As of today, Cerner would be my pick if I am building a smaller regional or municipal hospital. I'm not sure the corporate culture at Epic is sustainable. The turnover that others have described can't help but negatively impact customer support. But my opinion may be biased as I worked for a small regional provider (about 300 beds, including off-site diagnostic, outpatient surgery, and clinic locations). Hospitals like ours tend to implement a single vendor solution (as much as possible) for everything from EHR to patient accounting to HR to clinical support, etc. etc. Epic has a very robust and highly functional application suite. Most of the hospitals in South Mississippi have gone with them. I can see why powerhouses like Cleveland Clinic and Mayo went with Epic for their EHR. They have more leverage with the vendor when it comes to things like technical support and enhancement requests. They are also better positioned to integrate a mix of best-in-class solutions from multiple vendors. That's a lot tougher for smaller hospitals than for large hospitals and hospital systems like Encompass and Tenet who have much larger IT staffs and budgets. All hospital applications need to talk to each other and there are companies who specialize in so called HL7 interface systems that do nothing but facilitate communications between application systems. Such communication tends to go a lot more smoothly if all your applications are part of a single vendor solution. Also look and feel, and platforml consistency across applications makes internal technical support much easier and less expensive.

Before we chose a replacement for our older McKesson application suite, we had all four candidates, McKesson, AllScripts, Cerner and Epic, set up week long demonstration areas at our hospital. It was sort of like a mini-trade show. Clinicians, IT staff, HR, Accounting, Medical Records, and other hospital employees could drop in and see all the systems first hand, and discuss their needs with vendor marketing and technical pros. All employees then voted on the system they liked best. IT staff voted separately for the system they felt was technically superior. Cerner won both votes and, eventually, Memorial's business.

Meanwhile AllScripts continues to develop their hospital level suite of applications. Traditionally AllScripts targeted the stand-alone clinic market so they didn't have robust products to support things like lab, medical imaging, purchasing, etc. Memorial owns a number of clinics and most were using AllScripts. They will be the one to watch over the next decade.

The favorite system for clinicians and a favorite among support staff who have seen it is the one run by the VA. It was custom built in house so it is highly integrated, very easy to use, and provides very robust analytics. But it is also not for sale, of course. And you would need a very expensive development and programming staff to reproduce its success, something most hospitals don't have in-house.

 

Thanks for the education Mike. Our family doc's are all part of the Henry Ford Health System, so I checked my porthole. Yep, its run by Epic.

 

My local hospital also uses Epic.