Years of mergers and acquisitions left some of the largest U.S. health systems running dozens of EHRs at once. Most are now spending heavily to collapse those portfolios onto one platform, usually Epic.
How many a system runs depends partly on what gets counted. The typical health system used 18 EHR vendors across its affiliated providers, according to a 2024 Lown Institute analysis. The systems below report counts of core EHRs or EHR instances, and most of those numbers are falling as rollouts continue.
Here are the health systems running the most EHRs, ranked by their most recently reported count:
1. Northwell Health (New Hyde Park, N.Y.): More than 30 core EHRs. The 28-hospital system is replacing those core EHRs, along with more than 15 specialty systems and roughly 200 other applications, with Epic in a project previously estimated at $1.2 billion. Its first wave went live Nov. 1, 2025, across eight hospitals and about 39,000 users. The second, covering nine hospitals and about 42,000 users in its Central Region on Long Island, was completed by early June. Northwell was tentatively planning a third wave later this year and has not reported how many EHRs remain.
2. Vandalia Health (Charleston, W.Va.): 27 EHRs. The system grew from four hospitals to 16 over four years, and 10 of those hospitals run on three separate Oracle Health instances. Vandalia plans to take all 16 hospitals and more than 220 ambulatory sites live on Epic on the same day in fall 2028, leaving it with Epic and a specialty radiation oncology EHR.
3. CommonSpirit Health (Chicago): Nine EHRs, down from 19 over the past two years. About 67% of the system’s facilities are on Epic. Five states in its South region are set to move to a single Epic instance at the end of October, followed by the Pacific Northwest in spring 2027. The West Coast conversion will begin in fiscal 2028, after a pause for the system’s July 2027 Workday ERP cutover. CommonSpirit aims to be on a single Epic instance by the end of fiscal 2030.
4. UPMC (Pittsburgh): Nine EHRs at the start of its consolidation. UPMC announced in 2023 that it would move nine EHRs onto Epic; its core platforms had been Oracle Health for inpatient care and Epic for ambulatory care. The second wave of the rollout, covering 15 hospitals and hundreds of ambulatory practices in the Pittsburgh region and most of southwestern Pennsylvania, went live in early October. UPMC has not reported how many EHRs remain.
5. Kaiser Permanente (Oakland, Calif.): Eight clinical EHR instances, one for each of its markets, all on Epic. In early 2025, the system merged 12 instances in California, six in Northern California and six in Southern California, into two, migrating about 40 million patient records.
Several other large systems run multiple EHR vendors but have not published a count. St. Louis-based Ascension uses Epic, Oracle Health, Meditech and Athenahealth, and Franklin, Tenn.-based Community Health Systems uses Oracle Health, Athenahealth and Medhost, according to Becker’s reporting. Lifepoint Health, based in Brentwood, Tenn., described its mix in starker terms in 2022.
“If it’s made, we pretty much have it. We’ve got ’em all,” Al Smith, Lifepoint’s senior vice president and CIO, told Becker’s at the time.
Other systems are further along in working through sprawl on that scale. Livonia, Mich.-based Trinity Health, which chose Epic in 2018, previously ran Oracle Health and Athenahealth as its main EHRs, along with Meditech at some inpatient sites and three separate Epic instances.
“So we were 31 flavors,” Dan Roth, MD, then Trinity Health’s chief clinical officer and now its COO, told Becker’s in 2024.
Editor’s note: This list is not exhaustive. Email gbruce@beckershealthcare.com with any missing entries.
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