Health systems want EHR-native functions, and clinical capabilities lead the way

Having already invested so much in their EHRs, most health system leaders prefer clinical functions that integrate with their systems of record. Vendors selling “further-out” workflows may yet have a chance.

By admin

Oct 29, 2026, 2:46 PM

Key takeaways

Reports from Bain and KLAS Research and from Redesign Health show health systems defaulting to EHR-native capabilities for anything closely tied to clinical work, where Epic’s data position and workflow integration are hard to displace. Third-party vendors have better odds in further-out categories such as revenue cycle management, ERP and workforce management, and governance, risk and compliance, along with workflows that require coordinating with external entities. The message for digital health companies is that non-clinical workflows can compete on features alone, while anything clinical needs to integrate with the EHR or face a long uphill climb.

Reports of the death of the electronic health record appear to have been exaggerated, and the EHR’s staying power is influencing how health systems invest in technology and how digital health companies build it.

A recent report from Bain and KLAS Research described the EHR as “a resilient software category.” The reasons aren’t surprising. Organizations willing to roll their own are few and far between; so, too, are those willing to switch from one vendor to another.

That phenomenon has had downstream implications for IT departments and innovators alike. Bain and KLAS found that organizations tend to default to EHR-native capabilities, particularly for features “tightly coupled to clinical work.”

A second report, from Redesign Health, described this as the Epic Effect. As technology consolidates onto enterprise EHRs, third-party vendors must work even harder to get healthcare leaders’ attention – though addressing the right shortcomings of the EHR may get them a foot in the door.

A strong preference for EHR-native clinical capabilities

The Bain and KLAS report looked at healthcare IT investment priorities in general and EHR features in particular. In four areas, acute care providers showed a clear preference for EHR-native systems “because quality and depth of integration trump bells and whistles.”

	Would adopt basic EHR-native function	Would adopt partial EHR-native function	Would adopt best-in-class function
Clinical workflow optimization	34%	28%	37%
Clinical tools and department-specific solutions	32%	31%	37%
Patient access and engagement	30%	32%	37%
Telehealth and virtual care	28%	28%	43%

Redesign Health’s survey data tells a similar story. According to healthcare executives, Epic is strongest in areas where its “existing data position and workflow integration give it a structural advantage that is difficult to displace.” This primarily includes key clinical functions such as throughput management, decision support, and risk stratification, as well as interoperability and the patient financial experience.

Opportunities remain for non-clinical and external workflows

Not all hope is lost for EHR competitors. Bain and KLAS found three areas where healthcare leaders may prefer best-in-class technology. All represent “further-out categories” that aren’t as closely related to clinical care.

	Would adopt basic EHR-native function	Would adopt partial EHR-native function	Would adopt best-in-class function
Revenue cycle management (RCM)	24%	48%	28%
Enterprise resource planning (ERP) and workforce management	7%	49%	44%
Governance, risk, and compliance (GRC)	7%	32%	41%

RCM represents a particularly important opportunity, as 43% of acute care providers and 64% of ambulatory providers told Bain and KLAS it’s one of their three main IT investment priorities. Health systems “are worried about falling behind” when it comes to RCM automation, the report said, so it’s understandable in this case that functionality is more important than EHR integration.

Redesign Health’s survey showed a similar pattern. The top areas for digital health vendors to compete with Epic included quality reporting, transitions of care, provider credentialing, and RCM. According to the report, these tend to be areas where it’s necessary to coordinate with external entities, or where Epic hasn’t previously placed much emphasis. (To be fair, most EHR companies haven’t – and that helps explain Oracle’s big bet on end-to-end enterprise technology integration in healthcare.)

Taken together, the findings of the two reports send a clear message to digital health vendors. If the workflow has historically existed outside the EHR, companies may be able to compete on features alone. On the other hand, if the workflow is in any way clinical, then it had better be integrated with the EHR. If not, vendors can expect a long uphill climb.

Brian Eastwood is a Boston-based writer with more than 10 years of experience covering healthcare IT and healthcare delivery. He also writes about enterprise IT, consumer technology, and corporate leadership.