By Dr. Ara J. Deukmedjian, MD
Board Certified Neurosurgeon
Published: October 29, 2026
Disclaimer: The information on this page is for learning purposes. It shows the view of Dr. Ara J. Deukmedjian, MD and is not legal, financial or medical advice. Numbers about hospital spending, revenue and market share come from information that’s available to the public and can change. Always check the sources and talk to a qualified expert before making choices based on what is written here.
Key Points
✓ Hospitals spend $75 million to $1.2 billion per Epic EHR implementation.
✓ Epic Systems holds 56.9% of U.S. hospital beds and will earn $6.7 billion in 2025. 1,2
✓ Judy Faulkner, Epic’s founder, is worth $9.6 billion. 1
✓ Doctors spend 2 hours on EHR work for every 1 hour with patients, plus 1–2 more hours at home each night. 3
✓ 70% of physicians using EHRs report work-related stress linked to documentation burden. 5
✓ EHR use is federally mandated. Non-compliance triggers Medicare payment cuts of up to 5%.
✓ The VA’s EHR project has grown from $4 billion to a projected $50 billion. 6
✓ No strong evidence shows EHRs have improved patient outcomes at the scale of their cost. 7
Video Transcript
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Dr. Ara Deukmedjian: I’m Dr. Ara Deukmedjian, CEO and founder of the Deuk Spine Institute and Deuk Joint Institute. I’m here today to talk to you about a recent article in the news. This is 2026’s biggest electronic health record switches. This article talks about how hospitals and, frankly, our country are spending billions of dollars on electronic health record systems.
Now, I was brought up in the 70s and 80s, and back then doctors would keep track of patient records in their paper chart, and the paper chart would have important information documented. The doctor could interview a patient, examine a patient, and write records, all in about 10 to 15 minutes, making the right diagnosis and prescribing the right treatment or test. Unfortunately, over the last 40 years, there has become a mandate by our government, at the behest of insurance companies, basically, to convert all the paper charts over to electronic records.
What has pushed the use of electronic health records in the United States is politics. To summarize, it’s big companies making tens of billions of dollars a year in profit, basically Wall Street, and they are pushing politicians to pass laws in our federal government and state governments mandating that doctors’ offices, hospitals, and clinics across the country have to purchase extremely expensive electronic health record systems. These are software packages. So you’re basically buying a software package like a video game, right? When I go onto the internet and I buy a video game that took hundreds, if not thousands, of hours to develop, it costs about 50 bucks. It runs on your computer. You own that video game for the rest of your life. So for 50 bucks, you can buy a very sophisticated software package and use it to play complex, sophisticated video games, even online multiplayer games.
Well, these electronic health record companies have basically created a glorified spreadsheet that allows doctors, clinicians, hospitals, and clinics to access patient results and have them on their computer, basically a software program. But they charge hospitals billions, and that’s with a B, billions of dollars to purchase these software packages. And when the hospitals buy these software packages, there’s a tremendous amount of downtime where clinicians, doctors, physical therapists, and nurses have to learn how to use these software programs. So it takes away from patient care, right? Because patient care has been around for hundreds if not thousands of years, but patient care does not include sitting and typing information into a computer.
So we’re going to talk a little bit about electronic health records in the United States in 2026, and we’re going to talk about this article, which highlights some of the cost of these electronic health records to hospital systems. The way the federal government did this, the federal government passed laws that basically said hospitals and doctors have to go out, spend their own money or borrow money to purchase these electronic health record systems, which are basically overpriced software databases that you could buy for a few hundred bucks. They sell it to you for hundreds of millions of dollars. The hundreds of millions of dollars, of course, go to these companies, which are also owned by private equity, by Wall Street companies, and they’re making billions of dollars in profit.
I’ll tell you, Judy Faulkner, she is the founder of Epic. Epic is the biggest electronic health record vendor in the United States, one of the biggest in the world. Their revenue in 2025 was 6.7 billion. That’s with the B. It’s one year. Selling software for one year, they made $6.7 billion. In 2024, Epic made $5.7 billion. As a matter of fact, the founder, Judy Faulkner herself, is worth $9.6 billion. So she basically came up with an Excel spreadsheet that’s glorified, to put data into so you can access it on a network, and now she’s worth $10 billion. Okay, there’s something very wrong with this, especially when you consider the most important fact: that money, the billions of dollars that hospitals are spending to buy an electronic health record system, should have been used to take care of patients, to buy antibiotics, to update their equipment, to buy the latest medical devices and equipment, to improve outcomes for patient care.
And I want to say it has never been shown that buying an electronic health record system, implementing an electronic health record system, has ever shown to improve patient outcomes. It is not. Doctors know this. Hospitals know this. Why do we buy electronic health record systems? Because the federal government, lawmakers, pass laws that force us to buy these electronic health record systems. As a matter of fact, if you don’t buy an electronic health record system that the government approves, which has all these requirements, which means you’re going to be spending a hundred million to a billion dollars for yours at your hospital, if you don’t buy them, then there are penalties for the hospitals and for doctors. One of the penalties is called a negative payment adjustment of up to 5% of your payments. They don’t pay you. Basically, you do your surgery or you treat your patient, you send the bill to the insurance company, and they take out 5% because you’re not using an approved electronic medical record system. The other penalties include ineligibility for Medicare and commercial payer programs that basically pay hospitals and doctors money they need so they can stay operating and take care of patients. The other penalty includes information blocking penalties.
So if you don’t have an electronic health record system in your doctor’s office or hospital that the government approves, which is basically one that Wall Street owns the company, so that they can make billions of dollars out of the health care system that should have been used to take care of patients with treatments and surgeries and tests, that money has been diverted now to these electronic programs and to the pockets of big business and Wall Street. So if you don’t have these, they penalize you for information blocking, which are financial penalties for hospitals and doctors. Also, there are HIPAA penalties and reduced Medicare MIPS payments. MIPS is the Merit-based Incentive Payment System. So the government has created a system, and with the help, by the way, of influence from lobbyists in Washington, DC, from the electronic health record companies, which are purchased and owned by Wall Street companies. So the Wall Street companies, in cahoots with these electronic health record systems, have basically gone to the government, forced the politicians to write laws that penalize doctors and hospitals for not buying these ridiculously expensive systems that have never been shown, not one, to ever improve quality of care for patients. Not one. As a matter of fact, they take away quality of care.
Listen to this. Physicians in the United States report 70% burnout. That means 70% of our doctors are burning out from electronic health record system use. Why? Here’s why. Because every day the doctors see patients and then they go and spend between two to four hours a day on the computer adding information in that they couldn’t put in while they were seeing the patient, because it takes too long to type it in. So these electronic health records are putting a burden on physicians and their staff to spend two to four hours a day, which they never used to spend when they had paper charts, basically documenting in electronic health record systems so that the insurance companies can have more information so they can do more audits and deny more payments because you didn’t put the right information in. That’s their basis. Doctors spend 20 minutes out of every 30-minute patient visit typing and writing into their electronic health record systems.
Folks, in the old days, a doctor would sit down with you, look you in the eye, and focus on you and your medical issues, and they would use their brain instead of typing into an electronic health system. They would figure out what’s wrong with you, and they would educate you and tell you about your problem and what your options for treatment are. Now they’re taking time away from the patient, taking time away from thinking about and medical decision-making, figuring out what’s wrong with you, and they’re putting that time into the computer, because they all want to go home at the end of the day. They want to be with their families, their kids, their wives, their spouses, whoever it is. They want to go out to the gym and do stuff outside of work, but they can’t because they’re spending all this time entering useless data into the electronic medical record system.
Also, doctors are reporting negative effects of electronic health record systems on patient rapport. 60% of doctors report that they have reduced interaction with the patient and they feel like the patients are not trusting them because of this. That’s because they’re spending their time on the electronic health record. Another big thing to know: when doctors spend four hours a day typing information into the computer, they’re not paid for that time. They get zero payment from the insurance company. So the insurance companies are smart. The health insurance companies have said, “Hey, how could we get doctors to see fewer patients, order fewer tests, do fewer treatments? Let’s make doctors use the electronic health record system every day and type all this stuff in the computer, because then they could see fewer patients.” If you have the ability to see 40 patients in a day, now they can only see 20 patients. So doctors are seeing fewer patients. Wait times to see doctors have extended. You now have six weeks, six months, four months wait time to get in and see a doctor. Why? Because they’re spending their time filling out electronic health record systems instead of focusing on patient care. So, in my opinion, electronic health record systems have reduced the quality of patient care in the United States since they were mandated 20 years ago.
Also, there’s the cost of them. Who pays for electronic health record systems? The insurance company doesn’t. So the doctor is forced to pay out of pocket, or the hospital is forced to pay out of pocket, which eats into their ability to care for patients, because money spent on electronic health record systems is less money spent on equipment and surgery and patient care.
Let’s take a look at this article. Epic, which is the leading electronic health record system company in the country, has 56.9% of all hospital beds under the Epic EHR, and they had 77 new hospitals added to Epic in 2025. All this data comes from reliable sources. There are 325 million patients now on the Epic EHR system. As I told you, their revenue last year was $6.7 billion from hospitals paying them and doctors paying them. And the owner, who owns 43% of the shares, Judy Faulkner, she’s worth $9.6 billion from all the profits she’s made selling what honestly should be a dirt cheap software system.
Another is Oracle. And Oracle actually is going the opposite direction. It lost 56 hospitals. Its largest project is the federal government, specifically the VA health system. We’re going to talk about that in a minute.
Now, let’s take a look at some of the hospitals. In Michigan, Trinity Health is basically just completing its $800 million purchase of Epic and implementation of Epic. Remember, folks, they’re buying a software program to install on their computer, just like a video game. Instead of paying 50 bucks or 80 bucks for a very, very sophisticated video game, they’re spending $800 million on the same program that’s being rolled out to every other hospital. Isn’t this greed enough? That money should be spent on patient care, not computer software systems.
In New York, you have Northwell Health. This hospital spent $1.2 billion on Epic, and they’re migrating with Epic. Adventist Health in California, $1 billion plus for their Epic electronic health record system. Again, folks, let me remind you, these electronic health systems take doctors’ time away from you, the patient. They’ve never been shown to improve the quality or improvement in health care, and they’re costing hospitals and doctors tens of billions of dollars a year, which they could be spending on patient care, taking care of you, taking better care of you. We’ve seen the United States go from number one in the world in patient care down to the 60s. Why? Because we’re wasting all this money on useless crap like electronic health record systems that are overpriced. Now, I like electronic health records, but they should be much more affordable. They should be regulated. It shouldn’t be an eye-gouging price of billions of dollars for a hospital to install a software program.
Okay, another example in Mississippi, South Central Regional Medical Center, $115 million. Buffalo, New York, Kaleida Health, well, they just spent $170 million on Epic. And that created for them a $21 million deficit for one year, $21 million in the hole that year in operating costs. Basically, they’re putting themselves at risk for bankruptcy. Why? To get an electronic health record system. Miami, Nicklaus Children’s Health System, $75 million. And finally, the worst of all, the VA hospital system. They were told it would cost $4 billion to put an electronic health record system in. Now, they had VistA originally, which worked fine when I worked at the VA hospital. Now the price tag for the VA system is $50 billion for electronic health. That’s $50 billion that should be spent on patient care.
Well, thanks for joining me on this podcast. I’m Dr. Ara Deukmedjian, CEO and founder of the Deuk Spine Institute. You’re always going to get the truth from us, folks. We don’t pull any punches. We’re going to expose the corruption and the lies that are happening in health care every time we get the opportunity to. So please like and subscribe if you want to support our channel. Thank you.
What Is an Electronic Health Record System, Really?
The Electronic Health Record as a format is a computer program. It is a replacement of the paper chart which doctors had been using for most of the century with a database containing patient histories, lab tests, images, prescriptions, and notes. On the face of it, it may seem to be a sensible approach. But in practice, as it has been implemented in the United States in the last twenty years, it has become one of the most costly and least patient-centered failures in modern medicine.
In the 1970s and 1980s a well‑trained physician could interview a patient. Then examine them. The physician would write the encounter on a chart. Then reach a diagnosis and prescribe treatment or a test in ten to fifteen minutes. The chart itself was simple. The physician kept the focus on the patient. Today a thirty‑minute office visit usually contains around twenty minutes of typing on a computer. The physician then has about ten minutes left for real eye contact and clinical conversation with the patient.
That change was not driven by patient demand. It was driven by federal law, lobbying from EHR vendors, and the financial interests of insurance companies that benefit from more detailed data to use in audits and payment denials.
How EHR Adoption Became Mandatory
The Health Information Technology, for Economic and Clinical Health (HITECH) Act of 2009 initiated a series of regulations which the federal government used to compel the hospitals, clinics and private practices to purchase authorized EHR systems. The Medicare Access and CHIP Reauthorization Act (MACRA) also introduced some regulations. The federal government came up with a set of both carrots and sticks that could be used on the hospitals, clinics and private practices. The carrots included incentives in case they purchased EHR systems as per the regulations. The sticks included sanctions for failing to adhere to the regulations.
The penalties stack on top of each other:
- Negative payment adjustments of up to 5% on Medicare payments for providers who do not use a certified EHR.
- When Medicare becomes ineligible and commercial payer incentive programs are lost hospitals and practices may no longer stay solvent.
- Providers whose systems fail to meet interoperability requirements face information blocking penalties.
- HIPAA-related penalties arise from the way data is stored and sent electronically.
- Lower MIPS scores cut reimbursement more.
In other words: use the approved software, or get paid less for the same work. For most hospitals and large practices, the “choice” is not a choice at all.
Hospitals Are Paying Software Companies Like They’re Buying Buildings
When you buy a sophisticated video game, a product that may have taken thousands of developer hours and millions of dollars to build. You typically pay somewhere between $50 and $80, and you own that software on your personal computer indefinitely. When a hospital system “buys” an EHR, it pays hundreds of millions, and in some cases over a billion dollars, for what is functionally a very large, networked database of patient information.
Here are a few of the recent EHR implementations that have been publicly reported:
- Trinity Health: approximately $800 million for its Epic implementation.
- Northwell Health (New York): approximately $1.2 billion for Epic migration.
- Adventist Health (California): over $1 billion for Epic.
- South Central Regional Medical Center (Mississippi): approximately $115 million.
- Kaleida Health (Buffalo, New York): spent about $170 million on Epic, which contributed to a reported $21 million operating deficit in one year.
- Nicklaus Childrens Health System (Miami): spent about $75 million.
- U.S. Department of Veterans Affairs: originally budgeted $4 billion, for a new EHR but current projections now approach $50 billion over the life of the program. 6
These numbers are not small. For community and regional hospitals an EHR purchase is the single largest capital expenditure hospitals will make in a decade. EHR purchase is larger than operating rooms. It’s new MRI suites or expanded ICUs.
Who Is Getting Rich?
The dominant player in the U.S. hospital EHR market is Epic Systems, headquartered in Verona, Wisconsin. The numbers from publicly available reporting are striking: 1,2
- Epic reported approximately $6.7 billion in revenue in 2025, up from $5.7 billion in 2024 and roughly $4.6 billion in 2022.
- Epic’s software is now the EHR of record for approximately 325 million patients.
- Epic covers 56.9% of all U.S. hospital beds and added roughly 77 new hospital customers in 2025 alone.
- Epic’s founder and CEO, Judy Faulkner, has an estimated net worth of $9.6 billion, based largely on her 43% ownership of the privately held company. 1
Oracle Health (formerly Cerner) is the second major player, with a very different trajectory. It has been losing hospital customers, but it remains the primary vendor for the VA health system, which is one of the largest EHR projects in the world.
I do not mind a person building a company. I do not mind.. I do not like a system where federal law makes sure that the money, which comes mostly from hospital, clinic and taxpayer budgets, goes into one or two private vendors. In that system those vendors get little competition to lower prices or improve their products.
The Clinical Cost: Doctors Are Burning Out and Patients Are Waiting Longer
The financial cost is only half of the story. The clinical cost is harder to put on a spreadsheet, but it may be even more damaging.
Documentation Burden
A time-and-motion study published in the Annals of Internal Medicine found that for every 1 hour of direct clinical face time with patients, physicians spend nearly 2 additional hours on EHR and desk work during the clinic day and then another 1 to 2 hours of personal time each night finishing documentation. 3 A separate University of Wisconsin study of 142 family medicine physicians found that primary care doctors spent 5.9 hours of an 11.4-hour workday on EHR tasks. 4
Burnout
A survey of nearly 1,800 Rhode Island physicians, published in the Journal of the American Medical Informatics Association, found that 70% of physicians who used EHRs reported at least one measure of EHR-related stress. Doctors who did not have enough in-clinic time to complete their documentation were 2.8 times more likely to show symptoms of burnout than their peers. 5
Erosion of the Doctor-Patient Relationship
When a physician spends two-thirds of a visit facing a screen instead of the patient, something is lost that no software update can restore. In my own practice and in conversations with colleagues across the country, I hear the same complaint from patients: “My doctor didn’t look at me.” They are not wrong. They are describing what the data confirms. 3
Fewer Patients Seen, Longer Wait Times
When documentation time doubles, the number of patients a physician can see in a day falls. The downstream effect is exactly what patients report: wait times of six weeks, three months, or six months to see a specialist for conditions that used to be evaluated within a week or two. This is not a shortage of doctors. It is a shortage of doctor time that has been consumed by data entry.
Has Any of This Improved Patient Care?
I think this is a question that is rarely asked in policy debate and it should be the question.
To date I have not found evidence that requiring people to buy hundred-million-dollar EHR systems has lowered death rates, cut complication rates and made diagnoses more accurate or shortened recovery times for the whole population.
We do see some small benefits, such as fewer duplicate tests in some places, safer e-prescribing and better data, for research. However none of these benefits matches the hundreds of billions of dollars that have been spent across the system. 7
Meanwhile several measurable harms have been documented:
- Increased documentation burden and burnout. 3,5
- Reduction in direct patient face time. 3
- “Note bloat”: long, copy-pasted notes that make it harder, not easier, for the next clinician to find relevant information. 7
- Alert fatigue, with physicians overriding or ignoring safety warnings because the system generates too many of them.
- Diverted capital that could have been spent on equipment, staff, and treatment.
An EHR, done right, could be a modest clinical tool. As currently implemented, it is primarily a billing and auditing platform for insurers and a revenue engine for a very small number of software vendors.
What We Practice at Deuk Spine Institute
I built Deuk Spine Institute and Deuk Joint Institute around a simple commitment: the patient’s time, outcome, and dollars come before anything else. We use electronic records, as every modern practice must, but we are relentless about not letting the system dictate how we practice medicine. When you come in for a consultation, you get a real conversation with a real surgeon, not a scribe-and-screen exchange.
That is also why we offer a free MRI review for patients considering spine surgery. We would rather tell you honestly what your options are including the ones your current surgeon may not have mentioned. Than funnel you into a procedure that benefits the system more than it benefits you.
Hospitals spend $75M–$1.2B on EHR software — doctors now spend 2 hours on screens for every 1 hour with you
The system is billing for your data.
We’d rather spend that time on you.
Federal mandates force hospitals to spend hundreds of millions on EHR software that benefits insurers and vendors—not patients. Doctors spend two-thirds of every visit typing into a screen. At Deuk Spine Institute, you get a real conversation with a board-certified neurosurgeon, a free MRI review, and a 30-minute outpatient procedure that puts outcomes ahead of paperwork.
in 2025 alone
EHR-related burnout
every hour with patients
- ~20 min of typing per 30-min visit
- 1–2 extra hours of charting at home each night
- Months-long wait times for specialists
- Capital diverted from care to software
- No proven improvement in patient outcomes
- Real conversation with a neurosurgeon
- Free MRI review — no referral needed
- 95% DLDR success rate, 2,800+ procedures
- 30-min outpatient procedure, same-day discharge
- 0.01% complication rate
Board-certified neurosurgeon review · No insurance approval required · 100,000+ procedures performed
FAQs
What is an Electronic Health Record (EHR) system?
answer
I know that an EHR is a software platform that keeps medical information safe and ready for sharing. The EHR holds histories, lab results, imaging reports, prescriptions and clinical notes and the EHR replaces the paper chart that people used to carry. In the United States most hospitals and large medical offices rely on EHR software from vendors. Epic Systems and Oracle Health are the two vendors that most people talk about. 1
Why did hospitals and doctors have to adopt EHRs?
Answer
Starting with the HITECH Act of 2009, federal law created financial incentives for EHR adoption and penalties: including Medicare payment reductions of up to 5%, loss of incentive-program eligibility, and information blocking fines for providers who did not use certified EHR technology. For most hospitals, continuing to use paper charts became financially impossible.
How much are hospitals spending on EHR systems?
Answer
Large health systems have reported Epic implementation costs ranging from roughly $75 million for a children’s hospital to more than $1.2 billion for a major integrated network. The U.S. Department of Veterans Affairs’ EHR modernization, originally estimated at approximately $4 billion, is now projected to cost close to $50 billion over the life of the program. 6
Is Epic Systems really that dominant?
Answer
Yes. According to 2025 figures, Epic software controls 56.9 percent of all hospital beds in the U.S., with approximately 325 million people using Epic as their electronic health records. Epic’s income in 2025 reached six point seven billion dollars, up from five point seven billion dollars in the previous year. The estimated fortune of Epics’ owner and CEO, Judy Faulkner, stands at nine point six billion dollars. 1,2
Do EHRs actually improve patient care?
Answer
There is not a single study to show how much EHRs have helped reduce patient mortality rates, improve diagnostics or help in the clinical outcome. However, there are several advantages as e-prescriptions become safe and duplicate tests are reduced. Several research papers have been written on how EHRs affect physicians and patients negatively because they increase the burden of documentation, physician burnout, and less face-to-face contact time. 3,5,7
Why do doctors complain so much about EHRs?
Answer
Because the data confirms what they are experiencing. Published studies show physicians spend nearly 2 hours on EHR and clerical work for every 1 hour of direct patient care, plus another 1 to 2 hours of unpaid clerical work at home each night. Approximately 70% of physicians who use EHRs report at least one measure of EHR-related stress, and those who cannot finish documentation during the workday are 2.8 times more likely to show burnout symptoms. 3,4,5
If EHRs are so expensive, why don’t hospitals just buy cheaper software?
Answer
The competition is fierce. As a result of the certification criteria, interoperability standards, and the difficulty of interfacing with the billing, imaging, laboratory, and pharmacy systems, only a few vendors can compete. Switching costs exist for hospitals that have already adopted a system. In fact, migrating to a new vendor could cost hundreds of millions of dollars.
What should patients do about this?
Answer
Be an informed consumer. Ask your doctor to look at you, not just the screen. Ask for a copy of your records (you are entitled to them). And ask hard questions about where your hospital’s capital spending is going, because every dollar spent on overpriced software is a dollar not spent on care.
Sources
View Sources
- https://www.beckershospitalreview.com/healthcare-information-technology/ehrs/epics-dominance-in-14-numbers/
- https://www.beckershospitalreview.com/healthcare-information-technology/ehrs/epics-revenue-increases-to-5-7b
- https://www.acpjournals.org/doi/10.7326/M16-0961
- https://www.annfammed.org/content/15/5/419
- https://academic.oup.com/jamia/article/26/2/106/5230918
- https://www.va.gov/oig/pubs/VAOIG-report-ehrm.asp
- https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.1673
