Global EHR Trends: KLAS Insights on Market Expansion and Clinician Experience

Global EHR adoption surged in 2024, yet clinician satisfaction remains uneven. KLAS data reveal high vendor activity and strategic gains in countries like France, Brazil and Saudi Arabia. However, only the Middle East aligns infrastructure, training, governance and personalisation to deliver strong EHR experiences. To unlock value, healthcare systems must prioritise user engagement and continuous performance improvement over procurement volume alone.

Key Points

• Global EHR contracts rose in 2024 but impacted fewer hospitals than in past years.
• France, Saudi Arabia and Brazil led market activity with diverse vendor engagement.
• Clinician satisfaction varies widely, with the Middle East scoring highest globally.
• Training, governance and infrastructure gaps drive dissatisfaction in many regions.
• Personalisation boosts EHR value but remains underused outside the Middle East.

Healthcare systems worldwide increasingly rely on electronic health record (EHR) optimisation, building on the foundation of digital maturity established through earlier implementations. Two recent KLAS reports, one assessing the acute care EHR market globally and another exploring clinician satisfaction across both acute and non-acute settings, offer critical insight into how EHR investment aligns with operational and clinical outcomes. Together, these reports provide a composite picture of EHR progress in 2024–2025, combining data on market dynamics with the real-world experiences of over 52,000 clinicians in 38 non-US organisations.

A Shifting Landscape in EHR Procurement

KLAS validated 246 new EHR contracts in 2024, impacting 550 hospitals and over 122,000 inpatient beds. This represents a five-year high in the number of contracts, despite a five-year low in total hospitals impacted—indicating a trend towards smaller-scale, decentralised procurement. Fewer large-scale regional decisions were finalised than in 2023, yet multiregional vendors such as Dedalus, Epic and InterSystems continued to gain ground.

Dedalus maintained its market leadership with 24 decisions impacting over 21,000 beds, particularly in France, Germany and Austria. Epic expanded its reach in Canada and Singapore, while InterSystems saw its strongest year since 2020, winning contracts in the Middle East, Asia and Latin America. In the UK, Epic, MEDITECH, Oracle Health and Nervecentre all won new public sector contracts. MEDITECH also gained new clients in Oceania, Latin America and Africa. Vendors such as Aosta and TrioTree expanded in India and beyond.

Market activity was particularly strong in France, the UK, Saudi Arabia and Brazil. In Europe, France led with both public and private sector contracts. In the Middle East, Saudi Arabia accounted for the largest public contract—Cloud Solutions’ VIDA platform was selected by a cluster of 21 hospitals. In Latin America, Philips and MV led new signings, particularly in Brazil. Meanwhile, IQVIA and InterSystems increased their footprint in Southeast Asia and Costa Rica, respectively.

Regional Drivers and Procurement Strategies

Market dynamics in 2024 were shaped not just by vendor performance, but by distinct regional procurement strategies and evolving national health priorities. France, for example, saw contracts split between multiregional vendors like Dedalus and local firms such as Nexus AG and Numih France, reflecting a hybrid procurement model.

In Saudi Arabia, the drive to realise Vision 2030 has stimulated investment in digital health infrastructure, resulting in the largest public contract of the year. Similarly, the UK continues to pursue regional upgrades, with Epic, MEDITECH and Oracle Health securing contracts.

India showed a growing appetite for scalable solutions with strong local vendor participation, while Brazil reinforced its status as Latin America’s most active EHR market, led by Philips and MV. Elsewhere in Latin America and Southeast Asia, InterSystems and IQVIA made gains.

A notable trend in 2024 was the decrease in large-scale regional procurements—down nearly 20% from 2023. This shift towards more localised and tailored EHR strategies reflects greater digital maturity and a preference for autonomy over one-size-fits-all deployments.

From Adoption to Impact: Clinician Satisfaction Lags Behind

Despite this expansion, the clinician experience with EHRs remains uneven. KLAS’ 2025 Global EHR Satisfaction report reveals stark disparities in Net EHR Experience Scores (NEES), which measure clinician perceptions of EHR usability, efficiency and impact on care. The Middle East tops the list with a NEES of 75.4, while Canada (27.6), Oceania (23.6) and Europe (7.3) trail far behind.

The Middle East stands out for achieving the highest level of clinician satisfaction with EHR systems. Its strategic focus on foundational infrastructure, tailored education programmes and inclusive governance mechanisms sets a strong precedent for other global health systems. In contrast, Europe, Canada and Oceania report more modest satisfaction scores, often hampered by inconsistent performance, limited training and poor communication between clinicians and IT leadership.

Net EHR Experience Scores (NEES), measured on a scale from -100 to 100, illustrate these disparities. The Middle East leads with a score of 75.4, far ahead of Canada (27.6), Oceania (23.6) and Europe (7.3). These scores reflect clinicians’ overall perceptions of system functionality, efficiency and impact on care. The marked contrast underscores the importance of a well-coordinated strategy involving infrastructure, training and governance to elevate EHR usability and acceptance.

The data also highlight that without ongoing measurement of EHR impact, organisations may miss key opportunities to align their systems with clinician needs. Proactively tracking satisfaction helps identify problem areas and inform future improvements. In regions failing to assess performance systematically, gaps in experience and functionality can persist unnoticed.

Infrastructure: The Foundation for Success

Reliable infrastructure is a non-negotiable prerequisite for clinician satisfaction. Eighty percent of Middle Eastern clinicians reported dependable systems with fast response times, compared to just 64% in Canada and 50% in Europe. Issues such as delayed login times, Wi-Fi dropouts and system slowdowns hinder clinical workflows, amplify stress and reduce time available for patient care.

In high-performing regions, regular system maintenance, proactive monitoring of performance metrics (eg login and load times), and communication about scheduled downtimes help prevent disruptions. Where such practices are lacking, even best-in-class EHR systems can fail to deliver value.

Training: A Strategic Investment, Not a Cost Centre

Effective EHR training correlates strongly with clinician satisfaction. In the Middle East, 90% of clinicians said their training was sufficient, compared to 47% in Canada, 43% in Europe and 56% in Oceania. Clinicians receiving 11 or more hours of onboarding are significantly more likely to report positive EHR experiences.

Best practices include role-specific instruction, hands-on simulations and ongoing refreshers tailored to evolving clinical workflows. Yet, many healthcare systems reduce training investment to manage short-term costs, unaware of the downstream impacts on usability, burnout and turnover. For retention, workflow-specific training is particularly effective—it boosts user confidence and improves perceptions of system efficiency.

Governance: Listening to Clinicians

Governance frameworks that include clinician input consistently yield higher satisfaction. In the Middle East, 87% of clinicians reported that their leadership provided effective support for EHR implementation and optimisation. In Canada, Europe and Oceania, that number drops below 50%.

When clinicians are excluded from decision-making, they report feeling disempowered and disconnected. Poor governance leads to misaligned system updates and a lack of transparency. By contrast, layered governance—including executive, departmental and clinician voices—promotes shared ownership and builds consensus around system changes.

Good governance also enhances communication. Keeping clinicians informed of system upgrades and training opportunities encourages engagement and helps avoid resistance. Where governance supports shared strategy, alignment between clinical needs and system evolution is more likely.

Personalisation: Underused, High-Impact Tools

Personalisation remains an untapped opportunity in many regions. Tools like shortcuts, templates, macros and customised layouts significantly enhance daily workflows. In the Middle East, 86% of clinicians use personalisation features; in Canada, Oceania and Europe, fewer than 55% do.

These tools not only save time but restore a sense of control over the digital environment. Low adoption is often due to limited awareness and insufficient training. Embedding personalisation into initial and ongoing education, as well as tracking feature usage, can amplify benefits. Furthermore, identifying high-performing users can help organisations spread best practices across clinical teams.

Burnout: A Global Challenge, Unevenly Addressed

Burnout remains a common issue, cited by about one-third of clinicians globally. While EHR systems are not the sole cause, poor usability and unreliable infrastructure exacerbate stress. In Oceania and Europe, clinicians frequently blame the EHR for workload issues and reduced job satisfaction. In the Middle East, EHRs are less frequently cited as contributors—suggesting that system reliability and support structures can mitigate burnout.

Addressing burnout requires coordinated strategies that blend infrastructure improvements with education and user engagement. When clinicians feel supported and empowered to use their EHR effectively, the system becomes a tool for care delivery, not a barrier.

The EHR House of Success: A Blueprint for Improvement

KLAS advocates for a structured approach to improving EHR satisfaction, known as the "EHR House of Success." This model includes a solid infrastructure foundation, supported by the pillars of education, governance and personalisation. Each component must be addressed in concert, as weaknesses in one area can undermine gains in another.

To replicate the success seen in the Middle East, other healthcare systems should begin with infrastructure audits and establish rigorous performance monitoring protocols. Next, they must invest in comprehensive education programmes tailored to diverse clinical workflows. Governance structures should be revised to ensure meaningful clinician participation, and personalisation should be encouraged as a routine aspect of system interaction.

Regular feedback collection via tools like the Arch Collaborative EHR Experience Survey provides actionable insights for targeted improvements. By tracking satisfaction trends and correlating them with operational changes, organisations can continuously refine their EHR strategies.

Conclusion

The global outlook for EHRs is one of expansion tempered by uneven outcomes. Procurement alone is no longer a sufficient metric for success. True digital transformation hinges on aligning systems with the needs of their users. The Middle East sets a compelling example: by investing in infrastructure, education, governance and personalisation, it has achieved both widespread adoption and high clinician satisfaction.

Healthcare systems across the globe should take note. A well-implemented EHR is not just a digital tool; it is a strategic asset that can reduce burnout, enhance workflows and improve care. Achieving this potential requires more than technology. It demands leadership, collaboration and a sustained commitment to clinician experience.

Conflict of Interest

None.