So what explains the apparent disparity between the HIMSS Analytics Database, and the KLAS and Black Book results?

Partly, you need to read the fine print. For instance, in the Black Book Market Research release, an explanatory paragraph notes that 32 percent of large hospitals are reevaluating their vendors, but only 19 percent indicate that the reevaluation “will likely lead to a replacement system.”

So what the Black Book report really says is that only one in five large hospitals participating in the survey are “likely” to replace their EHRs. Which in turn begs the questions “How likely?” and “When?” Since EHR replacement projects at large hospitals can take several years to complete, even the 19 percent that are likely to replace their EHRs won’t do so in the same year.

That may also explain some of the KLAS findings. Assuming KLAS conducted the research in mid- to late-2013, finding that “nearly half” of large hospitals will replace EHRs by the end of 2016 would mean that about 14 percent of large hospitals plan replacement each year.

That’s a 40 percent higher annual replacement rate than the HIMSS Analytics data suggest, or about 64 more hospitals a year (based on 1,600 hospitals with more than 200 beds).

Another explanation for the difference in perspectives might be the nature of the data itself. KLAS’ methodology includes sampling the industry, and it provides opportunities for self-reporting. Thus, potential for sample bias exists.

Think about the 1948 election, and the Chicago Tribune headline that read “Dewey Defeats Truman.” Truman actually won, but the newspaper made its erroneous prediction based on early election returns and polls that appeared to show an inevitable Dewey victory. But the early returns weren’t representative samples, and the polls’ samples were biased because they relied on telephone surveys – people without phones weren’t represented in the sample.

It could be that hospitals that have “concerns about outdated technology and health system consolidation,” as the KLAS report noted, were more likely to participate in the study. This would weight the sample in favor of hospitals with purchasing plans, since unhappy CIOs are more likely to invest in replacement systems than CIOs who are content with their EHR.

What conclusions do I draw? All three research firms seem to predict that between 8 and 14 percent of large hospitals will be buying new EHRs in each of the coming years. The difference is significant, but not extraordinary.

More importantly, the range is consistent with HIMSS Analytics historic data for the past five years (a range of 8.2 percent in 2013 to 14 percent in 2008). So I don’t see a surge, a spree or even a wave, in this case – just business as usual.