US health systems consolidate fragmented electronic health records

Large US health systems are undergoing massive efforts to consolidate fragmented electronic health record (EHR) systems resulting from years of hospital mergers. Fragmentation poses significant challenges, as clinical data often fails to move cleanly between different platforms, hindering clinicians' ability to access complete patient records and complicating data analytics.

Several major systems have disclosed large-scale consolidation projects. Northwell Health is replacing more than 30 core EHRs and approximately 200 other applications with a single Epic platform. Vandalia Health in West Virginia aims to retire 27 systems to move all 16 of its hospitals and 220 ambulatory sites onto Epic by fall 2028. CommonSpirit Health has already reduced its EHR count from 19 to nine, while UPMC is transitioning nine EHRs to Epic.

These consolidation efforts coincide with increasing regulatory pressure regarding healthcare interoperability. Federal mandates, such as CMS-0057-F, require payers to implement specific FHIR APIs by January 1, 2027. Additionally, rules regarding information blocking and the TEFCA national exchange are driving the need for better data transmission across the healthcare stack.