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Epic, Cerner Predicted to Take Hold of the Ambulatory EHR Market

October 19, 2015
by Heather Landi
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According to a peer60 report looking at both vendor market share and mind share of the ambulatory electronic health record (EHR) market, both Epic and Cerner are predicted to take even larger portions of the market among outpatient care facilities.

The study, Trends and Insights in Ambulatory EHR, is based on information from 176 C-level, director and other management positions among providers from U.S.-based ambulatory care facilities, which was collected by Peer60’s research as a service (RaaS) platform.

Ambulatory care accounts for about one-third of healthcare spending in the U.S. and with the ongoing focus on managing patient populations and improving care coordination, the larger EHR vendors are putting more emphasis on capturing larger pieces of the ambulatory pie, according to the study authors.

One portion of the study examines the ambulatory EHR market in terms of both market share and mind share, which indicates which vendors occupy the biggest space in the minds of providers that are adopting a solution for the first time or are considering a switch to a competing vendor.

Not surprisingly, EHR vendor Epic not only owns the largest piece of the ambulatory EHR market, with close to 20 percent, but also is positioned to capture a more significant share of the market in the future with a mind share score registering higher than market share, the study reported.

Cerner registered a distance second in market share, but tied Epic for the highest percentage of mind share among ambulatory providers, at about 32 percent.

The study found that athenahealth and eClinicalWorks had mind share figures at approximately eight and five times their current market share in the overall ambulatory EHR market, respectively. This indicates these vendors are finding significant ways to connect with providers, the study authors stated.

“Considering these four standout mind share numbers (Epic, Cerner, athenahealth and eClinicalWorks) together, which accounts for the vast majority of mind share, all other vendors in this space must take corrective measures or face losing relevance among ambulatory providers,” the study authors wrote.


Among hospital-owned ambulatory facilities, Cerner and Epic have both large market share and mind share figures, however, the study found that athenahealth had a high mind share percentage, at 23 percent, which indicates that this vendor could enhance its position in this market in the near future, the study reported.

Among independent ambulatory organizations, NextGen controls the largest piece of the EHR market, followed by Epic and Cerner. However, Epic and Cerner have much higher mind share figures, at above 20 percent, additional market share for these two vendors is sure to follow, the report states. And, eClinicalWorks has a significant mind share figure as well, occupying a space in one-third of the minds of independent providers. This indicates that eClinicalWorks’ market share of the independent EHR market will likely grow, according to the study.

As part of the study, providers were asked how likely they were to recommend their EHR vendors to a colleague, on a scale of one to 10, with 10 as the highest. The average score across all vendors covered in the report was 6.2. In the report, the provider recommendations scores for each vendor were displayed anonymously. The lowest score was 4.46 out of 10, while two vendors received scores of 9.25 and 8 out of 10.

Ambulatory providers also indicated that missing functionality and usability were among their biggest challenges with their current EHRs. Other challenges reported include support for their strategic objectives, service and reliability/uptime.

The study also found that the ambulatory EHR market is relatively stable, with only one in six providers seriously considering a switch to a new vendor.

“However, with a 15 percent churn rate, vendors that don’t find meaningful ways to differentiate themselves will continue to bleed out as more aggressive, customer-obsessed competitors continually look for ways to improve their message to the marketplace,” the study authors wrote.

The study also looked at merger and acquisition activity among ambulatory facilities. According to the study, the larger the facility, the greater likelihood they are currently being acquired or may have plans to be acquired in the future.




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