Why health systems don't compete with Epic for talent

Epic, the giant EHR company, employs about 13,000 people. Health systems need IT workers. It would seem natural they would compete for talent.

But it doesn't really happen, hospital CIOs told Becker's.

One major reason: Epic has airtight noncompete agreements that keep employees from jumping ship to clients.

"If an employee leaves the employment of Epic, depending on the level they're at, their noncompete could be for six months, it could be for a year, could be for two years," said Don Reichert, vice president of information services at Waukesha, Wis.-based ProHealth Care. "So I think that's the big driving factor in this."

He said he believes these contracts are a "deterrent for individuals to even reach out to hospital systems."

Instead, Epic veterans often go on to work for consultants, getting hired by health systems on a temporary basis. Omaha-based Children's Nebraska, for instance, uses the Epic contractors when it needs to "move projects along or alleviate a backlog of maintenance requests," said Chief Information and Innovation Officer Jerry Vuchak.

"This is one of their primary selling points to health systems, to be able to say something along the lines of: 'We have just the right resource for your latest EHR project — he or she worked at the EHR company for 10 years and knows that module inside out!'" said Saad Chaudhry, chief digital and information officer of Annapolis, Md.-based Luminis Health.

Health systems then don't compete with Epic for talent, but with other Epic customers.

"If it were a level playing field, that would be fine — but it's not," said Dayton (Ohio) Children's CIO J.D. Whitlock. "The problem is that health systems in high cost-of-living areas are increasingly hiring away work-from-home talent from health systems in lower cost-of-living areas."

This trend is buoyed by CMS' wage index system, which bases Medicare reimbursements on the pay level in a given geographic area.

"This is great for Epic-certified analysts who can make a better salary working for a health system in NYC and living in a suburb of a small city in the Midwest with great schools and low cost of living," Mr. Whitlock said. "It is not so great for health systems in rural areas that are struggling with staffing and their bottom line."

Aultman Health Foundation, a three-hospital system based in Canton, Ohio, has also had several employees leave for remote jobs at fellow Oracle Health EHR customers. "Hospitals in other states with higher cost of living are offering higher salary, sign-on bonuses, and higher 401(k) matches," said Aultman Health CIO Raza Fayyaz.

The poaching of IT talent doesn't really go the other way, either. "I don't think Epic or Oracle would ever hire our employees away," said R. Hal Baker, MD, chief digital and information officer of York, Pa.-based WellSpan Health. "It is not what they do."

Some of it comes down to geography. Epic employees mostly work on site at the company's southern Wisconsin headquarters, and may not want to uproot their lives to work at health systems in other parts of the country anyway. Same with Oracle Health, formerly Cerner, which has a big presence in the Kansas City, Mo., area. "Many of the IT services we have that would overlap with Cerner talent are out of our headquarters in Orlando," a spokesperson for Florida-based AdventHealth's Kansas City region told Becker's.

Culture plays a part as well. "The for-profit vendor world is driven by profits and tends to be more business-focused, more product-focused," said Michael Restuccia, CIO of Philadelphia-based Penn Medicine. "Whereas the provider world is more mission-driven. We're here to support the community, here to support advancements in care, research.

"Both can pay equally well or equally bad. But it's just a different environment."

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