Who are the largest EHR vendors?

According to a report by Technavio, the 30 billion USD global EHR market will increase by 49.41 billion USD by 2029. By most estimates over 500 vendors are offering some type of EHR product.

Despite the sheer size and saturation of the EHR market, the lion’s share of the EHR market based on subscriber or revenue metrics is controlled by a small fraction of vendors. These large players in the EHR marketplace control large chunks of market share serving many of the various niche EHR markets.  

Who are the largest EHR vendors? To answer this question, it is important to look at the market segments that align with products aimed at servicing organizations within a specific care setting and the major players in the overall EHR market. 

Hospital EHRs

According to Definitive Healthcare, Epic EHR and Oracle Health hold the largest share of the acute care hospital EHR market. Based on data from the Atlas Technology Install Dataset and HospitalView, their 2024 examination of inpatient hospitals in the US, market share can be divided as follows: 

1. Epic: 37.7%
2. Oracle Health (Cerner): 21.7%
3. Meditech: 13.2%
4. Evident (CPSI): 9%
5. Altera Digital Health: 3.4%
6. Medhost: 3.3%
7. WellSky: 2.6%
8. Vista: 2.3%
9. Netsmart Technologies: 2.1%
10. Other: 1.3%

Ambulatory EHRs

The ambulatory market offers more diversity in the number of vendors who hold a meaningful share of the ambulatory EHR market.

In recent years, patient care has shifted significantly, with ambulatory (outpatient) care growing in popularity as hospital visits decline.

This shift has fueled steady growth, with the U.S. ambulatory EHR market projected to reach 3.97 billion USD by 2031, according to Research and Markets

1. Epic Systems Corporation 43.92%
2. Oracle Health (Cerner) 25.06%
3. Meditech 12.95%
4. TruBridge. 6.32%
5. Veradigm Inc (Allscripts) 3.6%
6. Athenahealth 2.01%
7. Medhost 1.42%
8. Netsmart Technologies 1.31%%
9. Vista 0.77%
10. WellSky. 0.74%

The 3 biggest players in the overall EHR market 

The EHR market has undergone significant changes over the years, but a handful of key players continue to dominate; Epic, Oracle Health (formerly Cerner), and Veradigm (formerly Allscripts) have solidified their positions in both hospital and ambulatory EHR markets. To understand their dominance, it’s essential to examine their growth and strategies within these two key segments.

Epic's dominance in the acute market

Epic Systems has long been a major player in the acute care hospital EHR space. According to Definitive Healthcare’s recent analysis, Epic now commands a 37.7% share of the acute care market, up from 28% in 2019. This growth is due in part to its seamless integration capabilities, comprehensive tools for clinical documentation, and a strong reputation for reliability.

At the time of this article's original publication, KLAS reported that Epic had the highest net market share gain, acquiring integrated delivery network hospitals, standalone hospitals, and new add-on customers. This trend continues, as Epic focuses on serving larger health systems looking to streamline operations and improve interoperability.

A strong showing in the ambulatory EHR market

Epic’s dominance extends into ambulatory care, where it holds an impressive 43.92% market share.  Its reputation for innovation and customer satisfaction has made it the go-to choice for large health systems managing diverse care environments.

Oracle Health's position in the acute care market

Oracle Health, previously known as Cerner, maintains its stronghold in acute care with a 21.7% market share. While its market share has seen some fluctuation, the company remains a key player, particularly among government institutions.

Cerner’s historic partnership with the Department of Veterans Affairs (VA) encompassing 147 acute care and 20 specialty hospitals underscored its influence in large-scale healthcare IT implementations. Oracle's $28.3 billion acquisition of Cerner in June 2022 further strengthened the brand despite some early obstacles.

Oracle's role in ambulatory care

Oracle Health has a smaller presence in the ambulatory EHR market, holding 25.06% market share. Despite this, it remains a strong competitor due to its established relationships with large health systems that use Cerner products for both inpatient and outpatient care. 

Allscripts’ historical influence

Once a leader in the ambulatory EHR space, Veradigm Inc. (formerly Allscripts) now holds a smaller market share, at just 3.6% in ambulatory settings. This marks a decline from previous years, reflecting increased competition from larger players like Epic and Oracle Health.

Veradigm continues to innovate, particularly in niche outpatient markets. By focusing on specialized solutions for smaller practices and outpatient providers, it retains a foothold in the market, albeit less significant than its competitors.

Smaller vendors in a consolidating market

While Epic and Oracle Health dominate, smaller vendors like Meditech (13.2%), Evident (9%), and Netsmart Technologies (2.1%) maintain relevance in the acute care market. These vendors often cater to smaller hospitals, rural healthcare providers, and specialty care facilities, offering tailored solutions that larger vendors may overlook.

Diversity in the ambulatory market

The ambulatory EHR market remains more fragmented than its acute care counterpart, with smaller vendors like TruBridge, Medhost, and WellSky finding success in specific niches. For example, Medhost serves rural and community hospitals, while Netsmart focuses on behavioral health and post-acute care.