EHR Strategy in 2026: Key Areas Healthcare Leaders Are Prioritizing This Year

Healthcare organizations typically begin each year with a set of goals and benchmarks, projecting a blueprint for what they would like to accomplish. As 2026 unfolds, the organization can set context for their goals in the real-world setting, prioritizing their plans and, as needed, recalibrating them.

This recalibration can involve reassessing technology decisions made in previous years and determining what needs to be optimized, expanded, or re-evaluated. This is not unique to any particular year, but here we’ll delve into where healthcare leaders are turning their strategic attention to in 2026.

Taking Stock of Your EHR Environment in Early 2026

Savvy leaders often use Q1 and possibly Q2 to reassess where they are in the EHR optimization landscape. This can serve as a time to celebrate successes and offer kudos for quality work while also examining barriers and setbacks and creating plans to address them.

Key questions that healthcare facilities and their leaders are asking now include:

• Is our EHR supporting current care models?
• If not, where are inefficiencies still persisting? Where can EHR optimization help?
• Looking ahead to projected regulatory, competitive, and technology developments, how should we proactively prepare for them rather than to retroactively react?

Common friction points emerging in 2026 include the following:

• Administrative burden
• Reporting limitations
• Workflow misalignment

If you were to step back and take inventory, where are the friction points within your healthcare system? What questions are you raising with executive and clinical teams, and how do those answers shape your vision for the future environment?

AI & Automation: Where Healthcare Facilities Are Applying It in 2026

Past years have seen leaders speculating over the future adoption and applications of AI in healthcare EHRs. In 2026, however, the focus is on practical adoption of the technologies. Organizations are leveraging AI within their EHR environments this year through clinical documentation support; coding, billing, and revenue cycle workflows; and decision-support and analytics.

When deciding where to use automation, decision tree branches include whether this approach helps to reduce staff workload. How is it aiding in data governance? Oversight and accuracy? Change management for clinicians? Analysis in these areas can help you to make your own decisions for AI in healthcare EHR usage in 2026 and beyond.

Striking the right balance between automation and human oversight is critical to maintaining quality, cost-effective care. Becker Hospital Review recently asked healthcare leaders about their balancing plans, and here is one response.

UC Davis Health Vice President Paul LePage uses this dividing line: automation for “high-volume, rules-based tasks—such as eligibility checks, charge capture, and documentation prompts” while reserving human management in situations that require “clinical judgment, exception management, and quality assurance.” In 2026, he expects “advanced analytics and AI-driven workflows will surface risk, variance, and compliance issues in real time, enabling staff to intervene where expertise adds the most value.”

EHR Interoperability Expectations Are Higher in 2026

Interoperability is transitioning from a “nice-to-have” to an operational requirement. In fact, demand for seamless data exchange in active care settings will increasingly become an expected feature of healthcare technologies in all four domains: sending, finding, receiving, and integrating information.

Specific focus areas for 2026 include EHR-to-EHR interoperability, data sharing across vendors, and integration with third-party platforms. Besides ease of access for clinicians, patients in 2026 will want access to consolidated records rather than having to piece them together across providers.

Healthcare leaders will find EHR interoperability gaps harder to ignore this year with two ongoing challenges. The first is navigating data normalization: the apples-to-apples standard. Normalization involves ensuring that clinical data from multiple sources “speak” to one another in a common language to ensure accuracy, ease of use, improved patient care, and more informed decision-making through the use of comprehensive electronic health records. When transitioning to another EHR system, it’s even more vital that data is appropriately cleaned and migrated to the new application.

When making EHR selections, it’s therefore more important than ever to consider vendor operability limitations as well as other types of limitations to meet the increasing demands of the year.

Another critical step that has often been missing from interoperability discussions comes into focus in 2026: how integrated, real-time data is actually presented and used. EHRs must deliver this information to clinicians in ways that support efficient, intuitive patient care, while also providing administrators and financial leaders with clear, relevant data they can confidently use for decision-making. In both cases, data must be secure and grounded in meaningful, easy-to-understand context.

In 2026, interoperability moves beyond a purely technical concern and becomes a usability imperative, one focused on translating data into actionable information for the people relying on it every day.

EHR Cybersecurity Remains a Front-and-Center Concern in 2026

Although the emphasis on EHR cybersecurity is nothing new, in 2026, this issue continues to demand attention, especially as the EHR ecosystem grows in complexity. Healthcare leaders are focusing on proactive, mature security controls rather than reactively responding to cybersecurity threats and incidents.

In its almost seven hundred page 2026 State of Global Healthcare Technology, Black Book Market Research proposed a Global Health System Connectivity Compact framework for the EHR/EMR industry. The core vision of the framework is to “align around a shared humanitarian and clinical-safety objective: ensure that patient information can move safely across facilities.”

Although Black Book’s key focus is on conflict zones, their observations are true across facilities with founder Doug Brown saying that “Modern care depends on identity resolution, medication truth, imaging and lab continuity, and transaction-grade clinical handoffs . . . 2026 is a defining opportunity for global vendors to coordinate on a neutral, standards-based continuity layer: resilient patient matching, FHIR-enabled exchange, offline-first workflows, and cyber-hardened deployments, so hospitals can reconnect care safely regardless of platform. This is a humanitarian opportunity to build interoperability as patient safety infrastructure.”

As part of the movement towards increasingly embedded AI in healthcare EHR systems, AI and automation tools are being used to enhance EHR cybersecurity. According to the Cambridge College of Healthcare & Technology, AI and machine learning serve as “lead forces in the battle against cyber threats.” Cambridge highlights several practical applications, including:

• Threat identification through algorithmically driven analysis of enormous sets of data to spot unusual logins, unauthorized access, and other abnormalities
• Breach containment in ransomware scenarios with suspect-looking accounts rapidly being disabled
• Symbiotic protections to counteract threats and attacks; what hackers use to attack systems should also be used by healthcare systems to protect their data

Healthcare leaders in 2026 will prioritize these factors. Another key focus involves vendor risk management as organizations evaluate the risks faced by third-party vendors to determine how they might impact the healthcare facilities. Vendor risk management should serve as an intricate element of the EHR selection process as well as a regularly-reviewed ongoing concern. When necessary, executives sometimes must off-board a risky vendor that creates vulnerabilities for their own healthcare organizations.

Other priorities in 2026 include the use of strong access controls (role-based with strong, regularly changed passwords and MFAs), a regularly audited system, and thorough incident response planning and post-incident plans shared with all relevant staff members.

Re-Evaluating EHR Fit in the Mid-Year

EHR re-evaluations often occur at the end of or beginning of a year, but they are appropriate whenever opportunities exist for improvements, with leaders often deciding to optimize current systems, revisit modules or integrations, or put out RFPs for new EHR selections to begin evaluation conversations.

Common drivers behind these decisions include:

• Misalignment with clinical workflows
• EHR interoperability limitations
• Vendor roadmap concerns

These factors and others unique to a particular healthcare organization serve as the impetus of the next industry leadership trend.

EHR Selection Conversations Gaining Momentum in 2026

In 2026, healthcare leaders are re-engaging in EHR selection discussions without assuming a full system replacement is the default solution. Many organizations are taking a more open, exploratory approach—evaluating whether their current platforms can be optimized, expanded, or complemented before committing to a major change.

When selection conversations do move forward, they are increasingly centered on long-term scalability, integration flexibility, and access to high-quality data and reporting. Leaders want systems that support advanced analytics, enable more informed decision-making, and ultimately improve patient care across clinical and operational teams.

As EHR ecosystems grow more complex, independent guidance has become increasingly valuable. Organizations are weighing a range of established platforms, including:

• Epic
• Altera Allscripts
• Greenway Intergy
• MEDITECH
• Netsmart
• NextGen
• Oracle Cerner
• TruBridge
• Healthcare Payer Systems

Working with an experienced EHR consulting firm can help healthcare organizations navigate these conversations with clarity, ensuring technology decisions align with strategic goals, timelines, and budgets rather than short-term pressures or vendor bias.

Staying Strategic Through the Rest of 2026

EHR strategy in 2026 is defined by intentional prioritization. This means taking a hard look at what is working, identifying persistent friction points, and aligning technology decisions with both clinical outcomes and operational realities.

Through structured assessments and informed planning, healthcare organizations can stay agile throughout the remainder of the year and position themselves for long-term success beyond it.