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Electronic Health Records (EHRs) are a critical but expensive part of any hospital’s technology infrastructure. The following lists highlight the top ten vendors for Inpatient EHR Systems and Ambulatory EHR Systems. For both inpatient and ambulatory, Epic Systems maintained the highest market share — accounting for 39 and 41 percent of deployments, respectively. At 22 and 23 percent implementation, Cerner holds the second-highest vendor market share for both inpatient and ambulatory [EHR] systems."

In both EHR system types, the vast majority of facilities utilized Epic, Cerner, MEDITECH, or Allscripts. Median total revenue at hospitals saw a large drop off after the top four vendors. For Inpatient EHR, hospitals using one of the top four vendors had a combined average total revenue 149 percent higher than the average total revenue of hospitals using alternative vendors. The revenue disparity lessens when examining ambulatory EHR system deployments. Hospitals using one of the top four vendors had a combined average total revenue 85% higher than the average total revenue of hospitals using alternative vendors. eClinicalWorks serves as an exception in the ambulatory space with the fourth highest average total revenue for user hospitals.

Proprietary systems account for only about 2 percent of all inpatient and ambulatory EHR systems across U.S. hospitals. This is because the vast majority of hospitals using a proprietary system are part of national, for-profit corporations. Their higher [operating] margins and large geographic footprint make building and maintaining an in-house system a more practical solution for them than other, more widely-utilized vendor technologies.

For Ambulatory systems, Evident, which focuses its products on rural, community, and critical-access hospitals, was installed at hospitals with the lowest median patient revenue, median discharges, and lowest rate of affiliation with IDNs.

Top 10 Inpatient EHR Systems at Acute Care Hospitals 

Rank EHR Vendor Deployments % in IDN Median Discharges Median Total Revenue (M)
1 Epic 1,572 95% 11,988 $458
2 Cerner 907 89% 10,799 $328
3 MEDITECH 697 74% 7,054 $186
4 Allscripts 273 77% 8,008 $257
5 MEDHOST 235 89% 1,692 $46
6 Evident 184 35% 1,441 $43
7 Proprietary System 80 96% 919 $41
8 Indian Health Service 27 77% 772 NA
9 Athenahealth 23 20% 1256 $45
10 Infomedika 13 84% 4,908 $48

Fig 1 Data from Definitive Healthcare  from the Hospitals & IDNs DatabaseTechnology data is proprietary from Definitive Healthcare. Hospital data is from January 2020 Medicare Cost Report release; the next scheduled Medicare Cost Report release is April 2020.

Top 10 Ambulatory EHR Systems at Acute Care Hospitals 

Rank EHR Vendor Deployments % in IDN Median Discharges Median Total Revenue (M)
1 Epic 1,612 95 11,310 $436
2 Cerner 925 89 10,539 $319
3 MEDITECH 485 66 5,631 $157
4 Allscripts 293 76 9,111 $293
5 Evident 170 32 1,432 $42
6 eClinicalWorks 154 97 11,280 $263
7 Athenahealth 133 85 4,578 $123
8 Proprietary System 70 98 1,160 $53
9 Indian Health Service 25 84 775 NA
10 NextGen Healthcare 15 60 3,468 $121

Fig 2 Data from Definitive Healthcare  from the Hospitals & IDNs DatabaseTechnology data is proprietary from Definitive Healthcare. Hospital data is from January 2020 Medicare Cost Report release; the next scheduled Medicare Cost Report release is April 2020.