Orthopedic EHR Adoption: Common Systems and Interoperability Trends
October 9, 2026
10 min. read
Orthopedic EHR systems connect patient information across medical practices, hospitals, surgical facilities, and rehabilitation services. As orthopedic care frequently involves multiple organizations, electronic health records (EHRs) provide an important foundation for documenting encounters, reviewing clinical information, and coordinating treatment.
Electronic health record adoption is widespread among U.S. physicians. However, the systems used across orthopedic organizations vary according to practice size, ownership, and affiliations with hospitals or health networks.
Unlike orthopedic-specific electronic medical record (EMR) platforms that emphasize musculoskeletal documentation, broader EHR systems may support clinical information exchange across multiple specialties and care settings.
This article examines national EHR adoption statistics, common platforms with documented orthopedic use, differences in practice ownership, and the role of interoperability in orthopedic care.
How widely are EHR systems adopted in orthopedic care?
Electronic health records are used by the vast majority of U.S. medical practices.
According to a June 2026 report from the Office of the National Coordinator for Health Information Technology (ONC), 95% of U.S. office-based physicians reported using an EHR in 2024, while approximately 91% reported using a certified EHR.¹
Among surgical specialists, which include orthopedic surgeons, the reported EHR adoption rate was 95.3%. Certified EHR adoption among surgical specialists was 92.5%.
These findings indicate that electronic record systems are widely used among surgical specialties.
However, ONC's published specialty categories group multiple surgical disciplines together. Therefore, the figures cannot be interpreted as the exact EHR adoption rate among orthopedic surgeons alone.
National physician EHR market share
ONC's 2024 National Electronic Health Record Survey included 1,725 office-based physicians and reported the following distribution of primary EHR developers.
EHR developer | Percentage of U.S. office-based physicians |
Epic | 27.7% |
MEDITECH | 11.1% |
eClinicalWorks | 7.5% |
athenahealth | 7.3% |
Oracle Cerner | 5.5% |
NextGen Healthcare | 4.1% |
Practice Fusion | 3.2% |
Allscripts | 2.7% |
Modernizing Medicine | 2.4% |
Greenway Health | 2.1% |
Other developers | 21.5% |
No primary EHR | 5.0% |
Source: ONC, 2024 National Electronic Health Record Survey, published June 2026. Percentages represent all office-based physicians rather than orthopedic-specific vendor market share.¹
The data shows that Epic had the largest reported share of office-based physicians nationally.
However, enterprise EHR adoption differs from specialty-specific software adoption. For orthopedic organizations, physician EHR usage may reflect technology decisions made by a larger health system rather than the orthopedic practice itself.
Common EHR systems used across orthopedic care
Several widely adopted EHR vendors have documented orthopedic implementations or provide technology that supports orthopedic services within broader medical organizations.
The systems below are presented as examples of established EHR platforms with evidence of orthopedic use, not as an orthopedic market-share ranking.
Epic
Epic is an enterprise EHR platform used across hospitals, health systems, and physician organizations.
Its software supports clinical records, medical orders, patient communication, referrals, and information sharing across departments and facilities.
Epic also provides an orthopedic-specific application called Bones, which supports musculoskeletal documentation, orthopedic procedures, patient-reported outcomes, and registry reporting.
Adoption evidence: Epic accounted for 27.7% of office-based physicians in ONC's 2024 national survey.¹
The company has also documented orthopedic technology usage at organizations such as OrthoVirginia and Hospital for Special Surgery.
Epic's broad presence makes it particularly relevant to orthopedic care delivered within larger healthcare organizations, although its national physician market share does not establish its share of orthopedic practices.
Oracle Health
Oracle Health provides enterprise electronic health record technology through its Millennium platform, formerly associated with Cerner.
The system supports clinical documentation, computerized medical orders, patient information access, and connections between outpatient and inpatient services.
For orthopedic care, these capabilities can support records associated with surgical admissions, diagnostic testing, consultations, and postoperative follow-up.
Adoption evidence: Oracle Cerner accounted for 5.5% of office-based physicians in ONC's 2024 survey.¹
Oracle's publicly available Millennium FHIR endpoint directory also identifies orthopedic organizations, including Southern Iowa Orthopedics, Crystal Clinic Orthopaedic Center, and OSS Orthopaedic Hospital.²
These endpoint listings document associations with Millennium technology, although they do not verify the current number of active orthopedic users at those organizations.
athenahealth
athenahealth provides cloud-based EHR technology through its athenaOne platform.
The system combines electronic clinical records with capabilities supporting referrals, patient communications, clinical data access, and administrative operations.
athenahealth serves independent physician organizations and multispecialty groups, including orthopedic practices.
Adoption evidence: The company reported more than 6,700 orthopedic providers on its network as of June 2024.³
The company has also documented implementation of athenaOne at New England Orthopedic Surgeons.
Although the reported provider count establishes orthopedic participation, it cannot be compared directly with national physician market-share percentages or hospital installation counts.
eClinicalWorks
eClinicalWorks provides an ambulatory EHR platform used across multiple medical specialties.
Its software supports clinical records, encounter documentation, referrals, patient portals, and information exchange.
The company also participates in national health information exchange infrastructure.
Adoption evidence: eClinicalWorks accounted for 7.5% of U.S. office-based physicians in ONC's 2024 survey.¹
The company announced in May 2024 that Atlantis Orthopedics had selected its cloud-based EHR and healow patient engagement platform.⁴
This implementation demonstrates use in orthopedic care, although published evidence does not establish the company's national orthopedic-specific installation share.
NextGen Healthcare
NextGen Healthcare provides ambulatory EHR technology supporting clinical documentation, electronic records, referrals, and practice workflows.
Its software serves medical practices across multiple specialties, including orthopedics.
Adoption evidence: NextGen accounted for 4.1% of office-based physicians nationally in ONC's 2024 survey.¹
The company has also published implementation materials involving Newport Orthopedic Institute.
These findings demonstrate both national physician adoption and orthopedic-specific use, but they do not provide the percentage of orthopedic organizations using NextGen.
How orthopedic EHR adoption varies by practice ownership
Practice ownership and organizational size are important factors when examining EHR adoption.
ONC's 2024 survey found that EHR adoption was substantially higher among physicians working in larger practices than among those working alone.
Physician group size | Any EHR adoption | Certified EHR adoption |
Solo physician | 86.1% | 79.9% |
2–3 physicians | 94.2% | 90.2% |
4–10 physicians | 97.9% | 92.9% |
11–50 physicians | 98.4% | 95.1% |
51+ physicians | 99.1% | 98.5% |
Source: ONC, 2024 National Electronic Health Record Survey. Figures represent physicians across all specialties, not orthopedic practices alone.¹
The findings suggest that organizational structure influences the likelihood of using EHR technology.
Independent orthopedic groups
Independent orthopedic organizations may operate their own EHR environments and maintain electronic connections with external hospitals, imaging providers, rehabilitation facilities, and referring physicians.
Their systems may include ambulatory EHR technology that supports clinical information exchange beyond the practice.
Hospital-affiliated orthopedic departments
Orthopedic departments affiliated with hospitals may use enterprise EHR software shared across the organization.
A shared platform can provide access to inpatient records, outpatient encounters, surgical documentation, imaging reports, and medication information within the same health system.
Epic and Oracle Health are examples of enterprise platforms with documented orthopedic use.
However, shared technology within one organization does not automatically mean records can be exchanged with every external healthcare provider.
Multisite orthopedic organizations
Larger orthopedic groups may operate across multiple locations and coordinate clinical records among physicians, surgical facilities, and rehabilitation services.
These organizations may standardize their EHR environments to reduce the number of disconnected patient records across locations.
The technology selected may depend on existing hospital relationships, organizational acquisitions, reporting requirements, and access to clinical information across the care continuum.
Orthopedic EHR interoperability and health information exchange
Interoperability refers to the ability of health information systems to access, exchange, and use electronic health information.
For orthopedic care, interoperability may involve communicating information between an orthopedic practice, imaging center, hospital, primary care provider, and rehabilitation facility.
The Trusted Exchange Framework and Common Agreement (TEFCA), administered by ONC, provides a nationwide framework for secure electronic health information exchange.
TEFCA establishes common requirements for participating health information networks and supports information exchange across organizational boundaries.⁵
In June 2026, the U.S. Department of Health and Human Services announced that more than one billion health records had been exchanged through TEFCA.⁶
This figure demonstrates the scale of nationwide information exchange, although it does not measure orthopedic-specific participation.
Clinical records and referral coordination
Orthopedic treatment frequently begins with a referral from primary care, emergency medicine, or another specialty.
Relevant information may include patient history, medication records, imaging reports, and previous treatments.
Electronic exchange can help participating organizations access this information without relying exclusively on faxed documents or manually transferred records.
The availability of specific information depends on the connected systems, exchange agreements, data standards, and access permissions.
Surgical and postoperative information exchange
Consider a patient undergoing total knee replacement at a hospital before receiving outpatient rehabilitation.
The hospital's EHR may contain the operative report, implant information, medications, and discharge instructions.
The orthopedic practice may need access to those records during postoperative follow-up, while the rehabilitation team may require information about weight-bearing status, activity restrictions, and the treatment plan.
Electronic information exchange can support continuity when the organizations use different EHR platforms.
However, a shared or connected EHR does not automatically provide every participating organization with all rehabilitation documentation.
Patient-reported outcomes and rehabilitation
Electronic health records can also support longitudinal orthopedic care when connected with patient-reported outcome measures and rehabilitation tools.
Measures such as the KOOS Jr., HOOS Jr., and Oswestry Disability Index provide information about symptoms, physical function, and recovery.
These measures may be collected within the EHR or through connected platforms.
Medbridge supports orthopedic care through patient-reported outcomes, Care Pathways, and home exercise programs.
These tools can complement EHR systems by supporting patient education, rehabilitation participation, and outcomes tracking between appointments.
The extent of information sharing depends on the capabilities and integrations available within each organization's technology environment.
Orthopedic EHR adoption reflects the widespread use of electronic health records across surgical specialties and the different technology needs of independent practices and larger healthcare organizations.
National data identifies Epic, eClinicalWorks, athenahealth, Oracle Health, and NextGen among established physician EHR platforms, while documented orthopedic implementations confirm their presence in specialty care.
However, national physician market-share percentages should not be confused with orthopedic-specific usage.
As health information exchange expands, understanding EHR adoption and interoperability provides useful context for how orthopedic organizations coordinate patient information across medical and rehabilitation settings.
References
Barker W. Office-based Physician Electronic Health Record Adoption, 2008–2024. Office of the National Coordinator for Health Information Technology. June 2026.
https://healthit.gov/data/data-briefs/office-based-physician-electronic-health-record-adoption-2008-2024/Oracle. Millennium Platform Public Endpoints for Providers.
https://docs.oracle.com/en/industries/health/millennium-platform-apis/millennium-endpoints-providers/athenahealth. Maximize Performance With athenaOne for Orthopedics. October 31, 2024.
https://www.athenahealth.com/resources/blog/athenaone-ehr-software-orthopedicseClinicalWorks. Atlantis Orthopedics Selects eClinicalWorks Cloud EHR and healow. May 7, 2024.
https://www.eclinicalworks.com/atlantis-orthopedics-selects-eclinicalworks-cloud-ehr-and-healow-to-improve-practice-efficiency-and-enhance-patient-care/Office of the National Coordinator for Health Information Technology. Advancing Nationwide Interoperability With TEFCA.
https://healthit.gov/policy/tefca/U.S. Department of Health and Human Services. HHS Expands Secure Access to Health Records Through the TEFCA Network, Announces Milestone of One Billion Health Records Exchanged. June 26, 2026.
https://www.hhs.gov/press-room/onc-strengthens-tefca-one-billion-health-records-exchanged.htmlOffice of the National Coordinator for Health Information Technology. Getting Started With Health Information Exchange.
https://healthit.gov/health-it-basics/hie/getting-started-hie/Epic. Specialty Software and Orthopaedic Care.
https://www.epic.com/software/standalone-specialties/
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