US sales of electronic medical record systems to large hospitals fell to a seven year low in 2008.

Sales of new EMR contracts are, however, predicted to be far higher in 2009, spurred by $19 billion of federal financial incentives for ‘meaningful use’ of EMRs.

The figures, produced from US research firm KLAS, say EMR vendors sold the lowest number of new contracts to hospitals with more than 200 beds in the US and Canada since it began recording figures seven years ago.

The biggest winner in the depressed 2008 EMR market was EPIC Systems, which continued to make gains among large hospitals even during the economic downturn, capturing nearly 40 percent of the new business, according to KLAS.

According to Hospital IT News McKesson and Siemens also counted wins, while Cerner saw no net growth in its clinical market share for the first time.

The main clinical wins in 2008 were for Epic’s EpicCare Inpatient, Siemens’ Soarian Clinicals and McKesson’s Paragon Clinicals.

Siemens proved its ability to grow its client base by winning five new non-Siemens hospitals, including three in the over-400 bed market segment, the end of the market which EPIC has come to dominate.

McKesson Paragon was also reported as making some inroads with larger hospitals. The product has in the past had a reputation as a smaller community hospital solution. Of the 12 McKesson EMR contract wins in hospitals with more than 200 beds, four chose Paragon over Horizon, suggesting the product is gaining momentum, reports Healthcare IT News

The KLAS report noted that Cerner and Eclipsys failed to translate leadership in Computerised Physician Order Entry (CPOE) into EMR wins.

Cerner has the highest number of hospitals employing CPOE, while Eclipsys has the greatest number of physicians with CPOE – but neither was among the top three in new large hospital EMR sales in the United States and Canada in 2008.