News: EHR purchase decisions delayed amid uncertainty, report shows
Health systems pulled back on acute care electronic health record (EHR) system purchasing in 2025 as part of a larger trend of organizations becoming more selective about large-scale replacement decisions, according to the U.S. Acute Care EHR Market Share 2026 report from KLAS Research.
The report found the number of hospitals making EHR purchase decisions dropped 40% compared with 2024 and nearly 50% compared with 2023. This was attributed to policy uncertainty and shifting technology priorities. Organizations increasingly favored investments with more immediate financial returns—including AI and operational efficiency tools—over large-scale EHR replacement projects.
The slowdown was significant among larger organizations. Only two health systems with more than 10 hospitals made enterprisewide EHR purchase decisions in 2025. Both selected Epic Systems, which overall held 43.7% of the acute care hospital market in 2025. Compared with 21.9% for Oracle Health and 14.7% for MEDITECH, Epic continued to expand its footprint while others face pressure.
While overall purchasing slowed, Epic Systems still added a net of 77 hospitals in 2025, while Oracle Health lost a net of 56. According to the report, Epic’s gains were driven largely by smaller health systems and midsize standalone hospitals. Many of those wins came from organizations leaving Oracle Health.
The uncertainty among Oracle Health customers results from repeated layoffs, restructures, and focus shifts since Oracle acquired Cerner in 2022. KLAS found many Oracle Health customers deferred purchasing decisions while awaiting greater clarity around the vendor’s long-term direction and new AI-enabled EHR. Customer satisfaction with Oracle Health’s Millennium EHR platform also continued to decline, according to the report.
KLAS reported that organizations selecting Epic frequently cited the ability to easily exchange data with regional partners, along with platform standardization and vendor partnership. Epic also continued expanding its reach among smaller standalone hospitals through Community Connect, which allows smaller organizations to align with larger health systems already using Epic. In 2025, seven standalone hospitals with fewer than 200 beds selected Community Connect.
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