Compilation shows US Veterans Administration spent the most at $16B
Clinical laboratory leaders and pathologists will be interested in which hospital systems are making the largest investments in electronic health record (EHR) technologies. Especially considering laboratory information systems (LIS) must interface with these platforms and require extensive reworking when hospitals change their EHRs. For example, hospitals moving to the Epic Systems EHR often require their laboratories to implement the Epic Beaker LIS as well.
According to information sourced by Becker’s Hospital Review, the top 16 hospital systems each spent $500 million or more on EHRs, adding, however, that the information is “not an exhaustive list.”
Number three on the list is Kaiser Permanente which operates multiple hospitals within its nine healthcare networks across the United States serving 12.5 million members. For that reason, its total investment in EHR technology represents a much larger number of hospitals than the other health systems on the list.
Of the 16 providers on the list, 12 installed EHRs provided by Epic Systems of Verona, Wis. Four of the providers implemented EHRs from Oracle Health (formerly Cerner), North Kansas City, Mo., and Meditech of Westwood, Mass.
“Looking forward, there are many advantages in terms of investing in the future and how we will be aligned with technologies including digital and AI applications,” said pathologist Angelique W. Levi, MD (above), vice chair and director of pathology reference services at Yale School of Medicine, in a news release following a site visit to Geisinger Diagnostic Medicine Institute in Danville, Pa., to see Epic Beaker in operation at Geisinger’s clinical laboratory. “But what we gain immediately—having all the patient information accessible in one place in a linked and integrated fashion—is very important.” (Photo copyright: Yale School of Medicine.)
Provider, EHR, Investment
Becker’s list below shows the total amount invested by the 16 healthcare systems was approximately $38.32 billion. The average EHR implementation cost is $2.39 billion for a large healthcare provider.
- US Department of Veteran Affairs, Washington, D.C. (Oracle) $16 billion.
- Military Health System, Washington, D.C. (Oracle) $5.5 billion.
- Kaiser Permanente, Oakland, Calif. (Epic) $4.0 billion.
- Catholic Health Initiatives (CommonSpirit Health),
Englewood, Colo. (Oracle/Meditech) $1.5 billion. - Mayo Clinic, Rochester, Minn. (Epic) $1.5 billion.
- Mass General Brigham, Somerville, Mass. (Epic) $1.2 billion.
- Northwell Health, New Hyde Park, N.Y. (Epic) $1.2 billion.
- Dignity Health, San Francisco (Oracle/Meditech) $1 billion.
- NYC Health and Hospitals, New York, N.Y. (Epic) $1 billion.
- Sutter Health, Sacramento, Calif. (Epic) $1 billion.
- NewYork-Presbyterian, New York, N.Y. (Epic) $964 million.
- Providence, Renton, Wash. (Epic) $800 million.
- Trinity Health, Livonia, Mich. (Epic) $800 million.
- Duke University Health System, Durham, N.C. (Epic) $700 million.
- AdventHealth, Altamonte Springs, Fla. (Epic) $660 million.
- Memorial Hermann Health System, Houston (Epic) $500 million.
Becker’s stated they assembled this list from public sources and that there may be other EHR/hospital contracts with a total cost that also would make the list. It is not common to see a list of what hospitals actually spend to acquire and deploy a new EHR.
Shifting EHR Market
According to KLAS’ 2024 US Acute Care EHR Market Share report, Epic was the only EHR vendor to increase its market share in 2023.
Epic added 153 hospitals to its client base in 2023. Epic’s EHR competitors—Oracle and Meditech—both experienced declines in client retention rate, Healthcare IT News reported based on the KLAS data.
“Both current and prospective large organization customers are drawn to Epic because they see the vendor as a consistently high performer that provides strong healthcare IT [information technology], quality relationships, and the opportunity to streamline workflows and improve clinicians’ satisfaction,” Healthcare IT News said of the KLAS report’s findings.
In a blog post, authors of the KLAS report explained that in 2023 Oracle added specialty hospital clients and Meditech “saw several new sales” which included healthcare systems and independent providers.
In the next few years, the industry is “ripe for disruption. Another vendor could come in and turn everything on its head,” the KLAS blog article concluded. “Even those who choose Epic want to have more competitive options to choose from.”
Preparing for an LIS Change
Clinical laboratory leaders who may be transitioning their LIS during a new EHR installation may learn from colleagues who completed such an implementation.
In September, Yale School of Medicine in New Haven, Conn., sent a department of pathology team to visit Geisinger Diagnostic Medicine Institute, Danville, Pa. Geisinger had adopted Epic Beaker and has a workflow similar to Yale’s, according to a Yale News article.
Angelique Levi, MD, vice chair and director of pathology reference services at Yale School of Medicine, who was part of the pathology team, noted that one challenge for labs is addressing “information that’s from many different places when we’re talking about cancer care, prognostic testing, and diagnostics.
“It’s become much more complicated to manage all those data points,” she continued. “Without being on an integrated and aligned system, you’re getting pieces of information from different places, but not the ability to have linked and integrated reports in one spot.”
EHR implementations are among the most labor-intensive, expensive projects undertaken by hospitals. Therefore, it is crucial that clinical laboratory and pathology leaders research and learn why an EHR (and possibly LIS) change is needed, what is expected, and when results will be received.
—Donna Marie Pocius
Related Information:
Broward Health Transforms Care with Epic Implementation
US Acute Care EHR Market Share 2024
Epic’s EHR Market Share Gains Continue, KLAS Report Shows
US Acute Care EHR Market Share in 2024
Pathology Team Encouraged about Migration to Epic Beaker Laboratory Information System