KLAS report analyzes EMR market in Canada

TORONTO – A new report from KLAS – its first-ever that focuses on the Canadian EMR sector – reports that Epic has grown significantly in Canada since 2015, becoming the preferred option in large, multihospital decisions. From 2015–2019, seven decisions finalized in favor of Epic, increasing their market share in the country from a single hospital to over 130 sites and making Epic the second largest EMR vendor in Canada in terms of hospitals contracted.

The report, “Canada EMR 2020”, notes that MEDITECH has a long history in Canada and is the largest EMR vendor in terms of hospitals contracted. 31 of the 35 hospitals (19 organizations) that chose MEDITECH’s Expanse platform from 2015-2019 were migrations from legacy MEDITECH systems, some as part of group decisions. These customers chose to gain the updated physician interface of MEDITECH’s latest platform, while retaining the familiarity of working with MEDITECH.

However, MEDITECH’s overall market share in the country has dropped – 8 other organizations (including 4 larger multihospital organizations and accounting for 88 hospitals) chose to leave (most moved to Epic).

Cerner is the only other vendor with a significant footprint in Canada. From 2015-2019, they were selected in 2 decisions (accounting for 9 hospitals).

Allscripts’ Sunrise platform has been used in Canada for over a decade. However, no hospitals have selected it in the last 10 years, and 3 customers have replaced it in that time period.

Epic’s 2015-2019 wins came in Ontario and Alberta, including Alberta Health Services, which accounts for over 100 inpatient facilities. An HIS manager reported, “There has been a national and provincial push for renewing HIS in recent years. So we have been seeing a wave of forward-thinking, larger hospitals and health systems making decisions, getting funding, and doing procurements.”

He continued, “Epic came out on top with just about everyone, certainly for every one of the leading hospitals and health systems. I think that is because of the same reasons that we see in the States or anywhere else. Epic’s system has superior functionality, ease of use, integration, and support. And Epic has superior implementations and a superior reputation. The clinicians prefer Epic’s system, so Epic always wins. And clinicians watch their peers. When one organization gets Epic’s system, the others watch and then want it too.”

One weak spot for Epic is ease of use. While Epic’s training, including their train-the-trainer approach, is generally highly regarded, one customer specifically said it didn’t adequately prepare them for the system’s complexity. Multiple other customers feel the training was strong but say the interface includes too many clicks and can be a bit overwhelming for end users.

From 2015-2019, MEDITECH Expanse was selected by over 20 organizations (some individually and some as part of group decisions), accounting for the second-highest number of contracted hospitals during that time frame in Canada. The Expanse platform was selected in a number of provinces, including Ontario and British Columbia as well as the Yukon and Nunavut territories.

The vendor’s current market makeup includes customers using legacy platforms (MAGIC, C/S, and 6.x) and customers using MEDITECH’s go-forward platform, Expanse. This latter group makes up less than a quarter of the Canadian hospitals using MEDITECH. With such a large legacy customer base, there is less opportunity for MEDITECH to add net-new wins, and the majority of their new contracts have come from legacy customers choosing to migrate to the Expanse platform, which is often viewed as a more economical option, especially for smaller organizations that still want broad functionality

From 2015-2019, Cerner, which has the third-highest EMR market share in Canada, was chosen by more net-new organizations (i.e., non-legacy customers) than MEDITECH. Two groups (representing eight hospitals) selected Cerner in Ontario, with the largest of the two being a group purchase by six hospitals in southern Ontario. Looking forward, Cerner seems poised for growth as they have been selected as a finalist in several large group decisions that have not yet been finalized.

Organizations view Cerner’s solution as being in the top tier of EMRs when it comes to functionality, and among the vendors who have had a presence in Canada for over 10 years (Cerner has been active in Canada for 35 years), Cerner has been the most successful at retaining customers. Since 2015, no Cerner customers have elected to leave the Millennium platform, and many customers have rolled the solution out to new hospitals or to new areas in their health systems (e.g., long-term care).

CPSI signed their first client in Canada in 2019; this will be a collaboration between CPSI and the customer organization to develop a CPSI solution for the Canadian market. A majority of TELUS Health’s customer base is located in Quebec (an area where KLAS has less visibility into overarching EMR plans). Outside of Quebec, TELUS Health was selected in 2015 for a territorial contract in the Northwest Territories.

KLAS is based in Orem, Utah. For more information about KLAS, please visit the website, www.KLASresearch.com.