 153 new acute care clients – across health systems, stand-alone hospitals and customer add-ons, Epic now has a footprint that includes more than half of inpatient multispecialty beds across the U.S.

"Both current and prospective large-organization customers are drawn to Epic because they see the vendor as a consistently high performer that provides strong healthcare IT, quality relationships, and the opportunity to streamline workflows and improve clinician satisfaction," researchers said. "Large specialty organizations have also turned to Epic to consolidate IT systems."

As for Epic's longtime rival, Cerner – now known as Oracle Health – the past year was one of attrition, however. It saw the "largest net hospital loss on record, the result of multiple large multispecialty organizations choosing to leave," according to KLAS.

Moreover, its growth among smaller independent hospitals of 200 beds or fewer has also slowed, the report shows.

Among those hospitals that have signed on, "net-new standalone customers that contracted with Oracle Health in 2023 cited a desire to improve integration, enhance relationships with exchange partners, and leverage the vendor’s broad technology platform," researchers write.

Another legacy EHR giant, Meditech, also saw its retention rate decline in 2023 – a big change from the previous year, when it was at an all-time high, according to KLAS.

"Meditech’s legacy customer retention rate – which has historically been 40%–50% – jumped to 84% in 2022 due to a large health system’s decision to migrate from MAGIC to Expanse," researchers write. "In 2023, however, the retention rate dipped to the lowest on record; about one-quarter of their legacy losses were due to merger and acquisition activity, while the remaining losses were more competitive."

The news was mixed for other smaller EHR players.

Altera Digital Health, which traces its roots to the former Allscripts and is now owned by Harris, "refocused on Paragon as their primary platform for smaller hospitals, with Sunrise being primarily for midsize hospitals," the KLAS report shows. "In 2023, three small health systems (comprising seven hospitals) contracted for Paragon; additionally, one Sunrise customer migrated to Paragon."

TruBridge, formerly known as CPSI, earned two new customer add-ons and three new standalone multispecialty hospitals; additionally, five legacy customers migrated to TruBridge EHR (formerly Evident Thrive)."

Both Azalea Health and Medhost saw no new or net-new contracts in 2023, said KLAS researchers, as "purchase energy among small standalone hospitals decreased overall."

THE LARGER TREND
While major health systems were among the bigger movers and shakers in 2023, that's in contrast to the year before, when smaller hospitals were driving EHR market demand.

Recognizing the need to do better to keep their clients happy – to keep their clients, period – vendors have become much more proactive in their service offerings and customer retention efforts, as was shown in the 2024 Best in KLAS report from earlier this year.

Oracle Health, for instance, has added new generative AI capabilities to its EHR platforms. But so has Epic.

This past year saw some significant health system migrations – such as longtime Cerner clients Intermountain and UPMC – away from Oracle Health and toward Epic.

Other major health systems that made moves to Epic in 2023 included Boston Children's Hospital, which announced plans to unify and consolidate its disparate systems with the vendor, and Northwell Health, a longtime Allscripts client that announced in March 2023 it would migrate to Epic.

ON THE RECORD
"Acute care EHR purchasing remained high throughout 2023," said KLAS researchers in the report. "While market energy in 2022 was mostly driven by small organizations, the majority of 2023 purchases were the result of large multispecialty and specialty organizations making go-forward decisions.

"Of the 319 hospitals impacted by go-forward decisions (including migrations and specialty hospital wins), 79% were part of health systems while the remainder were standalone hospitals," they added. "Key decision drivers were acquisition activity and the need to streamline IT departments and improve clinical usability."

Mike Miliard is executive editor of Healthcare IT News
Email the writer: mike.miliard@himssmedia.com
Healthcare IT News is a HIMSS publication.