Epic's revenue hit $3.3B in 2020: 10 ways the EHR giant's dominance is opening doors for competition  

Epic is a dominant force in healthcare with nearly 30 percent of the EHR market share. However, the company's growth has ignited opportunities for disruption within revenue cycle management, telehealth and other areas of health IT, according to CB Insights. 

In its Aug. 4 "Unbundling Epic" report, CB Insights analyzed the Verona, Wis.-based EHR company's growth and competition among other health IT companies. In 2020, Epic's annual revenue reached $3.3 billion, and the company has delivered a 15 percent growth rate every year for the last decade, according to the report. 

Here are 10 ways health technology startups are increasing competition with Epic, according to the report. 

1. Patient experience. The importance of connecting with patients outside of the hospital has increased since the COVID-19 pandemic, and startups are targeting this area to elevate engagement beyond traditional patient portals. Companies like Buoy Health and Conversa have introduced smart symptom checkers, while others like Cedar and RevSpring are developing artificial intelligence tools that integrate with patient portals to make digital payment easier. 

2. Telehealth. EHR vendors, including Epic, were unprepared for the rapid uptick in telehealth visits accompanied by the shift to digital during the pandemic, leaving new opportunities for startups like Bright.MD and Doxy.me to compete. In response to the pandemic, Epic launched a telehealth platform in May 2020 in partnership with Twilio and created a second offering in September 2020 through Microsoft Teams. 

3. Clinical workflow. Startups are targeting unhappy or frustrated clinicians to improve their EHR user experience; companies like Suki and Notable are creating virtual assistant tools to address all parts of clinicians' workflows, from order entry to charge captures. 

4. Surgical services. Health systems have traditionally relied on their EHRs to manage the operating room, but some startups are creating clinical decision support tools and quality improvement analytics to compete with EHR solutions. 

5. Ancillary services. Hospital executives are continuing to look outside for ancillary care technologies; lab departments are looking outside the EHR to support genomic data storage needs and quickly introduce new genetic testing services while radiology departments are seeing benefits from medical image analysis AI and clinical documentation tools. 

6. Revenue cycle management. Epic and other EHR vendors are competing with RCM vendors on prior authorizations, coding and collections. Companies like Myndshft and Cohere Health are building tools to integrate payer rules into EHR ordering workflows so they can flag users when prior authorization is required, automate requests and generate faster decisions from insurers. 

7. Population health. Startups are starting to build alternative population health management tools to Epic and other EHR vendors' offerings. Arcadia and Innovaccer are among the companies creating data science platforms that directly compete with EHR-based platforms by using AI to identify at-risk patients and predict deterioration. 

8. Patient flow. Epic's patient flow solution, Grand Central, is competing with startups that tap into predictive analytics to focus on high impact areas, such as the emergency department, staffing and operating rooms. 

9. Interoperability. With HHS' interoperability rules, various startups are emerging to make electronic health information accessible via application-programming interfaces. 

10. Enterprise innovation. Epic has focused on AI, analytics and Big Data to expand innovation efforts, while startups have been creating alternative platforms offering both pretrained models and AI development environments for healthcare organizations. 

Click here to view the full report.


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