One example was already given. Epic dates back to 1979, certainly they were doing something prior to 2009 (as was Cerner and Meditech). Other than HITECH, what other major regulation in the US are you referring to?

https://international.kaiserpermanente.org/wp-content/upload...

Both UPMC and Cleveland Clinic were early adopters around 2001. Meditech has been partnered with HCA since 1994.