UK-Based EHR Underdog Disrupting the March of Epic and Oracle

Cranfield, UK, 3rd September 2024, Written by Jon Hill – 

In the rapidly evolving landscape of healthcare technology, a small UK-based company is making waves and challenging the status quo. Nervecentre, once known primarily for its Best-of-Breed (BoB) Clinical Information Systems (CIS), has emerged as a formidable player in the UK Electronic Health Record (EHR) market, securing multiple contracts and turning heads in an industry dominated by international giants. This article delves into Nervecentre’s remarkable journey, the shifting dynamics of the UK’s EHR market, and the potential implications for the future of healthcare IT. 

The Rise of Nervecentre 

Nervecentre’s evolution from a specialised BoB solution provider to a full-fledged EHR vendor highlights the company’s adaptability and strategic vision. Anticipating the industry’s shift towards more integrated EHR systems, Nervecentre made a bold move that has proven to be highly successful. In just 12 to 18 months, the company has secured around seven EHR contracts, a remarkable achievement that has surprised many in the industry. This success is especially impressive considering Nervecentre’s recent entry into the EHR market and the intense competition from well-established international and local vendors. With a portfolio of over 40 NHS Trusts, Nervecentre is leveraging its existing relationships to convert BoB customers into EHR clients, providing a valuable pool of additional EHR customers to target. 

What sets Nervecentre apart is not just the number of contracts won, but also their geographic spread and the calibre of institutions they’ve partnered with. The company has made significant inroads in the East Midlands, securing contracts with major NHS Trusts in Leicester, Nottingham, Northampton, Chesterfield, and Derby. More recently, Nervecentre has expanded its footprint North, to Yorkshire, winning contracts with York and Scarborough Teaching Hospitals NHS Trust and Harrogate and District NHS Foundation Trust. These contracts, typically spanning a decade, represent long-term commitments from NHS Trusts and signal a strong vote of confidence in Nervecentre’s capabilities. 

In its 2023 report to Companies House, Nervecentre demonstrated impressive financial performance, with revenue increasing from £7.6 million to £9.0 million, reflecting an 18% growth. This growth is noteworthy as it highlights Nervecentre’s ability not only to transition its existing customer base to a new EHR product but also to drive overall business expansion simultaneously. This dual achievement of migrating customers while enhancing revenue underscores the company’s agility and effective market strategy.   

UK’s EHR Market Landscape 

To fully appreciate Nervecentre’s impact, it’s crucial to understand the current state of the UK EHR market. The sector is primarily dominated by a handful of large, international vendors and a small number of entrenched local vendors: 

Other significant players include Epic, InterSystems, and Meditech. 

However, the market is far from static. The NHS’s digital transformation agenda, coupled with evolving healthcare needs and technological advancements, has created an environment ripe for disruption. This is where Nervecentre has found its opening. 

Nervecentre’s Great Shift 

One of the most significant trends shaping the UK’s healthcare IT landscape is the shift from modular, BoB, CIS systems (e.g. standalone ICUIS, OR Manager, AIMS, EDIS, Perinatal IT, NICUIS and CPOE/EPMA) to comprehensive EHR solutions. This transition is driven by several factors, including government mandates, the reorganisation of healthcare providers into Integrated Care Boards (ICBs), and a move towards consolidated procurement. The UK government has set ambitious targets for EHR adoption, aiming for 90% of Trusts to have both a Patient Administration System (PAS) and an EHR in place by 2023, increasing to 95% by March 2025 and 100% coverage by 2026. 

This market shift presented both a challenge and an opportunity for Nervecentre. As a company with a strong track record in BoB CIS solutions for emergency departments, patient flow, and high-acuity care, Nervecentre faced the risk of being sidelined in the new EHR-centric landscape. However, the company’s leadership recognised this threat early and made the bold decision to develop their own EHR offering. 

Nervecentre’s success in the EHR market is no accident. The company has strategically positioned itself to capitalise on the changing market dynamics. By leveraging its existing relationships within the NHS ecosystem and its reputation as a trusted BoB provider, Nervecentre has gained an advantage in EHR contract discussions. The company’s mobile-first, cloud-native approach aligns well with the modern needs of healthcare professionals who require access to patient information at the point of care. 

As a smaller, more agile company, Nervecentre has been able to offer competitive pricing compared to larger international vendors, making its value proposition particularly attractive to NHS Trusts facing budget constraints. Unlike some vendors who have found success within specific regions, Nervecentre has demonstrated its ability to win contracts across different ICBs, suggesting that the company’s solution is adaptable to various healthcare settings and organisational cultures.  

Nervecentre Shaking Up the EHR Status Quo 

Nervecentre’s rapid ascent in the EHR market raises intriguing possibilities for the future of healthcare IT in the UK. The company’s successful pivot from a BoB specialist to an EHR vendor could serve as a model for other niche players in the market, potentially encouraging more innovation and competitive pricing across the industry. Nervecentre’s emphasis on user experience and mobile-first approach could push other vendors to prioritise these aspects in their offerings, leading to more intuitive and efficient EHR systems for healthcare professionals. 

As a UK-based company, Nervecentre may be better positioned to understand and respond to the specific needs of the NHS, challenging international vendors to tailor their solutions more closely to the UK healthcare system’s unique requirements. The company’s agility and willingness to challenge the status quo could spur increased innovation across the industry, pushing established players to step up their R&D efforts to maintain their market positions. 

In addition to this, Nervecentre have ambitions to broaden their offerings into new countries. This, however, could distract Nervecentre from more immediate opportunities, such as converting more of its 40 existing NHS customers into EHR clients. 

Challenges and the Road Ahead 

While Nervecentre’s rise has been impressive, the company faces significant challenges as it seeks to expand its market share. As it takes on more and larger contracts, Nervecentre will need to scale its operations, support, and development capabilities, accordingly, managing this growth while maintaining quality and customer satisfaction. The company can expect increased competition and potential price pressure from established players who are unlikely to cede market share without a fight. 

Nervecentre will also need to prove its long-term viability, demonstrating that it can deliver on its promises over the full lifecycle of these multi-year contracts. The company will need to continue innovating to stay ahead of trends in areas like AI, interoperability, and patient engagement. 

A New Chapter in UK EHR Market 

Nervecentre’s transformation from a BoB solution provider to a competitive EHR vendor represents more than just the success story of one company. It signals a potential shift in the UK’s healthcare IT landscape, where agility, innovation, and deep understanding of local healthcare needs can challenge the dominance of established international players. As the NHS continues its digital transformation journey, the success of companies like Nervecentre suggests that there’s room for diverse approaches and solutions. 

Nervecentre is likely to continue attracting new customers, but it’s up against a broader trend favouring the large international vendors. While it will achieve some successes, these are expected to be more localised or niche. Looking ahead five years, it’s likely companies like Oracle, Epic, Dedalus, and InterSystems will dominate the market, with SystemC possibly maintaining a significant share as well. Nervecentre is likely to be well-positioned but will probably fall into the tier below these major players. 

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About The Author

Jon joined Signify Research in 2023 as a Market Analyst in the Digital Health team. He holds a BSc in Pharmacology having graduated from the University of Bath in 2023.

About the Digital Health Team

Signify Research’s Digital Health team provides market intelligence and detailed insights on numerous digital health markets. Our areas of coverage include electronic medical records, telehealth & virtual care, remote patient monitoring, high-acuity clinical information systems, patient engagement IT, health information exchanges and integrated care & value-based care IT. Our reports provide a data-centric and global outlook of each market with granular country-level insights. Our research process blends primary data collected from in-depth interviews with healthcare professionals and technology vendors, to provide a balanced and objective view of the market.

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