This document provides a summary of the 2016 annual review of leading healthcare information systems (HIS) vendors ranked by revenue. It discusses the long history of such vendor reviews dating back to 1980. Definitions of what constitutes an HIS vendor are provided, excluding large firms that do not offer complete hospital information systems. Revenue figures for 2015 are presented along with analysis of changes from 2014 and notable trends for top vendors such as growth for Cerner and declines for McKesson, Meditech, and Evident. The review highlights the addition of athenaHealth and the potential entry of eClinicalWorks into the hospital HIS market. Plans are outlined to examine the performance of the top 10 vendors broken into market segments in follow-up discussions

1. 2016 HIS Vendor Review
© 2016 by H.I.S. Professionals, LLC, all rights reserved.
By Vince Ciotti & Susan Pouzar
HIS Professionals, LLC
1980 1990 2000 2010 2015

2. HIS-tory of Vendor Reviews
• If you’ve been reading the few print magazines in our industry
along with getting far more unvarnished insights from HIStalk,
you’ve probably followed our annual review of the leading HIS
vendors in order of their annual revenue for many years:
– Original credit for the idea must go to Bill Childs who created
this whole media when he started his Computers in Hospitals
magazine in 1980 with a whopping 52 page first issue.
• Bill’s magazines morphed & were renamed
many times over the years, and subsequent
rags expanded the vendor review from 25 to
100 vendors, in issues running 200+ pages.
• We’ve been continuing Bill’s tradition of HIS
vendor revenue reviews for about the past 20
years, recently listing it on HIStalk, the source
today for the latest HIS vendor information.

3. Definitions
• It’s important to define what one means by an “H.I.S.” vendor
since some HIT print rag’s rankings include billion-dollar firms in
their top 10 list like Optum, Dell, Cognizant, Phillips and Xerox,
that don’t really offer an H.I.S. system, which we define as:
- Hospital – acute care facilities are the primary
market, not “just” physician practices, managed
care, long term care, home health, PACS, etc.
- Information – the full suite of apps needed to
automate a hospital: both financial and clinical
systems. Thus, specialty vendor like Sunquest for
LIS and Oracle for ERP are excluded.
- Systems - the complete package of hardware,
software and implementation. This excludes
giants like Dell, CSC, IBM, Leidos, HP, etc, who
“only” offer hardware and/or consulting.

4. HIS Vendors Revenue for 2015
• We obtained the figures from year-end earning reports, SEC
filings (K-10s) or written communications received from the
vendors themselves. Estimates had to be made for only one
company that are privately held: QuadraMed/ N. Harris.

5. 2015 vs. 2014 Revenue
• This bar chart illustrates the increase/decrease in revenue per
vendor from last year, as well as the huge disparity in dollar size:

6. 2015 Revenue Shockers
• There are some surprises in this table that deserve highlighting:
- Cerner – forged way ahead of #2 McKesson for
the lead in the HIS industry by revenue for the
second year in a row, due mainly to the ≈$1.2B
they gained from Siemen’s largely remote-hosted
client base, the deal closed in February of 2015.
- McKesson, Meditech & Evident (CPSI) – actually
declined in revenue by ≈10% each, reflecting the
lack of HIS sales in this post-Meaningful Use market
when so many hospitals are reluctant to switch
systems again after costly upgrades for HITECH $s.
- Slow Growth – most other vendors showed little or
no revenue growth compared to previous years,
such as Allscripts, Medhost and QuadraMed.

7. Newbies
There is one new vendor in this year’s revenue review, and another
who will be in it shortly, that are well worth highlighting:
• athenaHealth – a huge physician practice vendor with ≈$1B in
revenue that entered the HIS market by acquiring small (mainly
CAH) hospital vendor RazorInsights (≈$2M in revenue) in 2015.
– RazorInsights = a modern cloud-based EMR with a solid &
integrated RCM, priced on an SaaS model, with ≈20 CAH
hospital clients, and the hottest demo booth at HIMSS.
– Athena also signed with Toledo Medical Center, a 200 bed
AMC, as a pilot site for their new integrated HIS/MD system.
• eClinicalWorks – also claims an integrated HIS is “in the works:”
– They claim ≈80 hospitals in India are are already using the
EMR from their extremely popular physician practice system
in the US, with an integrated “total HIS” being developed…

8. MIA!?
• Several HIS vendors are dropped since last year’s HIS vendor list:
– Siemens/SMS - the leader in HIS revenue for decades before
being acquired by Siemens circa Y2K, & then Cerner last year.
– GE – this tech giant is a massive player in the physician
practice and ancillary department (eg: OB) market niches, but
their few remaining HIS clients on the ex-IDX “Centricity”
HIS/EMR represent such a tiny slice of their total revenue,
they will be covered when we review MD practice vendors
next.
– Healthland – this small hospital (<100 beds) giant with over
350 hospital clients on their aging “Classic” and modern
“Centriq” systems was acquired by Evident (CPSI) this year.
– NextGen – acquired the Opus hospital EMR and Sphere
financials (RCM and ERP) several years ago, but couldn’t sell
the interfaced systems, and sold out to QuadraMed in 2015.

9. 20 Years of HIS Vendor Revenue
Here’s two decades worth of revenue for today’s leading vendors:

10. Next 3 Weeks
• We’ll delve into the details of the 10 vendors’ performance over
the next 3 episodes of the HIS review, broken down by the three
major HIS market segments (in terms of beds and revenue):
– Large – those vendors whose derive the majority of their
revenue from large hospitals over 300 beds in size, including
large AMCs & Multi-IDNS: Cerner, Epic, & Allscripts.
– Mid-Size – vendors whose target market includes mainly mid-
size hospitals of 100 to 300 beds in size, including Meditech
(all 3!), McKesson’s Paragon, NTT Data and QuadraMed.
– Small – vendors whose client base consists of mostly under
100 bed facilities, including CAH (Critical Access Hospitals) of
under 25 beds, where Evident & Medhost are leaders.
• For questions, comments, or legal action, please contact us at:
vciotti@hispros.com, 505.466.4958 or spouzar@hispros.com, 407.321.1110