10 notes about Epic

Epic Systems is a large, privately held IT company based in Verona, Wis. Epic's EMRs are among the most widely used in hospitals and health systems in the U.S.

1. Judy Faulkner, Epic's CEO, founded the company in 1979 after completing graduate school at the University of Wisconsin-Madison, where she studied computer science. Initially, Epic consisted of three part-time employees who worked in the basement of an apartment building. Today, Epic has more than 8,000 employees across a 1,000-acre campus that is valued at more than $700 million, according HIT Consultant. Ms. Faulkner was named to Forbes' 2015 list of billionaires in the world, ranking No. 663 on the list, with a net worth of $2.8 billion. Last year, she was ranked No. 520 with a net worth of $3.1 billion, according to In Business Madison.

2. Epic's customers include community hospitals, academic facilities, children's organizations and multi-hospital systems. In total, Epic is the EMR provider of choice for 315 customers, and 69 percent of HIMSS Stage 7 U.S. hospitals use EpicCare, Epic's ambulatory EMR. Additionally, EpicCare was reported to hold the largest market share among physician practices with four or more clinicians in a survey from AmericanEHR Partners. According to health research firm KLAS, Epic, along with athenahealth and Medfusion, was identified as a vendor that most effectively helps their customers drive patient portal adoption.

3. Many of the largest and most prestigious hospitals and health systems in the U.S. use Epic EMRs, including Oakland, Calif.-based Kaiser Permanente, Cleveland Clinic, Johns Hopkins Medicine in Baltimore, UCLA Health in Los Angeles, Arlington-based Texas Health Resources, Massachusetts General Hospital in Boston, Mount Sinai Health System in New York City and Duke University Health System in Raleigh, N.C. In February, Rochester, Minn.-based Mayo Clinic announced it selected Epic to replace its existing EMR and revenue cycle technology, which was formerly provided by Cerner.

Additionally, Epic recently launched a new partnership with IBM Watson Health, the new dedicated healthcare unit of IBM. Together, the IT companies are partnering with Mayo Clinic to apply Watson's cognitive computing capabilities to EMRs using open standards, which will allow patient data to be extracted from health records and delivered to Watson. The supercomputer will then analyze the data against its massive volumes of stored clinical data and produce medical literature and case studies most relevant to individual patients' care to help inform clinical decisions in real time.

4. As of December 2014, Epic was the most commonly selected EMR among eligible professionals participating in meaningful use, according to CMS. For hospitals and health systems, Epic came in second for most used, following MEDITECH.

5. All of Epic's EMR systems and apps are developed, implemented and supported in-house. Epic users look to the system favorably, and in 2015, physician leaders identified Epic, Cerner and MEDITECH as the top performers in the realm of acute-care EMR usability, according to the latest KLAS report. The report aggregated data on the usability of EMR modules including physician documentation, computerized physician order entry, medical reconciliation and clinical decision support. Based on this data and interviews with physician leaders at 110 healthcare organizations, KLAS named Epic the industry leader in usability performance.

6. Despite its popularity, Epic's EMR systems are among the most expensive available.. It also costs more to upgrade Epic's EMR systems than other EMR providers. According to a Peer60 survey, in 2013 Epic users spent an additional 40 to 49 percent of the system's initial costs in major and minor upgrades, while Cerner users spent between 30 and 35 percent and Allscripts users spent between 20 and 22 percent. For an idea of the cost of implementation, Duke University Health System reportedly paid $700 million for its Epic EMR, and Kaiser Permanente paid $4 billion.  

7. As the healthcare industry and Congress emphasize the need for EMR providers to improve interoperability, Epic has been a vocal antagonist against the CommonWell Health Alliance, a coalition of EMR vendors and other partners to develop and deploy technical standards that improve the data-sharing process and health information exchange among providers. The coalition was launched at the HIMSS Conference in 2013 and began implementing its interoperability services at the end of 2014, according to Health IT Analytics. In mid-March, Peter DeVault, Epic's director of interoperability, criticized CommonWell at a hearing held by the U.S. Senate Committee on Health, Education, Labor and Pensions, calling the Alliance an "aspiring" network and questioning the alliance's intention of how it would use data. Following Mr. DeVault's comments, tensions between fellow IT giants Cerner and athenahealth and Epic rose during an exchange of tweets.

8. Despite Epic's refusal to join the CommonWell Health Alliance, the company strongly defends the interoperability of its systems. During the U.S. Senate Committee on Health, Education, Labor and Pensions, Mr. DeVault described Epic's contributions to the goal of improving interoperability. According to Mr. DeVault, Epic has exchanged more electronic records and patient data through its Care Everywhere record exchange platform than any other vendor, pointing out more than 1,000 hospitals and 26,000 clinics are live on Care Everywhere, and they exchanged 8.5 million patient records last month. He also noted Care Everywhere launched in 2005, four years before the HITECH Act was enacted.

9. At HIMSS15 in Chicago, Epic and several other partners, including Healtheway, Surescripts, eClinicalWorks and Kaiser Permanente, announced the rollout of Carequality, a health data interoperability framework designed to connect disparate health information exchange networks. According to Health IT Analytics, Epic's interoperability package Care Everywhere comprises a substantial part of Carequality's 200,000-wide physician user network. As of April, Carequality includes 70 organizations. Additionally, Epic announced during HIMSS15 it will no longer charge a fee to exchange patient records with providers using a different EMR vendor, effective April 1. "We felt the fee was small and, in our opinion, fair and one of the least expensive, but it was confusing to our customers and others in understanding how it worked," Eric Helsher, vice president of client success at Epic, said during the conference. "There was logic to it, but it confused people, so we decided to end the fee until at least 2020 when we'll consider reevaluating."

10. Despite its prominence as a leading EMR vendor, Ms. Faulkner has built Epic as a notorious marketing-free company. Just 1 percent of Epic's employees in 2012 were in sales and marketing with only five salespeople, none of whom earned commission, according to Forbes. The company does not issue press releases and there isn't even a "media" department on its website. "When I started the company, I had no idea how to do marketing, so we just didn't do it," Ms. Faulkner told Becker's Hospital Review. "What I did know, because I was a technical person, is to be able to write good software. So we focused on writing good software, and we focused on doing good support. And then fortunately, word of mouth did the rest."

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