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A small group of software vendors has largely controlled the flow of patient data in U.S. health care for more than two decades. The biggest health systems have paid billions of dollars for their electronic health records, and mostly accepted the costly strings attached that constrict how they can share data or which apps they can adopt.

Now, many of those hospitals are no longer willing to make that tradeoff.

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Spurred by increasingly valuable digital health products and imperatives for data sharing laid bare by the coronavirus pandemic, health systems are forming their own companies that directly compete with products and services provided by the same major electronic health record vendors they’ve been locked in deals with for years, such as Epic Systems and Cerner Corp.

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