DH Intelligence releases report on EPR contract wins and migrations

Digital Health Intelligence released its latest electronic patient record (EPR) contract wins and migrations snapshot report on Thursday.

After a mixed 2023 that saw a flurry of EPR contract awards and go-lives as well as partial raids on digital funding, 2024 looks set to see an acceleration of announced awards as those trusts without a preferred EPR provider seek to meet the target set in the government’s goal for 90% of NHS trusts to have an EPR by December 2023 and all hospitals by 2025.

NHSE said the 90% target was achieved ahead of schedule in November 2023. Trusts and Integrated Care Systems (ICSs) are being urged to “converge” their EPRs in order to help streamline the range of systems used across the NHS.

Yet questions remain about this schedule. The Frontline Digitisation programme, launched in 2021 to elevate trusts to a minimum capability level, has extended its deadline to March 2026.

However, budgetary constraints have had a significant impact on the programme, with the original £2.6 billion budget slashed to £1.9 billion in early 2022 and likely to be further reduced due to the impact of industrial action on budgets.

While funding priority is being given to the least digitised trusts, many of those with an EPR already in place, which were initially promised funds to improve or extend their systems, are now uncertain of the support they will receive.

Fears of a market duopoly recede

The report, which covers acute trusts from July 2022 through December 2023, includes segmentation of trust EPR installations, volume of EPR contract expiry dates by year, top contract wins and losses by supplier and changes in market share.

The report identifies seven companies – Oracle Health (formerly Cerner), MEDITECH, Epic, System C, Nervecentre, Dedalus and Altera – as the top suppliers to the market.

Of the leading suppliers, MEDITECH secured the most wins from trusts without prior systems, whereas Oracle outperformed its competitors in terms of migrations. Both System C and Dedalus experienced losses, with further setbacks expected this year from trusts replacing systems.

With three confirmed wins, Nervecentre is on course to join the top ranks, as DHI anticipates three additional trusts will sign with them this year.​ With regard to market share, Oracle is the clear market leader, with five contract wins in the past 18 months.

The report noted that as of December 2023, 19 acute trusts (13%) out of 134 in England were without a live EPR but either in the process of business case development, actively procuring or implementing the system.

It found that just six acute trusts across the North East and Yorkshire, Midlands and the South East are without a system and have no announced plans to procure one, down from 12 trusts in that situation in July 2022.

While the EPR market has faced adjustments in its timeline and budget, it remains resilient and the landscape is likely to continue evolving as trusts look to incorporate best-of-breed solutions and converge systems to enhance integrated care.

You can download the latest EPR Snapshot Report 2023 here.