Allscripts vs Epic | Detailed EHR Comparison

Posted in EHR/EMR

Allscripts vs Epic is no longer a comparison between two companies. Epic has 43.7% of US acute care hospitals and 56.9% of hospital beds, according to KLAS data reported in May 2026. Allscripts split in 2022: its hospital products now sell as Altera Digital Health, which holds 2.9% of hospitals, and its ambulatory products sell as Veradigm. Epic fits large and mid-size health systems and academic centers, Altera Sunrise is the lower-cost hospital alternative, and Veradigm fits small practices. This guide explains what Allscripts is today, and how it compares to Epic EHR. 

What Is Allscripts EHR

Allscripts EHR is a an electronic health record product, now sold by two separate companies. 

On May 2, 2022, Allscripts Healthcare Solutions completed the sale of its Hospitals and Large Physician Practices business to N. Harris Computer Corporation, a subsidiary of Constellation Software, for $670 million in cash plus up to $30 million in contingent payments. Harris renamed the unit Altera Digital Health. 

The products that moved to Altera were Sunrise, Paragon, TouchWorks, Opal, STAR, HealthQuest and dbMotion. Sunrise is the large-hospital EHR, Paragon is the community-hospital EHR, TouchWorks is the large-group ambulatory EHR, and dbMotion is the data aggregation platform.

The part that stayed was the Veradigm segment, and in January 2023 the remaining public company renamed itself Veradigm. Veradigm sells the Veradigm EHR (the former Allscripts Professional EHR), Practice Fusion, ePrescribe, practice management, and a payer and life sciences data business. Veradigm was removed from the Nasdaq listing in 2024 after it fell behind on financial filings, and it now trades over the counter.

Allscripts vs Epic Differences

Area	Epic	Altera / Veradigm (former Allscripts)
Company structure	One private company, all products built in-house	Two companies since 2022: Altera (hospitals) and Veradigm (practices)
Flagship products	EpicCare Inpatient and Ambulatory, MyChart, Cosmos	Altera: Sunrise, Paragon, TouchWorks, dbMotion. Veradigm: Veradigm EHR, Practice Fusion
Best-fit organization	Health systems, academic medical centers, standalone hospitals above 200 beds, affiliated clinics	Altera: mid-size and community hospitals. Veradigm: independent and small-group practices
Patient record model	Single database across inpatient, outpatient, and billing	Separate products; dbMotion aggregates records from multiple systems
Data exchange	Care Everywhere, Happy Together, Epic Nexus (TEFCA QHIN), FHIR R4 APIs, Showroom app marketplace	dbMotion, FHIR R4 APIs, Veradigm Connect developer program
Patient portal	MyChart, more than 190 million users	FollowMyHealth (Veradigm)
AI	Around 200 AI projects, ambient documentation through Abridge and Microsoft, in-house generative tools	Veradigm Predictive Scheduler and analytics; Altera ambient documentation through partners
Cloud posture	On-premises, Epic-hosted or public cloud (Tufts Medicine runs Epic on AWS)	Altera moving Sunrise and Paragon to Microsoft Azure; Veradigm products are cloud-hosted
Cost tier	Enterprise. Public projects range from under $4 million for a small hospital to $1.2 billion for a 21-hospital system	Altera: custom, not published, generally below Epic. Veradigm: per-provider monthly pricing, modules from $59 per month
2026 market share (acute care)	43.7% of hospitals, 56.9% of beds	Altera: 2.9% of hospitals, 2.8% of beds

Clinical Workflow and Documentation

• Epic documentation runs on SmartTools: SmartPhrases (dot phrases), SmartTexts, SmartLists, and NoteWriter, all pulling from the same chart. A clinician on an inpatient unit and a clinician in an affiliated clinic work in the same note structure. The trade-off is that configuration is deep, and training is long.
• Altera Sunrise uses structured documentation with editable templates and a rules engine that fires alerts during charting. Veradigm EHR and Practice Fusion use simpler template-based notes designed for a small practice with no IT department. New users are typically productive in days rather than weeks.

In the Allscripts vs Epic workflow comparison, this matters most for organizations with many specialties under one roof. The more service lines you run, the more Epic’s standardization pays off.

Patient Record Architecture

Epic stores inpatient, ambulatory, emergency, billing and scheduling data in a single Chronicles database. A lab result ordered in the ED is the same record the primary care physician sees a week later, with no interface in between.

Altera’s dbMotion pulls records from Sunrise, Paragon, TouchWorks and non-Altera systems, matches patients across them and presents a combined view. It works, but it is an aggregation layer on top of separate databases, so timing and matching rules have to be managed.

For a health system that has grown by acquisition and still runs several EHRs, dbMotion can be useful on its own. For a system that wants to retire those EHRs, Epic’s single-database model is the simpler end state, and it is the architectural core of the Allscripts vs Epic difference.

Order Entry and Medications

Epic’s computerized provider order entry is tied to Willow (pharmacy), Beaker (lab) and Radiant (imaging), so an order moves through the whole chain without an outbound interface. Order sets are built per specialty and governed centrally. A common complaint is that changing an active order means canceling and re-entering it.

Sunrise has mature CPOE with medication management, including barcode administration and dose checking. Veradigm’s strength is ePrescribe, which it sells both inside its EHR and as a standalone module, including controlled-substance prescribing.

Hospital pharmacy leaders will care about the Sunrise vs Epic order entry comparison. Practice managers will care about how good the ePrescribe workflow is, and Veradigm does that well.

Specialty Modules

Epic sells named modules for most specialties: Beacon (oncology), Cupid (cardiology), Stork (obstetrics), Kaleidoscope (ophthalmology), OpTime (surgery), Bones (orthopedics), Wisdom (dental), and others, each built on the same chart.

Altera Sunrise covers acute care, emergency, surgical, and ambulatory settings and relies on third-party vendors for deeper specialty needs. Veradigm EHR has specialty templates but no module catalog of comparable size.

If your organization runs a cancer center, a cardiology program, and a surgical service line, this is often the deciding factor in Allscripts vs Epic discussions.

Interoperability and Data Exchange

Epic exchanges records between Epic sites through Care Everywhere, shows patients their records across organizations through Happy Together, and operates Epic Nexus as a designated QHIN under TEFCA. It exposes FHIR R4 APIs and runs the Showroom marketplace (formerly App Orchard) for third-party apps.

Altera and Veradigm both support FHIR R4 and US Core as required by ONC certification. Altera’s dbMotion is designed to pull from any vendor’s EHR, and Veradigm Connect is its developer program for ambulatory apps.

The 2026 ABFM five-year analysis of 36,785 family physicians found that Epic’s interoperability advantage is confined to Epic-to-Epic exchange; for exchange with a different vendor, non-Epic users reported it as easier. In the Allscripts vs Epic interoperability question, buyers whose referral partners are mostly on Epic should weigh the network effect heavily. Buyers in a mixed-vendor region should not assume Epic solves cross-vendor exchange.

Patient Portals

 

Epic MyChart has more than 190 million users and lets a patient see records from every Epic organization they have visited in one login. It handles scheduling, messaging, bill pay, proxy access, telehealth, and device data.

FollowMyHealth, sold by Veradigm, covers appointments, messaging, results, and video visits, with multi-language support. It does not have MyChart’s cross-organization view because most Veradigm customers are single practices.

On portals, the Allscripts vs Epic gap is mostly about reach. For a health system, patients often already have a MyChart account from another provider, which lowers enrollment friction. For an independent practice, FollowMyHealth does the job.

Clinical Decision Support

Epic’s BestPractice Advisories fire rules at the point of care, SlicerDicer gives clinicians self-service population queries, and Cosmos, Epic’s de-identified dataset of 1.7 trillion medical events, feeds predictive models for sepsis, deterioration and readmission.

Sunrise ships a native rules engine for alerts and order guidance, and Altera customers add third-party decision support for specialty content. Veradigm’s analytics are geared toward quality reporting and payer programs rather than real-time inpatient alerts.

Chief medical information officers comparing Allscripts vs Epic on sepsis and deterioration models will find Epic’s catalog larger. Alert fatigue is a known problem on every platform, including Epic.

Telehealth and Virtual Care

Epic runs video visits inside the clinician’s normal workflow, with the note, orders, and MyChart messaging in one place. Remote monitoring data from devices feeds the chart through MyChart.

Veradigm delivers telehealth through FollowMyHealth. Video visits, scheduling, and documentation flow back into the EHR. It is a lighter layer and quicker to turn on.

Organizations that want hybrid care pathways, where a virtual visit leads to an in-person procedure with no re-entry of data, benefit from Epic’s approach. High-volume outpatient clinics that just need reliable video visits do fine on Veradigm, so the Allscripts vs Epic telehealth choice follows organization size.

AI Capabilities

Epic has about 200 AI projects in development. In production: ambient note drafting through its partnerships with Abridge and Microsoft (DAX), draft replies to patient messages, chart summarization, and predictive models trained on Cosmos. Epic’s AI tools are deployed from inside the product rather than bolted on.

Altera’s visible AI work is the move of Paragon and Sunrise to Azure, where it has added ambient documentation through partners. Veradigm sells a Predictive Scheduler that forecasts no-shows and optimizes slots, plus analytics for payer and research use.

For buyers who expect AI to reduce documentation time in the next two years, this gap is the biggest single difference in the Allscripts vs Epic comparison.

Usability and Training

The American Board of Family Medicine surveys every recertifying family physician. In the 2023 analysis of 3,358 physicians, Epic, athenahealth, and Practice Fusion were rated significantly higher on six usability measures, and Allscripts users were among the least likely to be very satisfied. The 2026 five-year follow-up found that only Epic’s users became significantly more satisfied over time, widening the gap with every other vendor.

The counterweight in any Allscripts vs Epic usability discussion is training. Epic go-lives are long, with classroom and simulation time measured in days per role, and the Northwell project discussed below is budgeted across several years. Veradigm and Practice Fusion are designed to be learned in hours.

Mobile and Cloud

Epic’s mobile apps are Haiku (phone, for physicians), Canto (tablet), Rover (nursing and barcode administration), and MyChart for patients. Hosting can be on-premises, in Epic’s own hosting service, or on a public cloud; Tufts Medicine moved its Epic environment to AWS.

Altera has committed to Microsoft Azure for Sunrise and Paragon, with Paragon Denali as the cloud-native version. Veradigm EHR and Practice Fusion are web-based and need no local servers, which is part of why small practices choose them.

Hospital IT teams that want to exit their data center should ask both vendors for a dated cloud migration plan. Practices will find both Allscripts vs Epic options are already cloud-delivered.

Who Uses Allscripts vs Epic

Epic is used by most large US health systems, nearly all academic medical centers and a growing number of mid-size standalone hospitals. Altera is used by mid-size and community hospitals, and Veradigm by independent practices.

KLAS data shows Epic leads among large systems, small systems, standalone hospitals above 200 beds, academic medical centers and children’s hospitals. Of the top 10 US health systems by revenue, only Tenet is not at least partly on Epic. Epic also reaches small clinics through Community Connect, where a large Epic customer extends its system to affiliated practices and smaller hospitals.

Altera’s Sunrise customers are large and mid-size hospitals, including a number in the UK NHS. Paragon serves community and critical access hospitals. In 2025, KLAS counted a net loss of six hospitals and 2,634 beds for Altera in US acute care. Veradigm and Practice Fusion serve tens of thousands of small practices that would never be in Epic’s price range.

Cost and Implementation

Epic costs more at every size. Altera is cheaper but still a multi-million-dollar hospital project. Veradigm is priced per provider per month.

Neither Epic nor Altera publishes list prices, so the best public evidence is what organizations disclose. Recent Epic projects reported by Becker’s include Veterans Memorial Hospital in Iowa at $3.88 million for a single small hospital, St. Peter’s Health in Montana at $25 million, University Hospitals in Cleveland at $400 million for 18 hospitals, and Northwell Health at $1.2 billion for 21 hospitals. Northwell is moving from an Allscripts Sunrise environment, which makes it the most direct Allscripts vs Epic cost data point available.

Organization size	Epic	Altera Sunrise / Paragon	Veradigm / Practice Fusion
Independent practice (1 to 20 providers)	Usually through Community Connect, priced by the host system	Not sold at this size	Per-provider monthly subscription; ePrescribe from $59 per subscriber per month
Community or standalone hospital	$4 million to $30 million, depending on beds and modules	Custom; generally below Epic for a comparable scope	Not applicable
Multi-hospital system	$100 million to more than $1 billion	Custom; Sunrise is the only Altera product at this scale	Not applicable

 Hidden costs apply to both sides of the Allscripts vs Epic ledger: backfill staffing during training, data migration from the legacy system, interface rebuilds for every connected device and lab, temporary productivity loss at go-live, and annual maintenance that typically runs 15 to 20 percent of the license value. Epic implementations at a health system usually take 12 to 36 months. Veradigm practice deployments take weeks.

The ROI case for Epic rests on consolidation. University Hospitals retired more than 15 systems and projects annual benefits above $100 million with a payback period under five years. That math only works at scale.

Security and Compliance

Epic has no publicly reported breach of its own infrastructure. Its exposure comes through customer environments and third-party apps, and it has faced antitrust claims from Particle Health and a lawsuit from the Texas attorney general over data-sharing practices, which buyers may want to track.

Allscripts suffered a SamSam ransomware attack on January 18, 2018, that took its cloud-hosted Professional EHR and ePrescribe offline. About 1,500 practices lost access for up to a week, and a class action was filed. The affected products are now Veradigm products. Altera’s Sunrise was not involved.

Allscripts vs Epic: Market Share 2026

Vendor	Share of acute care hospitals	Share of hospital beds	Net hospital change in 2025
Epic	43.7%	56.9%	+77
Oracle Health	21.9%	20.4%	-56
Meditech	14.7%	12.5%	-7
TruBridge	7.6%	2.4%	+2
Altera Digital Health	2.9%	2.8%	-6

 Source: KLAS US Acute Care EHR Market Share 2026, as reported by Becker’s. 

Folio3 Digital Health and Epic

Folio3 Digital Health builds and maintains interfaces between digital health products, medical devices, and the EHRs discussed in this Allscripts vs Epic comparison. Our teams work with Epic’s FHIR R4 and HL7 v2 interfaces, with Altera Sunrise and dbMotion, and with Veradigm’s ambulatory APIs, under HIPAA-compliant development and hosting practices. If your product needs to read from or write to one of these systems, our Epic integration team can scope the interface, handle the vendor review, and support it after go-live.

Closing Note

Choosing between these vendors is less about the feature list than about how you run the evaluation. Ask each vendor to demonstrate your own workflows, not a scripted demo: your busiest clinic day, your most complex order set, your worst referral loop. Require a five-year total cost of ownership from both, including staffing, interfaces and maintenance, and make them show the assumptions. Call two reference sites that match your size and specialty mix, and ask what broke in the first ninety days. Pilot the lab, billing and health information exchange interfaces before the contract is signed, because those are where go-lives slip. Finally, check the exit terms: data export format, cost and timeline, since whichever platform you pick, you will one day leave it. Run the Allscripts vs Epic decision that way and the right answer for your organization will be obvious before the sales teams finish their slides.

Frequently Asked Questions 

Allscripts vs Epic, which is more widely used by large U.S. hospitals?

Epic is the market leader among large health systems and academic centers. Recent U.S. hospital‑share data show Epic installed in well over 40% of hospitals, especially major IDNs and teaching hospitals, while Allscripts‑based platforms are more common in mid‑size and community‑oriented settings.

Allscripts Sunrise vs Epic, which is better for a large hospital?

• Epic is a monolithic system, meaning all departments (clinical, financial, and administrative) run on a single, unified database. This is the preferred choice for massive academic medical centers that want a single “source of truth.”
• Allscripts Sunrise (now part of Altera Digital Health) is built on an open, multi-vendor architecture. It is often favored by large hospitals that want to maintain a “best-of-breed” approach, allowing them to integrate specialized third-party software more easily than the rigid Epic ecosystem.

How does the Allscripts charting system handle clinician documentation?

The allscripts charting system is designed with high configurability in mind. Unlike some rigid platforms, it allows different medical specialties to customize their views and templates to match their specific clinical thought process. In 2026, the charting system includes integrated AI-driven ambient listening, which helps capture patient encounters and automatically drafts notes to reduce “click fatigue” for providers.

What is the typical Allscripts pricing structure?

Allscripts pricing is generally customized based on the size of the practice and the specific modules required.

• For ambulatory practices (Veradigm), pricing can be modular, starting as low as $59/month for specific tools like e-prescribing.
• For full EHR suites, costs are typically per-provider, per-month.
• Hospital-grade solutions (Altera) involve significant upfront implementation fees followed by annual maintenance or subscription costs, though these are traditionally 20–30% lower than an equivalent Epic deployment.

Which offers better analytics and population health tools?

Epic is stronger in enterprise‑level predictive analytics and population health, with tools for risk‑stratification, readmission scoring, sepsis detection, and care‑gap dashboards across large networks. Allscripts‑based analytics (especially Veradigm) are solid but more suited to smaller‑scale and ambulatory‑focused reporting.

Which is faster to implement in a U.S. healthcare organization?

Allscripts‑style deployments typically go live faster, especially for small‑to‑mid ambulatory practices and some mid‑size hospitals. Epic implementations for large health systems are famously long, often 12–36 months due to project‑management, data‑migration, and change‑management overhead.

Which is better for ambulatory clinics in the U.S.?

Allscripts‑branded EHRs are commonly chosen by ambulatory clinics because of their modular design, lower upfront costs, and more flexible workflows. Epic is also used in ambulatory settings, but usually when the clinic is part of a large Epic‑based IDN rather than a standalone small practice.

Will switching from one vendor to the other be disruptive?

Yes. For either platform, migrating EHRs is a major undertaking: expect significant workflow redesign, clinical‑staff training, data‑migration work, and temporary productivity dips. The disruption is usually larger for Epic, given its depth and scale, but Allscripts‑style transitions still require careful planning and parallel‑run periods.

How should a U.S. healthcare organization evaluate Epic vs Allscripts?

Run real‑workflow demos that match your specialty mix, demand a 3–5‑year total‑cost‑of‑ownership (TCO) model from both vendors, check reference sites similar to your organization size, and pilot key integrations (billing, labs, HIEs) before signing long‑term contracts. The right choice depends less on features alone and more on fit with your size, budget, and strategic vision.

Can Allscripts and Epic exchange patient records?

Yes, Allscripts and Epic can exchange patient records through standardized health information networks.

Is Practice Fusion part of Allscripts?

Practice Fusion was bought by Allscripts in 2018 and stayed with the company that became Veradigm. It is a Veradigm product today and was rated well in the ABFM physician satisfaction data.

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