New Hyde Park, N.Y.-based Northwell Health is undertaking the most ambitious health IT transformation in its history: a $1.2 billion investment to unify its sprawling system under a single iteration of Epic’s EHR platform.
The move will consolidate more than 30 different medical record systems across hospitals and ambulatory sites, positioning Northwell to improve care coordination, accelerate data-driven decision-making and lay the foundation for future growth.
“It’s basically ripping out the electronic health record and our backend revenue cycle processes — essentially the central nervous system — and installing this new Epic platform across the organization,” Northwell CFO Michele Cusack said during an episode of the Becker’s CFO and Revenue Cycle Podcast. “We’re going live with our first wave and continuing over the next two years. We’re really excited about all the efficiencies that’s going to come from a single platform — not just for our team members, but for our patients as well.”
Northwell’s second go-live wave alone will be one of the largest in Epic’s history, covering more than $8 billion in revenue and 40,000 users simultaneously, according to Ms. Cusack.
Following the merger with Danbury, Conn.-based Nuvance Health — set to be finalized May 1 — the platform could soon support more than $24 billion in combined revenue within two to three years. Nuvance, a $3 billion health system, expands Northwell’s reach significantly. Northwell reported $16.9 billion in revenue for 2023, the most recent full year of available financial results.
Despite the scale and complexity of the transition, Ms. Cusack expressed confidence in Epic’s ability to deliver a seamless, comprehensive solution.
“When we looked at what [Epic] was able to provide compared to the competitors, it was a very easy decision,” Ms. Cusack said. “The simplicity of the technology, the maturity of the product across inpatient, outpatient, post-acute care — they had the most developed product.”
Northwell leaders say the Epic investment goes far beyond operations — it’s about transforming both the staff and patient experience. Improved care coordination, medical record access, bill payment and appointment scheduling are just a few of the patient-friendly features expected with Epic’s platform.
That vision is echoed by Nancy Beran, MD, vice president and chief quality officer of ambulatory care at Northwell.
“My current focus is certainly around data aggregation,” Dr. Beran said during an upcoming episode of the Becker’s Healthcare Podcast. “Right now, we have about 5,000 different physicians and another 1,500 or more ambulatory advanced care providers, spread across 30-plus different electronic medical record systems. I think about the quality of transitions of care — just the challenge of getting information from one system to another.”
While Northwell’s hospitals already share a common medical record, its ambulatory settings are fragmented. The shift to a single platform will enable better analytics, quality tracking and patient management.
“Having one large, unified data set will be a tremendous improvement,” Dr. Beran said. “We’ll be able to analyze cohorts more effectively — identify areas for opportunity, where we’re lagging and allocate resources to truly improve care across populations.”
The Epic project is just one part of Northwell’s broader growth strategy. Ms. Cusack emphasized the system’s commitment to meeting unmet demand — both inside and beyond its current footprint.
“While we have an extensive ambulatory network, not all specialties or subspecialties are available in all communities,” Ms. Cusack said. “We’re leveraging technology and talent to speed up how we meet that unmet demand.”
Northwell is also expanding through vertical integration — bringing services like anesthesia in-house — and investing in its pharmacy, laboratory, hospital-based, and ambulatory care operations. Ms. Cusack said the system is committed to growing at a “measured pace”
Hospitals remain vital to Northwell, but they no longer define the system. Hospitals now account for about 46% of Northwell’s total business, down from 49% in 2021 — a reflection of healthcare’s broader shift toward outpatient settings.
Meeting that shift means collaboration. “It’s not always about doing it ourselves,” Ms. Cusack said, pointing to Northwell’s partnership with GoHealth to create urgent care centers as an example of creative expansion.
Ms. Cusack credits Northwell’s leadership, including her partnership with longtime President and CEO Michael Dowling, as critical to navigating this transformation.
“There’s 100% transparency,” she said. “It’s about giving feedback on the challenges ahead and working together on solutions — always with the lens of protecting the organization and the communities we serve.”
For Ms. Cusack, the Epic investment is more than a system upgrade. It’s a strategic statement about Northwell’s future: integrated, patient-centered and built for long-term growth.
