Health systems are updating their EHR upgrade strategies amid the shift to AI and rapid technological evolution in healthcare, executives told Becker’s.
IT leaders refresh their EHRs as little as annually to as much as quarterly, based on what their vendors offer and to stay on top of the latest application releases.
New Hyde Park, N.Y.-based Northwell Health, which is in the middle of a $1.2 billion EHR implementation, renews Epic twice a year, combining two of the company’s quarterly releases into a single “double upgrade,” said Kristin Myers, executive vice president and chief digital officer of the 28-hospital system.
“At the start of each upgrade, we target the most current release; however, because Epic may publish a newer version during the upgrade process, we may go live on a version that is one release behind,” she said. “This approach allows us to maintain system stability while keeping pace with ongoing enhancements, including rapidly evolving generative AI capabilities that are increasingly embedded in Epic’s platform.”
Northwell also enables most new EHR features by default while controlling when they’re introduced to end users, aligning those rollouts with training and readiness, Ms. Myers said.
Cleveland Clinic upgrades its EHR twice annually but has been working to revise its schedule to shorten the time from when a new version is released and the health system’s update event, according to Sarah Hatchett, senior vice president and CIO.
“We have a goal that with each upgrade we are taking 75% of all new enhancements so we stay current on the latest features,” she said. “We have found it’s important not to get behind, which makes for a significant backlog and higher level of effort over time.”
Norfolk, Va.-based Sentara Health also upgrades Epic twice a year, operating two releases behind. But the 12-hospital system plans to move to quarterly upgrades, trailing by only one release.
“This approach helps us stay current with Epic’s latest enhancements,” said Tim Skeen, executive vice president and CIO of Sentara Health. “It also reduces reliance on third‑party integrations by leveraging more native Epic functionality.”
The health system also intends to start adopting all new features by default with a formal governance structure for Nova (Epic’s release notes), he said. Sentara’s latest upgrade was completed in a record of only 9 minutes and 32 seconds of downtime.
West Orange, N.J.-based RWJ Barnabas Health is preparing to switch from semiannual “double upgrades” to quarterly refreshes in 2027 to “keep pace with evolving technology and industry standards,” said Robert Adamson, PharmD, executive vice president and CIO.
The 12-hospital network also takes the latest release and enables over 90% of new features each time. “Our approach is both ambitious and strategic, ensuring we maximize the value of the enhancements Epic provides,” Dr. Adamson said.
The benefits include empowering patients with self-service tools, enhancing clinical decision support and safety protocols, and streamlining revenue cycle operations, he said. RWJ Barnabas joins only 3% of Epic clients who earned a 10/10 designation in the vendor’s Gold Star program for configuration.
Omaha-based Nebraska Methodist Health System, which has been an Oracle Health (formerly known as Cerner) customer for three decades, updates the EHR annually.
“We typically do our upgrades for a couple of reasons,” said Susan Clauser, senior IT director at the four-hospital system. “Sometimes it’s regulatory in nature. And then enhancements from a quality standpoint — especially in the last two to three years, there’s been significant improvement just with quality and the overall ease of Oracle EMR upgrades.”
The vendor, however, is moving to a quarterly update tempo, and Nebraska Methodist will evaluate whether to follow suit.
“My stance with my team is that there has to be a reason why we’re going to introduce change into our environment,” Ms. Clauser said. “So if we’re in a steady, consistent situation, no major issues in our environment as it exists today, we’re just not going to go introduce all this new code on a quarterly basis if we don’t have to, or there’s no significant enhancement coming out. Because we have to do a lot of testing, it introduces issues, so on and so forth.”
Houston-based Memorial Hermann Health System upgrades its EHR quarterly, staying no more than one release behind. “We have found that this cadence balances the need and desire from the organization to take new features and keep current while also minimizing some technical risk that comes with adopting a new release immediately,” said Desiree Gandrup-Dupre, senior vice president and CIO of the 17-hospital organization.
Memorial Hermann also only disables features by exception, if a process or function doesn’t dovetail with the organization’s business or care practices or if a longer runway is needed for change management or adoption, she said.
Emplify Health, headquartered in Green Bay and LaCrosse, Wis., upgrades quarterly, about six months behind the latest version.
“This deliberate approach allows us to benefit from early adopter learnings, vendor remediation of initial issues, and more predictable change management for our clinical and operational teams,” said Praveen Chopra, chief digital and information officer of the 11-hospital system.
But Emplify selectively pilots new functionalities as an early adopter, and typically implements about 85% of new features, given they sync with organizational priorities including clinical effectiveness, quality and safety, revenue cycle performance and throughput optimization, he said.
“Overall, this strategy enables us to stay meaningfully current, maximize return on our EHR investment, and adopt innovation in a disciplined, value-driven manner without introducing unnecessary disruption,” Mr. Chopra said.
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