According to a new report from the Orem, Utah-based research firm, KLAS, Epic and Cerner have moved into first and second place, respectively, in the 200-plus bed EMR market thanks to strong integration options. The KLAS study, Clinical Market Share 2012: Meaningful Use Momentum Continues, looks at the clinical vendor market share across 1,470 U.S. hospitals and 151 Canadian hospitals.

The KLAS report says that other EMR vendors such as Allscripts, McKesson, MEDITECH, and Siemens brought on new clients, but lost market share in larger hospitals as organizations steer toward higher levels of integration and clinical functionality.

"Many providers who might normally be patient with their vendors feel they can't afford to wait." report author Colin Buckley, said in a statement. "They want an integrated platform with stable meaningful use functionality that their physicians won't fight them over. Additionally, meaningful use deadlines are forcing some providers back to the market sooner than expected."

In addition, KLAS compared vendors in three scenarios of special interest to providers when considering a new EMR: satisfaction for clinical users, rate of meaningful use attestations, and quality of implementations. Performance in these three areas correlates with market share success.