KLAS 2026 EHR Market Share Report: Epic Gains as Oracle Health Faces Third Year of Losses – Image for illustrative purposes only (Image credits: Pexels)
The number of hospitals making EHR purchase decisions fell 40 percent in 2025 compared with the prior year, according to the latest KLAS Acute Market Share Report. Health systems largely paused major system replacements and redirected spending toward artificial intelligence tools and operational improvements that promised quicker financial returns. The slowdown left most vendors with fewer opportunities, yet one company continued to expand while another recorded its third straight year of net losses.
Market-Wide Pause in EHR Decisions
Health systems cited uncertainty over federal policy and the need to prioritize near-term savings as the main reasons for deferring large EHR projects. The result was a broad contraction in activity that affected nearly every vendor except those already embedded in large networks. Many organizations chose instead to invest in AI applications that could improve revenue cycle management or reduce staffing costs without requiring a full platform change.
The decline marked the second consecutive year of reduced decision volume, following a 50 percent drop from 2023 levels. Smaller and midsize hospitals, which historically drove more frequent vendor switches, accounted for most of the slowdown. Larger systems with more than ten hospitals made only two enterprise-wide decisions during the entire year.
Epic Captures Nearly Every New Selection
Epic remained the only vendor chosen by large health systems in 2025 and added 77 hospitals along with 18,679 beds to its multispecialty footprint. The company succeeded by offering its Community Connect program, which lets smaller facilities connect to a neighboring Epic instance without bearing the full cost of an independent installation. Regional data-sharing needs also played a role, as hospitals sought easier exchange of records with existing Epic partners.
Standardization across newly merged organizations further favored Epic. Facilities leaving other platforms cited the desire for consistent workflows and reduced interface maintenance as decisive factors. Epic’s gains came almost entirely from smaller and standalone hospitals that had previously used competing systems.
Oracle Health Records Third Year of Net Losses
Oracle Health lost 56 hospitals and 14,676 beds in 2025, extending a pattern of customer erosion that began after the Cerner acquisition. Nearly one-third of sampled customers indicated the Millennium platform is no longer part of their long-term strategy. Repeated restructuring and staff reductions have contributed to lower satisfaction scores and slower response times on support requests.
The vendor now faces a critical test in 2026 with the scheduled launch of its AI-enabled EHR. Success in restoring confidence among remaining customers will depend on demonstrating measurable improvements in usability and interoperability. Without clear progress, further attrition appears likely.
MEDITECH Strengthens Retention Among Legacy Users
MEDITECH achieved its highest legacy-customer retention rate on record, with 84 percent of deciding clients choosing to move to the Expanse platform. That figure rose from 63 percent in 2024 and 30 percent in 2023. Continued refinements to nurse documentation and clinical workflows were cited as the primary reasons for the improved loyalty.
Customers still identified gaps in interoperability and the need for fewer third-party add-ons, particularly for capacity management and analytics. Those limitations kept some organizations from fully retiring external solutions even after completing the Expanse migration.
| Vendor | Net Hospital Change | Net Bed Change | Key Factor |
|---|---|---|---|
| Epic | +77 | +18,679 | Community Connect and standardization |
| Oracle Health | -56 | -14,676 | Third consecutive year of losses |
| MEDITECH | Strong retention | Not specified | 84 percent Expanse migration rate |
The 2025 results show a market that has become more selective and cost-conscious. Health systems appear willing to invest only when clear operational or financial benefits are immediate. Vendors that can demonstrate those benefits quickly, whether through AI features or streamlined workflows, are positioned to gain ground in the year ahead. Those still addressing platform stability and customer support challenges face continued pressure to reverse recent losses.
