When health system CIOs weigh new digital tools, one factor consistently rises to the top: integration with their EHR system.
From ambient AI solutions to patient engagement platforms, whether a technology can integrate seamlessly with the EHR often determines whether it gets a yes or no.
“At AtlantiCare, we are deeply committed to leveraging technology to make healthcare safer for our patients and more efficient for our providers,” Jordan Ruch, CIO of Egg Harbor Township, N.J.-based AtlantiCare, told Becker’s. “Our EHR system, powered by Oracle Health, is not just a record-keeping tool — it’s a strategic platform that shapes how we evaluate and adopt digital solutions.”
Mr. Ruch said AtlantiCare’s Value Analysis Committees, co-led by physicians and administrative leaders, ensure all new technology aligns with the organization’s clinical and financial goals. The system’s recent success with Oracle’s Clinical AI Agent — which cut documentation time by 42% — is a prime example of integration guiding a green light.
“If a tool integrates seamlessly and supports our goals … it moves forward. If it introduces friction or misaligns with our vision, we pause,” Mr. Ruch said.
This sentiment was echoed by CIOs at both rural and academic health systems.
“EHR integration plays a critical role in shaping the digital tools we consider at North Country Healthcare,” Darrell Bodnar, CIO of the Berlin, N.H.-based system, told Becker’s. “In many cases, whether we say yes or no … hinges directly on how well it aligns with Meditech’s integration standards.”
Mark Weisman, MD, CIO of Salisbury, Md.-based TidalHealth, said integration is especially important for technologies that touch clinical staff or patients directly.
“Poor integration leads to adoption challenges and failed implementations,” Dr. Weisman told Becker’s. “If staff must flip back and forth between applications … they are likely to abandon the effort.”
He added that Epic’s roadmap also heavily influences IT purchasing decisions.
“Tools that Epic produces are natively well placed in the clinical workflows … that small detour in their workflow may be enough to derail their interest,” he said.
At Richmond, Ind.-based Reid Health, CIO Muhammad Siddiqui said the health system routinely says no to tools that add friction or require duplicative work.
“If a tool doesn’t integrate smoothly or requires double documentation, we usually pass,” Mr. Siddiqui told Becker’s. “We’ve also said yes to platforms such as ambient AI and patient engagement apps that worked well with our EHR.”
At Seattle Children’s, integration is nonnegotiable.
“Any new tool must seamlessly interoperate [with the EHR] to ensure data integrity, avoid inefficiencies, and support patient safety,” Zafar Chaudry, MD, chief digital officer and chief AI and information officer, told Becker’s. “A lack of robust, secure, and workflow-enhancing integration … leads us to typically reject those that would create data silos.”
Even promising technology isn’t spared. Seattle-based Fred Hutchinson Cancer Center turned down an AI documentation tool “because it lacked support for integration with our EHR and would have required clinicians to toggle between systems,” CIO Omer Awan told Becker’s.
However, not all CIOs view EHR integration as the sole deciding factor.
“EHR integration plays a meaningful — but not exclusive — role,” Amy Trainor, system vice president and CIO at New Orleans-based Ochsner Health, told Becker’s. “While it makes implementation easier, it’s not the only criteria. We prioritize decisions based on the greatest organizational need.”
Still, Ms. Trainor noted that when EHR vendors offer native capabilities — especially around AI — those features often gain traction faster due to existing trust, compliance and infrastructure.
Across the board, CIOs agree: the EHR isn’t just an IT backbone — it’s a gatekeeper for digital transformation. And as vendors push deeper into AI and automation, health systems appear increasingly likely to say yes to tools that come from, or connect deeply with, their EHR.
