The 2026 EHR Market is Cooling as Leaders Pivot to AI

Hospitals are terrified of switching their electronic health record (EHR) systems. The massive capital costs, multi-year timelines, and disrupted clinical workflows mean most healthcare organizations are putting a pin in their migration plans. Instead, they are keeping their current systems and shifting their budgets toward AI solutions.

To get the inside scoop on these changing market dynamics, I sat down with Paul Warburton, Senior Market Research Analyst at KLAS Research, to unpack the findings from their latest US Acute Care EHR Market Share Report.

Key Takeaways on the EHR Market from KLAS’s Paul Warburton

1. EHR buying decisions have cooled significantly as major health systems pause large migrations to focus on shorter-term AI pilots.
2. Epic is capturing smaller hospitals through its Community Connect program, driven by local data exchange needs rather than software features.
3. Short-term thinking is dominating IT budgets, with a massive rise in six-month pilots and month-to-month vendor contracts.

Highlights from the KLAS Research US Acute Care EHR Market Share 2026

• 0 “Whale” EHR Decisions in 2025. KLAS tracked zero large health system migrations during the past year. “The whole market overall at a macro level is in a bit of a holding pattern,” Warburton noted. Leaders are betting that emerging AI can patch their current IT stack issues over the next 12 to 24 months, delaying the need for a full rip and replace of their EHR infrastructure.
• 1 to 2 Hospital Systems are Driving Epic’s Growth. Epic still had a big year, but the wins came from small community hospitals extending existing local networks. “It was a big year for Epic’s Community Connect approach,” Warburton said. Local data coordination and heavy pushback from shared physicians drove these decisions, not necessarily software functionality.
• $350 Billion in RCM Waste is a Focus. Financial pressure is forcing organizations to prioritize survival over large IT projects. Organizations are demanding immediate payback which has put a focus on revenue cycle management technology and relief – especially related to prior authorizations and denials management.

 Questions Healthcare IT Leaders are Asking

 Why are EHR satisfaction scores dropping for Oracle Health? The decline in ratings is a communication issue rather than a technology problem. Oracle is developing a promising AI-driven interaction layer that sits on top of existing architecture to prevent a full rip and replace. However, they have struggled to communicate this roadmap to their broader community base, leaving mid-market customers frustrated.

Is Meditech holding onto its current customer base? Yes. While Meditech is losing overall market share, it is successfully migrating its existing base to its cloud-based Expanse platform. This cloud migration simplifies infrastructure updates and allows hospitals to adopt a flexible, best-of-breed approach to AI integrations with third-party partners.

Learn more about KLAS Research at https://engage.klasresearch.com/

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