The Swiss canton of Vaud has committed 207 million Swiss francs to implement Epic Systems’ electronic health record software across its university hospital and 11 affiliated medical facilities, a decision that has drawn criticism over potential cost overruns and concerns about reliance on American technology amid shifting geopolitical dynamics.
The investment, announced in late 2025 and debated in early 2026, aims to replace the aging Soarian system deployed in 2008, which Oracle has announced will be decommissioned by the end of 2027. Officials argue the Epic platform will improve information continuity across patient care pathways within and between institutions, addressing long-standing inefficiencies caused by inconsistent local configurations of the current system.
Critics, including members of the cantonal parliament, have pointed to the experience in Bern, where the implementation of the same Epic system at the Inselspital saw costs rise from an initial estimate of 83 million francs to 182.5 million francs — more than doubling the projected budget. Michael Wyssa, a PLR deputy, warned that unanticipated additions during implementation could trigger similar financial escalation in Vaud.
The procurement process faced legal challenges from Geneva-based software provider Kheops, which alleged the tender criteria favored Epic Systems. However, the Federal Tribunal rejected these appeals, with the final ruling issued on November 5, 2024, clearing the way for the contract to proceed.
Supporters of the project emphasize its rigorous evaluation process, which involved over 150 subject-matter experts and more than 300 hospital staff who tested competing systems through simulated clinical scenarios. The CHUV and the Federation of Vaudois Hospitals IT (FHVi) stated that Epic was selected because it best met the functional requirements defined by a multidisciplinary working group spanning medical, nursing, technical, IT and research domains.
The chosen solution is used by more than 3,000 hospitals and 72,000 clinics worldwide. While patient data will be hosted exclusively within Switzerland, the annual maintenance cost is projected at approximately 10 million francs, adding a significant recurring expense to the initial outlay.
Rebecca Ruiz, head of the Vaud Department of Health and Social Action, has defended the investment as essential for modernizing the canton’s healthcare infrastructure and ensuring interoperability amid the planned phase-out of the legacy system. She acknowledged the scrutiny surrounding public IT projects but maintained that the selection followed a transparent and evidence-based procedure.
The decision remains subject to final approval by the Grand Council of Vaud, which is expected to review the funding proposal in the coming months. No date has been set for the parliamentary vote as of April 2026.
As healthcare systems globally grapple with digital transformation, the Vaud case highlights the tension between pursuing technological standardization and managing fiscal and sovereignty risks in public procurement — particularly when relying on foreign vendors for critical national infrastructure.
For ongoing updates on the Epic implementation in Vaud’s hospitals, readers are encouraged to consult official communications from the Canton of Vaud’s Department of Health and Social Action and the Centre Hospitalier Universitaire Vaudois (CHUV).
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