Established Vendors Lead Tumultuous EMR Market

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Allscripts is the most considered ambulatory EMR in a market rife with turnover, according to a new KLAS report, Ambulatory EMR: Win Rates, Replacements, and Provider Loyalty.

That turnover is represented by the fact that 35% of all providers interviewed for the report plan to replace their existing EMRs sometime in the next two years. This includes nearly a third of the smallest practices.

Mark Wagner, KLAS director of ambulatory research and author of the report, says about 15% of those planning to switch are driven by the need to get off a sunsetting product. "As we dig deeper, a subsection of those are moving off of legacy systems because many of those systems are not going to be certified for Meaningful Use or are not keeping up from technology perspective," said Wagner. "These practices are looking to go broader and deeper with the products."

The remaining 20% of those planning a switch are doing so because the grass just looks greener on the other side of the product fence. "There are some going from one well-known EMR to the next well-known EMR, and they need to look into the mirror to understand that maybe the problems and challenges they are facing could be as much about the way they are handling and dealing with these systems as they are with the vendor," he said.

Overall, the market is quite bullish, with ambulatory EMR sales -- both first-time and replacement -- shooting up again over the last year.

According to the report, the most popular vendor was Allscripts, considered in 16% of deals. Wagner said buyers are often drawn to names they recognize, and Allscripts may be benefitting in that respect from its recent M&A activity, including the acquisitions of Misys and Eclipsys.

"People know Allscripts for both positive and negative reasons," he said. "Whether you are most considered or most avoided, you are the most known. They are the most known at this point." Specifically, Allscripts came up as the most considered EMR by physician practices with 1-5 doctors.

Next up was Epic, considered by 12% of those looking at new systems. That number goes up significantly when looking at practices with more than 25 physicians, where it is the most considered.

Most considered by practices with between 6 and 25 physicians is NextGen. Overall, that company gets mindshare with 10% of those hitting the market for an ambulatory EMR. Interestingly, NextGen is the most considered by those going for their second or third EMR. "When you're done with your starter EMR, NextGen is a place folks are looking to go. One physician told us, 'I know I'm not using all of NextGen, and I will never run out of room to grow with the system.'"

The report also highlights AdvancedMD, athenahealth, Cerner, eClinicalWorks, e-MDs, GE Healthcare, Greenway, McKesson and Sage. For the report, KLAS conducted nearly 400 provider interviews to identify the ambulatory market’s purchasing trends and interest in various EMR products.