The 10 most common inpatient EHR systems by 2021 market share

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Ten years ago, overall electronic health record (EHR) adoption was hovering at about 72% of U.S. hospitals. Most recent data from The Office of the National Coordinator for Health Information Technology show EHR adoption has climbed to 96%.  

EHR adoption spurred on by the HITECH Act   

The Health Information Technology for Economic and Clinical Health (HITECH) Act helped to advance the fast embrace of EHRs thanks in part to financial incentives for Meaningful Use. The HITECH Act passed in 2009 and was designed to encourage healthcare providers to utilize electronic data recording and sharing technology, such as EHR systems, to improve clinical quality and care transparency among patients.  

But what about the remaining hospitals that have not yet installed EHR systems? The holdouts tend to be on the smaller end of the spectrum in terms of both revenue and bed size. They typically are also more likely to be more specialized facilities. Specifically, psychiatric hospitals are the most likely to not have adopted an EHR yet

Ambulatory versus inpatient EHR systems 

Ambulatory or outpatient EHR systems are designed for use in small physician practices and other outpatient facilities. These EHRs are often only used within a single department and have little need for in-house interoperability.  

Inpatient systems, however, are designed for hospital settings. This requires a EHR system to function for multiple departments, and in-house interoperability is emphasized more than in an outpatient setting.  

Though choosing the right inpatient EHR application can be challenging, having an EHR system in place is advantageous compared to the traditional manual method of printing and note-taking. 

Top 10 Inpatient EHR vendors by market share 



Market Share 











Evident, a CPSI Company 









Netsmart Technologies 






Harris Healthcare 



Indian Health Service 






Fig 1 Inpatient EHR vendor market share. Data from Definitive Healthcare's HospitalView. Data accessed in June 2021. 

The EHR vendors that dominate the inpatient space 

Large vendors Epic and Cerner collectively hold over 50 percent of the inpatient EHR market share. While dominated by large nationwide vendors, smaller vendors and proprietary systems are still holding their own, particularly in rural and critical access hospitals.  

It is true that larger hospitals are more likely to implement advanced EHR systems like those offered by Epic and Cerner, but 80 percent of critical access and rural hospitals reported using at least a basic EHR system

In addition to dominating the inpatient EHR market, Epic and Cerner collectively also hold over 50% of ambulatory EHR market share. 

We've seen Epic as the biggest mover of EHR market share over the years. In 2009, Epic captured around 5% of the EHR market share and now accounts for around 34% of the inpatient implementations. Cerner could be poised to gain more market share with Oracle's proposed acquisition of the EHR vendor. 

On the flip side, a few bigger vendors have seen their market share decrease significantly. MEDITECH saw its market share decrease nearly 13 percentage points since 2009, although they still rank third in terms of the overall market share. 

What's next for EHRs? 

EHR systems do a great job of managing the patient record, but they can lack functionality for other services.  

Modules such as clinical decision support systems, patient portals, and computerized physician order entries have been at the forefront of this next wave.  

We will also start to see ancillary systems such as laboratory information systems, oncology management tools, operating room software, and other deeper-level integration programs start to tie together not only hospitals but also associated sites of care like physician groups and surgery centers

Learn more 

Want to learn more about EHR market share, and which EHR vendors and systems a particular hospital uses? Interested in learning about other technologies that hospitals are implementing, like telehealth systems, health information systems, patient portals, etc.?  

Definitive Healthcare's platform can help you: 

  • Determine vendor market share of specific technologies 

  • Assess which technology modules, vendors, and applications a facility is using. 

  • Segment technologies by type (EHR, data sharing and management, revenue cycle management, etc.)  

  • And much more! 



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