EMR Market Share: Independent Practices, 2026

Nobody publishes open EMR market-share data for ambulatory practices. Hospital-side reports are paywalled, and vendor-published numbers are marketing. So we built it from the federal registry: every provider in the CMS NPPES database whose Direct-messaging endpoint identifies the EMR their practice runs — 37,310 providers across 26 specialties.

The data on this page is free to reuse with attribution (CC-BY). Machine-readable version: emr-market-stats.json.

Headline findings

• Dermatology is a one-vendor specialty. Modernizing Medicine accounts for 79.9% of EMR-identifiable dermatology providers (n=663) — the highest single-vendor concentration of any specialty.
• Eye care splits two ways. NextGen leads both ophthalmology (50.3%) and optometry (43.6%), but eye-care-specific Compulink takes 25.4% of optometrists against only 13.7% of ophthalmologists.
• The generalist market is a five-way fight: athenahealth (24.4%), Oracle Health (20.4%), eClinicalWorks (15.2%), NextGen (13.4%) and Veradigm (13.2%) split it between them.
• Some small specialties are far more concentrated than the headline suggests. NextGen holds 52.4% of rheumatology (n=347) and Veradigm 46.7% of allergy & immunology (n=75) — concentrations the all-specialty table completely hides.
• Specialty-built EMRs win their home turf — where one exists (ModMed in dermatology, NextGen in ophthalmology), it over-indexes dramatically against general-purpose systems.

National share — all identified providers (n=37,310)

By specialty — leader and top three

n = providers in that specialty whose registry endpoint identifies their EMR. Small n means read directionally.

Leading EMR by state — 15 largest identified populations

Methodology

The Centers for Medicare & Medicaid Services publishes the National Plan & Provider Enumeration System (NPPES) — the public federal registry of every U.S. healthcare provider. Providers who exchange clinical data register Direct-messaging endpoints, and when an EMR vendor hosts that endpoint, the domain identifies the vendor (for example, *.emadirect.md is Modernizing Medicine). We analyzed all 9,671,888 registry records and all 600,750 registered endpoints in the July 2026 dissemination, and counted a provider as identified only when their endpoint sits on a registrable domain the EMR vendor itself owns — 37,310 providers. Each is assigned to a specialty from their primary NUCC taxonomy code at full ten-character precision, which is what lets cardiology, gastroenterology, pulmonology, nephrology, endocrinology, rheumatology and oncology appear separately instead of collapsing into one "internal medicine" bucket. Nurse practitioners and physician assistants are counted in the specialty their own subspecialty code names; where that code is generic, they are left out rather than guessed at.

What this lens sees — and doesn't. Epic and other hospital-deployed systems typically exchange through hospital-hosted domains, which don't name the vendor; Epic is therefore undercounted here. Read these tables as the ambulatory vendor market — providers whose EMR vendor hosts their messaging — not total U.S. market share. About 5% of providers register a Direct endpoint at all, and only 0.4% sit on a domain that names the vendor; n is stated on every table. A specialty needs at least 50 identified providers before we publish a percentage for it. NPPES data is public domain; the analysis is ours. Vendors who believe a domain pattern is misattributed can reach us via the Contact page — we verify and correct.

Frequently asked

Which EMR do most dermatology practices use? Among dermatology providers whose federal Direct-messaging endpoint identifies their EMR, 79.9% use Modernizing Medicine (EMA) — the highest single-vendor concentration of any specialty (n=663, July 2026).

What is the most-used EMR in independent practices? athenahealth leads at 24.4% of EMR-identifiable providers, followed by Oracle Health (20.4%) and eClinicalWorks (15.2%).

Where does this data come from? The federal NPPES registry — every U.S. provider — analyzed as described in the methodology above. It is not vendor-reported or surveyed.