Purchases of electronic medical record systems for emergency medicine declined significantly in 2025 as market uncertainty hampered purchasing decisions among hospitals and health systems, according to data from KLAS Research.
The number of hospitals affected by EHR purchasing decisions decreased by 40% compared to 2024 and by nearly 50% compared to 2023, KLAS Research reported in its 2025 EHR Market Share Report. Analysts at KLAS Research say continued questions over government policy have contributed to the hesitation, at the same time many health systems have shifted investments toward technologies with more immediate economic benefits, such as AI and other solutions designed to improve operational efficiency.
Despite the economic slowdown, Epic’s share of the U.S. EHR market continued to grow incrementally, driven primarily by contracting awards at smaller health systems, or organizations with two to 10 hospitals.
“In recent years, as EHR purchasing energy has been on the decline, Epic has expanded its reach to include smaller health systems and medium-sized freestanding hospitals, adding 49 hospitals from these groups in 2025,” KLAS Research analysts wrote in the report.
Overall, Epic gained a total of 77 multispecialty hospitals and 18,679 beds in 2025, but “lost” one customer. The health IT company currently controls 43.7% of the acute care EHR market, up from 42.3% a year ago. Epic has a 56.9% market share in hospital beds, according to KLAS Research data.
Only two large health systems (organizations with more than 10 hospitals) made enterprise-wide EHR purchases in 2025, and both chose Epic. In decisions involving three or more specialty hospitals, no other vendors were selected. KLAS reports that these wins have come primarily from organizations that have exited Oracle Health.
Health system leaders cite the strength of Epic’s platform, partnerships, and standardization as important factors in deciding on EHR contracts, along with a desire to easily exchange data with community partners.
Epic continues to expand into smaller independent hospitals and organizations with fewer than 200 beds with its Community Connect service. Epic Community Connect extends the EHR platform to small practices, clinics, and hospitals, giving them access to tools without their own implementation costs. Seven small, independent hospitals chose Community Connect in 2025, but the KLAS report did not specifically name them.
KLAS Research’s market share data is based on acute care EHR purchasing activity in the United States from January 1, 2025 to December 31, 2025, specifically contracts entered into. It includes EHR market share data for acute and non-acute specialty hospitals (meaning psychiatric, long-term acute care, rehabilitation, surgical, orthopedic, and other specialty hospitals). KLAS collects data based on publicly available information and “thousands of conversations” it has with healthcare providers each year.
KLAS also offers vendors the opportunity to report annual acute hospital EHR outcomes, which the company said it will work with healthcare organizations to verify.
According to KLAS data, 2025 marks the third year in a row for Oracle Health to experience the largest net loss in market share compared to other EHR vendors. Oracle acquired competing EHR vendor Cerner for $28.3 billion in June 2022, resulting in the company losing a net of 56 hospitals and 14,676 beds in 2025.
The company currently has a 21.9% share of the acute hospital EHR market, down from 22.9% a year ago, according to KLAS estimates. Cerner’s market share in 2020 was 25%.
Notably, KLAS said Oracle Health has not provided a list of new contracts for 2025, marking the second year in a row that the company has refused to share information about new contracts. KLAS said it relied on internal research methods and publicly available information to independently identify Oracle Health’s 2025 “wins.”
Oracle lost 56 hospitals and 14,676 beds, according to a KLAS tally. The company’s 2025 losses were the highest among small health systems, with all but three of the losses attributed to Epic, KLAS reported.
Oracle Health’s gains in 2025 were primarily due to one large professional organization selecting the company’s EHR for eight rehabilitation hospitals.
“Customer satisfaction with the Millennium platform has continued to decline amid repeated layoffs, restructuring, and refocusing since Cerner was acquired by Oracle,” said analysts at KLAS Research. “In the 2026 Best in KLAS report, it was the lowest scoring solution across large, medium and small organizations.”
As a result, the customer base is becoming more volatile. Thirty percent of customers surveyed reported that Oracle Health is not in their long-term plans, and 35% said they might leave or “want to leave, but can’t,” KLAS said in the report.
After the 2022 Oracle-Cerner deal, KLAS Research analysts spoke with customers for a year and found that CIOs were concerned about the company’s vision. Oracle Health implemented several major technology developments from 2023 to 2024, including clinical AI agents, seamless exchange capabilities, and Oracle Cloud Infrastructure.
In August, the company launched a next-generation electronic health records solution with the latest artificial intelligence and voice capabilities. This solution is designed to be easier for clinicians to navigate.
Analysts at KLAS Research noted that 2026 will be a significant year for Oracle Health customers as new AI-enabled EHRs become a reality. Analysts say the success of the new platform is essential to regaining the confidence of both existing customers and the broader market.
Many of Oracle Health’s customers are delaying action as they wait for more clarity on the vendor’s evolving direction, analysts said.
Meditech will lose seven hospitals and 1,015 beds in 2025 and has a 14.7% share of the acute care EHR market, according to KLAS data, but the company has strong retention among its traditional customers. Meditech’s customers make up the third largest acute care EHR customer base in the United States. Approximately 45% of these hospitals use one of Meditech’s various legacy platforms, and each year many of these customers make future EHR purchasing decisions.
“Thanks to Meditech’s continuous improvement efforts, the proportion choosing to migrate to Expanse over another vendor has steadily increased since 2023,” KLAS Research analysts said in the report.
While purchases by small, independent hospitals have generally slowed across the market, a small number of these organizations signed net new contracts with Meditech last year.
“Meditech customers, and those considering vendors when making purchases, recognize the need for better interoperability and broader functionality that can eliminate third-party solutions in areas such as capacity management,” KLAS analysts wrote.
Other EHR vendors evaluated in the report include TruBridge (7.6% share of the acute hospital market) and Altera Digital Health (2.9%);
In May 2022, N. Harris Computer Corporation, a subsidiary of Constellation Software, acquired the hospital division of health IT company Allscripts, which includes Sunrise, Paragon, Touchworks, Opal, dbMotion, STAR, and Healthquest solutions. The business, currently operating as Altera Digital Health, had just one net new customer in the acute hospital market in 2025, according to KLAS data.
The customer, a 155-bed hospital, is the vendor’s first “win” since 2023. Customers are cautiously optimistic about Paragon, including future clinical usability improvements, and in 2026, customers went live with Denali, a new web-enabled version of Paragon.
TruBridge (formerly CPSI) continues to be considered and chosen by smaller organizations with budget constraints and existing customers using TruBridge’s legacy solutions. In 2025, TruBridge added six hospitals and lost four hospitals, resulting in a net change of two hospitals.
