Livonia, Mich.-based Trinity Health has finished moving its hospitals onto a single instance of Epic, eight years and $1.4 billion after the Catholic health system chose the EHR.
The 12th and final implementation wave went live in September at MercyOne Genesis in Davenport, Iowa, and Trinity Health Grand Haven in Michigan, President and CEO Mike Slubowski told Becker’s. Along the way, the project’s cost rose from the $800 million figure Becker’s previously reported.
“The original scope when we started eight years ago was $800 million, but we’ve added on all these additional facilities,” Mr. Slubowski said. “So between capital and operating expenses, the total project over eight years was $1.4 billion, but it was all budgeted and approved by our board.”
The timeline stretched for the same reason, he said.
“We had scope changes that added to it, and our board has been with us on the scope and the locations and the additional budget through the whole process,” Mr. Slubowski said.
The additions included the rest of Iowa, where Trinity Health bought out CommonSpirit Health’s share of MercyOne in 2022, along with other acquired hospitals and physician practices.
“Genesis was an acquisition that we had. Grand Haven was an acquisition. We added more medical group physicians,” he said.
Trinity Health also brought home care, hospice and PACE programs onto Epic after initially leaving them out of the plan.
“At that point in time, the code and the operating systems that Epic had written were not as far along as we needed to be able to implement that systemwide,” Mr. Slubowski said. “So we actually assisted in the final design of those modules, so that they cover our facilities adequately.”
The finished build spans 88 hospitals, 130,000 employees and 40,000 physicians, according to Mr. Slubowski. Trinity Health had said it expected to become the largest single-instance Epic user in the country.
“Actually, it’s the largest single instance internationally, so we’re the largest single instance of concurrent users,” he said.
The project grew out of a fragmented starting point. When Mr. Slubowski returned to Trinity Health a little over nine years ago, after leading Broomfield, Colo.-based SCL Health, the system was running Oracle Health for inpatient care, Athenahealth for outpatient care and a mix of Meditech, Oracle Health and separate Epic instances at other sites.
“When I met with our leadership in IT, and I said, on the path we’re on right now, five years from now, are we going to be any more patient-centered than we are now? And no one could answer that question on the path we were on,” he said.
Consolidation is now paying off on the expense side. Through what it calls its Singularity Program, Trinity Health retires legacy platforms once sites move to common ones. Mr. Slubowski said the program has saved $485 million through the current fiscal year and will reach $838 million by the end of 2028, savings that sit outside the project’s $1.4 billion cost.
“We were the Heinz 57 variety of EMRs,” he said.
The same fragmentation showed up in clinical workflows.
“When we started on this journey, being on Heinz 57 variety of EMRs and people doing one-offs, we had over 20,000 order sets. Now we have 700, and those were all developed by our clinical excellence councils,” Mr. Slubowski said.
Trinity Health was an early adopter of Epic’s payer platform, and Mr. Slubowski pointed to the revenue cycle as an early return.
“We’ve seen hundreds of millions of dollars improvement in coding documentation and revenue cycle improvements since we started this journey,” he said.
On the patient side, Trinity Health avoided 57,000 duplicate procedures in 2025 through EHR alerts and closed 13 million care gaps using outside data from Epic’s Care Everywhere, Mr. Slubowski said. Patients booked 4 million appointments online, and nearly 400,000 acted on outreach from Epic’s Cheers campaigns for services such as breast imaging and diabetes checks.
The system is also encouraging inpatients and their families to use MyChart at the bedside. Mr. Slubowski saw the effect firsthand when a family member was hospitalized last year.
“I was literally sitting in the room with her and was getting the results faster than the clinicians could show up and talk with her,” he said.
With the rollout complete, Trinity Health is turning to Epic’s AI tools. The system bought Epic’s AI bundle and has 35 of its early capabilities live, including drafted nursing notes, discharge summaries and patient messages. Mr. Slubowski said the system is moving its clinicians from a previous ambient listening tool to Epic’s. Primary care physicians using ambient documentation see an average of 1.4 more patients per day, he said, and Trinity Health is now expanding it to emergency departments and inpatient rounding.
“We’re actually about 10% of Epic’s AI utilization right now already,” he said.
Mr. Slubowski doesn’t expect the build to stay finished. Every legacy site is now on Epic, he said, but new practices and outpatient locations will keep coming online, and Trinity Health is working with Epic on a module designed for freestanding ambulatory surgery centers.
“The reason I don’t think this is ever done is we’re adding new physician practices. We’re adding new outpatient locations. We have rural hospitals that we partner with, so those will all be things that’ll be ongoing,” he said.
For other health systems weighing a project of this size, his advice is to keep it out of the IT department’s sole hands. Trinity Health set up a separate team, TogetherCare, to run the implementation, with IT as a partner on hardware, software and devices.
“This is not an IT project. It’s got to be owned by operations,” Mr. Slubowski said. “I know a lot of organizations have just given it to the IT team. If they’ve got an IT team that really is operationally focused, great. But if they’re not skilled at having operations ownership, I think it’s going to be a long, long, hard ride.”
He tied the platform to Trinity Health’s broader strategy of connected care, growing its medical groups and expanding community-based care.
“Our legacy was hospital-centric. Our destiny is community-based care, and we’re moving really rapidly in that direction,” he said.
