U.S.-based EHR giants such as Epic, Oracle Health, Meditech and Altera are facing mounting competition from a new generation of regional and international vendors, according to a May 10 report from Black Book Market Research.
The findings are based on input from more than 11,000 clinicians, IT leaders and healthcare operations executives across 44 countries.
Here are five takeaways from the report:
- While major U.S.-based health IT vendors continue to secure global contracts, they are encountering increased resistance abroad.
- Health leaders outside the U.S. cited rising anti-American sentiment, trade-related tariffs and digital protectionism as reasons to avoid U.S.-based systems in 2025 and beyond.
- In 28 of the 44 countries surveyed, 71% of provider organizations using U.S.-based EHRs reported issues — primarily stemming from workflow mismatches, local coding incompatibilities, language barriers and privacy compliance challenges.
- Respondents from Europe and the Middle East also raised concerns about pricing structures, vendor transparency and political pressure to choose local alternatives.
- Industry experts noted that the challenge isn’t technological, but relational: Regional vendors are forming stronger partnerships and tailoring their offerings more effectively to local markets.
The report concludes that global success now depends on understanding local users and designing systems that reflect regional realities. The Q2 2025 Black Book report emphasized that future market leaders will be those who prioritize trust, speed, localization and client collaboration.
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