Electronic health record giant Epic continued to amass a greater share of the U.S. hospital market in 2024, adding 176 multispecialty hospitals and 29,399 beds. The health IT company now commands 42.3% of the acute care EHR market, up from 39.1% a year prior.
In 2024, 10 large health systems chose Epic for 108 hospitals — 67 of which were from just two organizations contributing to Epic’s largest net gain on record, according to KLAS Research's latest EHR market share report.
"Over the last decade, Epic has been the only vendor chosen by large health systems making go-forward EHR decisions, leading to their consistent growth in market share," KLAS Research analysts wrote.
Epic also had the most 2024 wins among small standalone hospitals, thanks to the stable customer experience with its Community Connect solution. This contributed to Epic winning nearly 70% of all hospitals, regardless of size, impacted by EHR decisions in 2024, KLAS Research reported.
Epic is the only EHR company to gain hospitals last year.
In 2020, the Verona, Wisconsin-based company had a 31% share of the acute care hospital EHR market, according to KLAS' 2021 report, and its steadily grown over the past five years.
Epic's gain has been Oracle Health's loss, according to KLAS' estimates. Oracle bought Cerner, a competing EHR vendor, for $28.3 billion in June 2022 and the company lost a net 74 hospitals and 17,232 beds in 2024.
The company now has a 22.9% share of the acute care hospital EHR market, down from 23.4% a year prior, according to KLAS' estimates. Cerner's market share stood at 25% in 2020.
It's the first time Oracle Health declined to share a list of new contracts with KLAS. The healthcare IT data and insights company said it relied on publicly available resources and its standard internal research methods to calculate Oracle Health's "wins" in 2024.
The market share counts for Oracle Health are estimates, particularly for smaller hospitals, where purchase decisions are less likely to be publicized, the researchers said.
KLAS counted 9 multispecialty acute care hospitals that selected Oracle Health in 2024 — two standalone hospitals and 1 small health system with seven hospitals.
The strength of vendor partnerships has emerged as a key differentiator in the EHR market, the researchers noted, and that likely has contributed to Epic's continued gains with providers, particularly large hospitals.
"Epic purchase decisions have often been driven by the stability and interoperability capabilities of the product as well as generally high satisfaction among current customers. Beyond strictly technological considerations, Epic’s reputation for customer partnership has brought them to the forefront of most EHR considerations," KLAS Researchers wrote in the report.
Many large health systems that have considered Epic but have not made the switch cite the cost of switching platforms—in terms of both financial and human resources—as the main barrier.
Oracle Health is at a critical juncture, market researchers say. "As has been the case historically, healthcare organizations continue to cite poor partnership and a lack of follow-through on promises as some of their biggest concerns," KLAS wrote.
Following the Oracle-Cerner deal in 2022, analysts at KLAS Research spoke with customers over the course of a year and found that CIOs were concerned about the company's vision.
"In March 2022, respondents were generally more optimistic about Oracle Health being a long-term partner. That optimism has dropped over the course of the year, and in November, about one-fourth of respondents reported they no longer see the vendor as a viable long-term partner," KLAS Research analysts wrote in a March 2023 report.
While many Cerner customers hoped the 2022 acquisition by Oracle Health would lead to relationship
improvements, the vendor’s loyalty and relationship ratings have dropped over 10 points since November 202, just before the announced acquisition, analysts noted in the latest report.
Analysts noted that throughout 2023 and 2024 Oracle Health implemented several major technology developments, including its clinical AI agent, seamless exchange capabilities and Oracle Cloud Infrastructure. The company also made announcements about other new capabilities, such as a next-generation EHR and patient portal.
These recent developments, especially the clinical AI agent, have led to "cautious optimism" among some current and potential customers, KLAS noted.
"More than one-third of customers report that over the last six months, there has been a positive change in the vendor’s execution/delivery; this represents a notable change from the overall sentiment during the last couple of years," analysts wrote.
KLAS' report evaluates U.S. acute care EHR market share, based on purchase decisions made from January 2024 to December 2024.
Acute care EHR purchase energy slightly cooled in 2024, analysts noted. Across all hospital types and including migrations, 272 hospitals were impacted by an EHR purchase decision, as opposed to 319 in 2023.
Health systems continued to drive most of the decisions in 2024. Vendor relationships are becoming a key factor in purchase decisions. "A vendor’s reputation for listening to customers, taking feedback, and implementing requested changes greatly impacts customer satisfaction—often translating to gains in overall market share," KLAS wrote.
How other EHR vendors fared in 2024
Meditech lost 57 hospitals and 6,979 beds in 2024. The company's acute care hospital market share now stands at 14.8%, down from 16% a year prior.
Meditech's overall negative net change in market share was largely due to one large health system that moved 41 hospitals from Expanse to Epic, according to KLAS' report. Of the 23 multispecialty organizations that left Meditech, 19 of them chose Epic—13 to the EpicCare platform, and 6 to Epic Community Connect—citing the potential benefits of interoperability with other nearby Epic organizations.
Additionally, 11 specialty hospitals, mostly behavioral health and surgery hospitals, moved to Meditech in 2024, nine of which came from health systems that standardized their organization to Meditech.
Meditech continues to have very high retention of legacy customers, the report notes. Relative to other vendors in the market, the company has by far the largest percentage of customers still on legacy products, comprising over 400 hospitals, about half of its overall customer base.
"As such, every year, many of these customers decide whether to move to the go-forward Expanse platform or to another vendor’s product. In 2024, 63% of legacy Meditech customers who made a go-forward EHR decision chose to migrate to the Expanse platform, more than doubling the 30% in 2023," KLAS researchers wrote.
Interviewed legacy customers who moved to Expanse, especially small hospitals, cited the enhanced technology with Meditech as a Service (MaaS), the potential value over other solutions, and the stable vendor relationship, including close involvement with executives as the vendor works to address customer needs.
Other EHR vendors evaluated in the report include TruBridge (7.6% share of acute care hospital market), Altera Digital Health (3%), Medhost (2.3%) and Azalea Health (0.4%). Other EHR vendors made up 6.7% of the market.
In May 2022, N. Harris Computer Corporation, a subsidiary of Constellation Software, bought health IT company Allscripts' hospital business segment which included Sunrise, Paragon, Touchworks, Opal, dbMotion, STAR and Healthquest solutions. That business, now operating as Altera Digital Health, saw no net-new contracts or migrations in the acute care hospital market in 2024.
Current Paragon customers are focused on upgrading to Denali, the web-enabled version of Paragon, KLAS noted. "Efforts to improve partnerships, including technology enhancements to Paragon and greater executive communication, have led to increased customer satisfaction and optimism. Time will tell whether these efforts influence future market stability," the analysts wrote.
In January, N. Harris Computer Corporation also acquired Medhost, a health IT company that serves community and rural hospitals. Medhost saw no net-new contracts in 2024. Since the Harris Healthcare acquisition, interviewed customers have reported an update to the clinical documentation tool and some changes to the support structure.
"Overall, though, respondents note it is too early to know the full impact of the acquisition and don’t feel they know Harris Healthcare’s long-term plans for the system," KLAS wrote. Of Medhost’s losses, two hospitals moved to Meditech Expanse, one to Epic Community Connect, and one to TruBridge.
TruBridge, formerly CPSI, continues to be viewed as a good option for small hospitals to meet their budgetary needs, KLAS researchers noted.
"The vendor’s efforts to partner with customers and improve the product in 2024 have led to a slight increase in overall customer satisfaction that has coincided with a net increase in bed market share. Still, TruBridge had negative net hospital market share," KLAS wrote.
Five hospitals moved to Meditech Expanse, one moved to Oracle Health, and nine hospitals moved to Epic.