Ten years ago, overall electronic health record (EHR) adoption hovered at about 72% of U.S. hospitals. Most recent data from The Office of the National Coordinator for Health Information Technology show that EHR adoption has climbed to 96%.
What is an electronic health record?
An electronic health record (EHR), also referred to as an electronic medical record (EMR) is a digitized version of a patient’s chart. EHRs store information like demographics, medical history, diagnoses, immunizations, notes, laboratory and radiology data and vitals.
EHRs are a critical piece of technology for most healthcare facilities as they serve as a digital record system for patient healthcare data.
Below we explore the top EHR systems based on inpatient market share.
Top 10 inpatient EHR vendors by market share
||# of Installs
||% of Market Share
||Epic Systems Corporation
||Evident, a CPSI Company
||Altera Digital Health, a Harris Company
Fig. 1 - Data from Definitive Healthcare HospitalView product. Data is propriety and updated on a continuous basis. Data accurate as of June 20, 2022.
Fig. 2 - Data from Definitive Healthcare HospitalView product. Data is propriety and updated on a continuous basis. Data accurate as of June 20, 2022.
Ambulatory EHRs versus inpatient EHRs
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 less need for in-house interoperability.
Inpatient systems, however, are designed for hospital settings. This requires an 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.
Epic and Oracle Cerner are the top inpatient EHR systems
Large vendors Epic and Oracle Cerner collectively hold nearly 60% 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.
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.
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 nearly 37% of the inpatient implementations.
However, with Oracle’s acquisition of Cerner, we could see the EHR vendor make some gains in market share.
MEDITECH ranks third on the list of top hospital EHR systems, however, it has a significantly small share of the market compared to Epic.
Why were EHRs adopted in healthcare?
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 count. 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 as they were excluded from the initial funding from the HITECH Act and Meaningful Use programs, which made adopting these platforms more expensive. Additionally, psychiatric hospitals must deal with additional privacy guidelines which makes it a challenge for them to adopt a standard EHR.
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 provider 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.
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