Our Take
Epic's gains are real but narrow: it won in a contracting market by vacuuming up defectors from Oracle's chaos, not by proving superiority in the segments that matter most (large, multi-hospital systems made just two purchasing decisions total in 2025).
Why it matters
Healthcare IT leaders are in pause mode due to cost pressure and policy uncertainty, creating a window where vendor momentum matters more than feature parity. Oracle's stumble after the Cerner acquisition is reshaping customer lock-in equations across mid-market hospitals.
Do this week
Oracle Health customers: audit your contract renewal timeline and audit whether your governance board has formally assessed departure cost vs. migration risk before 2026 EHR rollout results are published.
40% collapse in EHR purchasing decisions
Hospital EHR purchasing activity fell sharply in 2025 according to the KLAS U.S. Acute Care EHR Market Share report. The number of hospitals making purchasing decisions dropped 40% compared to 2024 and nearly 50% versus 2023 (per KLAS research examining contract data, vendor reporting, and hospital interviews).
Three factors converged to freeze the market. Health systems faced economic pressure and policy uncertainty. Operational efficiency initiatives consumed capital that might have gone to platform refresh. Oracle Health customers, spooked by the 2023 Cerner acquisition, delayed decisions pending clarity on the vendor's long-term direction.
Epic captured 49 hospitals in a deflating market
Despite the overall slowdown, Epic expanded its footprint among smaller health systems and standalone hospitals. The vendor added 49 hospitals in 2025, with most wins coming from organizations replacing Oracle Health (per KLAS). Just two large health systems with more than 10 hospitals made enterprise-wide EHR decisions in 2025, and both selected Epic. No competitor besides Epic was chosen in a purchasing decision involving more than three multispecialty hospitals.
Winning organizations cited desire for easier data exchange with regional partners, Epic's platform strength, and standardization. Seven smaller standalone hospitals selected Epic's Community Connect program.
Oracle Health hemorrhaged customers for the third consecutive year. Nearly all departing customers from smaller health systems chose Epic (per KLAS). Almost a third of sampled Oracle customers told KLAS the vendor is no longer part of their long-term plans. Another third said they are considering leaving or want to leave but feel unable to do so. Oracle's Millennium platform received the lowest scores in KLAS's 2026 Best in KLAS rankings across large, midsize, and small organization solutions.
Meditech showed stronger resilience among its own user base. The percentage of legacy Meditech customers migrating to Expanse instead of leaving for competitors has increased steadily since 2023, aided by workflow improvements including updated nursing functionality. TruBridge posted a net gain of two hospitals. Altera Digital Health recorded its first Sunrise platform win since 2023 and saw its fewest annual hospital losses in four years.
The 2026 test for Oracle and what it means for your vendor roadmap
KLAS flagged 2026 as a "pivotal proofpoint" year for Oracle Health as it rolls out its new AI-enabled EHR platform. Success will be critical to restoring confidence among existing customers and the broader market.
For practitioners, this freeze in purchasing decisions creates two competing pressures. On one hand, the market is less competitive right now. Fewer hospitals are evaluating options, which reduces vendor innovation pressure and shifts power toward incumbents. On the other hand, Oracle's instability (layoffs, restructures, shifting priorities following the Cerner acquisition) is a concrete defection risk for current customers. Epic's gains came not because it shipped new capability but because Oracle created an opening.
The absence of large, multi-hospital purchasing decisions signals that enterprise health systems are waiting out the cycle. They are not in buying mode. Smaller hospitals, which have fewer switching costs and less complex integration debt, are the only segment moving. This matters because it means the next generation of EHR architecture will be shaped by defaults, not deliberate choice, among the segment that can least afford vendor lock-in.