EMR Systems List: Complete Guide (2026)

What the data shows about hospital EHR use

The hospital EHR market is considerably more concentrated than the broader ambulatory market. ASTP/ONC reports that in 2024, three developers provided technology to over 4 in 5 US non-federal acute care hospitals.

• Epic 50.8%
• Oracle Health 20.1%
• MEDITECH 15.6%
• All others 13.4%

The market has also changed substantially over time. MEDITECH held the largest share of hospitals in 2010 at 23.3%, while Epic accounted for 8.7%. By 2024, Epic was used by 50.8% of hospitals, just over half.

This concentration is one reason hospital EMR comparisons tend to feature a relatively small group of enterprise vendors. It should not be read as a quality ranking: adoption reflects health-system size, existing infrastructure, acquisitions, setup requirements and purchasing decisions as well as product capability.

Source: ASTP/ONC, Non-Federal Acute Care Hospital Electronic Health Record Adoption, 2008–2024. AHA Annual Survey IT Supplement.

Which EHR systems do physician practices actually use?

The ambulatory market is far more fragmented than the hospital market. In ASTP/ONC’s 2024 National Electronic Health Record Survey, Epic was the most commonly reported EHR developer among US office-based physicians at 27.7%, followed by MEDITECH at 11.1% and eClinicalWorks at 7.5%.

• Epic 27.7%
• MEDITECH 11.1%
• eClinicalWorks 7.5%
• athenahealth 7.3%
• Cerner 5.5%
• NextGen 4.1%
• Practice Fusion 3.2%
• Allscripts 2.7%
• Modernizing Medicine 2.4%
• Greenway 2.1%

These figures describe reported EHR use among office-based physicians, not a ranking of which systems are best. They are useful for showing how the ambulatory market differs from the hospital market and which platforms physicians encounter most often.

Source: ASTP/ONC, Office-based Physician Electronic Health Record Adoption, 2008–2024, Appendix Table 2. NEHRS 2024, n = 1,725.

A multi-centre usability study observed emergency physicians completing the same clinical scenarios at four health systems, two running Epic and two running Cerner. For certain tasks the researchers recorded an average nine-fold difference in completion time and an eight-fold difference in clicks between sites. Error rates on a single task ranged from 16.7% to 50%.

The differences appeared even between organisations running the same EHR product, which is the study’s actual point: how a system is built and configured locally matters as much as which system it is.

For buyers, evaluate the build, not just the software. Workflow configuration, customisation, training, clinical content and local decisions all shape how efficiently clinicians can work.

Ask prospective vendors to demonstrate your own high-frequency workflows rather than a standard product demo. Bring the clinicians who will use it daily, and test documenting an encounter, reviewing results, prescribing, answering messages and placing common orders.

Research source: Ratwani et al., A usability and safety analysis of electronic health records: a multi-center study. JAMIA, 2018;25(9):1197–1201.

Practice size changes the EHR landscape

Practice size does not just affect which features a medical group needs. It also tracks differences in EHR adoption and in how concentrated the vendor field is.

• 1 physician 86.1%32%
• 2–3 physicians 94.2%51%
• 4–10 physicians 97.9%60%
• 11–50 physicians 98.4%74%
• 51+ physicians 99.1%90%

Used any EHR Used one of the five leading developers

Adoption rises with size, from 86.1% of solo physicians to 99.1% in practices of 51 or more. The vendor mix shifts further still: about 90% of physicians in practices of 51+ used one of the five leading developers, against roughly 32% of solo physicians.

That distinction matters when comparing EMRs. A solo practice has a much wider field of viable products, while larger organisations often need enterprise capability such as extensive interoperability, centralised administration, analytics and support for more complex clinical and operational workflows.

Source: ASTP/ONC, Office-based Physician Electronic Health Record Adoption, 2008–2024, Table 1 and Figure 3.

Do not treat “integrations” as a yes-or-no feature

An EMR advertising integrations does not tell you how easily it will exchange data with the systems you already run.

In a national survey of 141 digital health companies, 92% had an integration underway with at least one EHR and 78% with two or more. Successful integrations were reported most often with Epic (64%), athenahealth (37%) and Cerner (36%).

Go past asking whether a system “supports integrations.” Ask which ones are already live, whether it supports standard FHIR APIs, what data moves in and out, whether interfaces carry extra fees, and whether connecting a new application needs custom development.

For an organisation with an established technology stack, those answers can matter as much as the native feature list.

Research source: Barker et al., A national survey of digital health company experiences with electronic health record application programming interfaces. JAMIA, 2024;31(4):866–874.

Patient access is now a core capability, not an add-on

Patient-facing digital access is close to universal in US hospitals. In 2024, 99% let patients electronically view their health information, 96% download it, 95% view clinical notes, 92% message providers securely and 81% reach records through API-enabled apps.

Hospital capability is not a minimum specification for every independent practice. It does show how expectations around record access have moved.

When evaluating an EMR, look past whether it has a patient portal and ask what patients can actually do in it: view results and notes, message securely, download records, use apps, request appointments and handle routine tasks without calling your staff.

Source: ASTP/ONC Data Brief 79, Growth of Health IT-Enabled Patient Engagement Capabilities Among U.S. Hospitals: 2021–2024.