Allscripts, McKesson, Meditech and Siemens are losing market share in hospitals with more than 200 beds, as the better integrated product lines of Epic and Cerner lead the pack, according to vendor research firm KLAS Enterprises.

A study of market share across 1,470 U.S. hospitals and 151 in Canada shows larger hospitals favoring higher levels of integration and clinical functionality, with Epic the leader, followed by Cerner.

Meaningful use deadlines are forcing providers back into the EHR market sooner than they expected, and they can’t be patient and wait on existing vendors, says report author Colin Buckley. “They want an integrated platform with stable meaningful use functionality that their physicians won’t fight them over.”

The report lays out new market share dynamics and rates vendors on satisfaction by clinician users, rate of meaningful use attestations and quality of implementations. The report, “Clinical Market Share 2012: Meaningful Use Momentum Continues,” is available at

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