50 things to know about Epic and Judy Faulkner

With roots dating back to 1979, Epic Systems has become a major player in the health IT world.

The vendor has achieved this status without going public, and without significant marketing efforts.

Epic is one of the biggest EHR providers for hospitals and health systems nationwide. As of March 2015, it was the third most commonly used EHR among hospitals and health systems participating in meaningful use, according to data from CMS. Additionally, a September KLAS report found Epic was one of just two vendors that did not lose any clients in 2014 (athenahealth was the other).

Here are 50 things to know about Epic Systems and the woman behind it all.

The company

1. Epic's name comes from a meeting with former clients of Judy Faulkner, the company's founder. In the mid-1970s, Ms. Faulkner was a programmer who had developed a clinical data management system; she had no plans to start a company. But, following repeated requests from clients, Ms. Faulkner agreed to create a company around the system she had developed. During a preliminary meeting at her home, one of the company's original clients pulled a dictionary off the shelf and looked up the definition of "epic": "the glorious accounts of a nation's events." The group liked the name, and it would be the story of a patient, not of a nation.

2. The first office of Epic was comprised of three part-time employees in the basement of an apartment in Madison, Wis. Epic was originally named Human Services Computing.

3. Human Services Computing began with a $6,000 investment, part of which came from Ms. Faulkner's parents. Today's Epic is entirely self-funded, as Ms. Faulkner and Epic's early leadership did not raise money from venture capitalists or private equity investors, according to Forbes.

4. Epic remained in Madison, eventually occupying a main office and five satellite sites, until 2005, when it moved to neighboring Verona.

5. In addition to its headquarters in Verona, Epic also has offices in The Netherlands, Dubai, Singapore and Copenhagen.

6. Epic added approximately 1,400 employees in the last year, with a workforce now reaching approximately 9,400 employees, Dana Apfel, an Epic spokeswoman, told Wisconsin State Journal.

7. Epic is privately and employee-owned. In order to ensure the company remains private, Ms. Faulkner created a charitable foundation that her stock will go into and allow the company to remain privately held. The foundation is called the Epic Heritage Foundation.

8. Since Epic remains privately held, full financial and shareholder information isn't available, but Forbes indicates the company's 2014 revenue totaled $1.8 billion.

About Judy Faulkner

9. Ms. Faulkner is the founder and CEO of Epic Systems.

10. Ms. Faulkner received her undergraduate degree in mathematics from Dickinson College in Carlisle, Pa.

11. Ms. Faulkner was ranked No. 256 on the 2015 Forbes 400 list, which ranks the wealthiest individuals in the country list. Her reported net worth is $2.6 billion.

12. In June 2015, Ms. Faulkner joined the Giving Pledge, an initiative launched by Warren Buffett and Bill and Melinda Gates where some of the world's wealthiest individuals pledge to donate the majority of their assets to philanthropy. "Many years ago I asked my young children what two things they needed from their parents," Ms. Faulkner wrote in her pledge letter. "They said, 'food and money.' I told them, 'roots and wings.' My goal in pledging 99 percent of my assets to philanthropy is to help others with roots — food, warmth, shelter, healthcare, education — so they too can have wings."

13. Epic and Ms. Faulkner gave a gift last year that will endow three faculty associate positions in the computer sciences department at the University of Wisconsin-Madison, where Ms. Faulkner earned a master's degree in computer science. The newly endowed positions will center on teaching software development, application design and user interfaces.

14. When Becker's Hospital Review asked Ms. Faulkner what the secret behind Epic's marketing-free success is, she said there really isn't one. "When I started the company, I had no idea how to do marketing, so we just didn't do it," she said last March. "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."

The EHR platform

15. The average age of a physician using Epic is 47.7 years old, the youngest average user age among vendors, according to a research report from Wells Fargo Securities.

16. Epic's self-reported numbers indicate the vendor has 355 customers. Some of Epic's latest big-name clients include Allentown, Pa.-based Lehigh Valley Health Network, Burlington, Mass.-based Lahey Hospital & Medical Center,  Providence, R.I.-based Lifespan, Rochester, Minn.-based Mayo Clinic, Boston-based Partners HealthCare and Chattanooga, Tenn.-based Erlanger Health System.
17. Additionally, CVS Health uses EpicCare at its CVS MinuteClinic locations. And in November 2015, retail healthcare giant Walgreens announced plans to transition its healthcare clinics across the country to Epic's EHR platform.

18. Implementing Epic's EHR is a significant investment, as they are often the most expensive platforms to adopt. Partners HealthCare invested $1.2 billion on its Epic implementation, the health system's biggest single investment to date.

EHR vendor competition/market share

19. As of March 2015, Epic was the third most commonly used EHR among hospitals and health systems participating in meaningful use, according to data from CMS.

20. A September KLAS report found just two vendors reported losing zero clients in 2014: Epic and Watertown, Mass.-based athenahealth. Additionally, Epic, athenahealth and Cerner were the only three vendors who posted a gain in market share in 2014, according to the report.

21. The top three states where Epic is the most commonly used EHR system for office-based providers participating in meaningful use are North Dakota (it holds 51 percent of the state's EHR market share for office-based providers), Wisconsin (58 percent) and Washington state (44 percent), according to April 2015 CMS data.

22. The top three states where Epic is the most commonly used EHR system for hospitals participating in meaningful use are Minnesota (it holds 55 percent of the state's EHR market share), Wisconsin (44 percent) and Oregon (42 percent), according to April 2015 CMS data.

23. In February 2015, healthcare marketing firm SK&A reported Epic as the top EHR vendor in the physician practice market, holding 11.6 percent of the market.

Recent implementations

24. In 2015, Phoenix-based Banner Health decided to transition two Tucson hospitals — Banner-University Medical Center Tucson and Banner-University Medical Center South — to Cerner's EHR. The hospitals used Epic's EHR while part of the former University of Arizona Health Network, which Banner acquired March 1. Banner uses Cerner's EHR and decided to switch the Tucson hospitals to Cerner to be on board with other hospitals in the system.

25. Denver Health's CEO Arthur Gonzalez told The Denver Post last year that the system is scheduled to go live on the Epic EHR in 2016, and the project remains under budget. Still, Denver Health's former CIO Gregory Veltri has expressed concerns about the implementation. He resigned due to a disagreement over the decision to switch to Epic.
26. Mayo Clinic also selected Epic's EHR and revenue cycle management platform in early 2015. The switch means the health system will drop its Cerner and GE contracts for certain service lines. The implementation is scheduled to begin in 2017.

27. Four executives of New York City Health and Hospitals Corp., (newly re-branded to NYC Health + Hospitals) were fired over a six-month period, including the hospital's CIO and CTO. The hospital is in the middle of implementing an Epic EHR, with a total implementation and maintenance cost totaling $764 million over six years. The Inspector General's Office has been investigating allegations of improper billing related to the implementation since August 2014, but the hospital told Becker's the firings were not related to the Epic implementation.  

28.  In late January 2016, Midland, Mich.-based MidMichigan Health announced plans to implement Epic's EHR platform at all the hospitals, physician offices and outpatient care facilities in its 15-county region.

29. South Shore Hospital in Weymouth, Mass., is in the process of implementing the Epic EHR. As part of the process, the hospital is hiring more than 50 people to provide support. Additionally, a number of hospitals working with Epic have posted job listings for new talent, including Boston Medical Center, Detroit-based Henry Ford Health System and Toledo, Ohio-based ProMedica, to name a few.

30. Epic claims it is the first vendor to facilitate a patient data exchange between two different EHRs in August 2008 between two facilities in Long Beach, Calif., according to Politico.

31. Much of the flak directed toward Epic relates to the vendor abstaining from joining other marketplace collaborations that claim to be dedicated to interoperability, such as the CommonWell Alliance, whose members include competitors Cerner, athenahealth, McKesson, Allscripts, CPSI and Greenway Health.

32. However, Epic is among the first five vendors to adopt the Carequality Interoperability Framework, a set of standards to make data exchange more efficient. It joined athenahealth, eClinicalWorks, NextGen Healthcare and Surescripts in adopting the framework.

33. As of September 2015, Epic's customers had prevented 219,000 harmful or fatal medication incidents and delivered 860,000 babies in the previous year, Ms. Faulkner said at Epic's annual meeting in 2015

34. According to Epic, 15.3 million patient records were exchanged securely on the Care Everywhere network in June 2015 — to and from Epic EHRs, non-Epic EHRs, HIEs and government agencies.
35. In April, ONC announced Epic was participating in CMS' Designated Test EHR Program, a voluntary program that allows eligible hospitals, providers and critical access hospitals participating in meaningful use to demonstrate their ability to exchange data. EHRs are registered on an EHR Randomizer, a software system that matches MU participants with an EHR other than the one they use to exchange data.

36. Epic has a director of interoperability, Peter DeVault. Mr. DeVault testified in front of the Senate Committee on Health, Education, Labor and Pensions in a March 17 hearing defending the vendor's interoperability. He said Epic provides customers with the vendor's source code and developer support, as well as tools to support the free flow of information between systems and organizations.

37. At HIMSS15, Epic announced it was waiving its record-sharing fees for exchanging data between Epic and non-Epic vendors until 2020. In an interview with Becker's Hospital Review, Eric Helsher, vice president of client success at Epic said, "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…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." Mr. Helsher did not disclose how much the fee was.

Controversies and legal issues

38. At the March 17 Senate hearing, Mr. DeVault was asked why Epic did not join the CommonWell Alliance. He said CommonWell is an "aspiring" network that requires significant money to achieve its goal of interoperability. Mr. DeVault also suggested CommonWell intended to sell data downstream, as it requires joining companies to sign non-disclosure agreements.

39. In response to the above comments, Cerner issued a statement defending CommonWell, saying Mr. DeVault's comments were "potshots and false statements" and a "slap in the face" to those working to advance interoperability. Cerner and athenahealth's Jonathan Bush exchanged heated words about Epic on Twitter.

40. Ms. Faulkner has received criticism and questioning for her political ties. She donated to President Obama's 2008 presidential campaign and supports congressional Democrats — factors that Republicans suggest played a role in the government's HITECH Act and federal incentives to boost health IT.

41. Ms. Faulkner also served on the Health IT Policy Committee as the representative of health IT vendors, a position to which she was appointed in 2009. She served until 2014.

42. In 2006, Epic came under fire when an employee of Kaiser Permanente accused the nonprofit system of corruption and wasteful spending, with much of the ire directed at KP HealthConnect, the HMO's $3 billion Epic EHR.

43. More recently, Epic the Connecticut State Attorney General began an investigation into Epic Systems' information sharing practices after independent medical groups accused hospital networks of using EHRs to control patient referrals and steer patients back to their networks, according to a Politico.  

Life at Epic

44. In an interview with Becker's Hospital Review, Ms. Faulkner identified the company's dress code as something that might surprise readers. "Our dress code is when there are visitors, you must wear clothes," she said. "As long as there's nothing objectionable, everything's fine."

45. Epic doesn't follow a budget, Ms. Faulkner told Becker's Hospital Review. "Our philosophy with that is if you need it, buy it. And if you don't need it, don't buy it," she said. "We teach people how to judge things appropriately and make the right decisions, so it isn't chaos by any means. What we did see is that if you have budgets, people spend to their budget."

46. In 2014, Business Insider ranked Epic No. 5 on its list of companies with the best pay and benefits, reporting an average salary for a technical services employee of $72,000 and average salary for a project manager of $82,000.

47. Epic is known for its marketing-free success. Just 1 percent of Epic's employees in 2012 were in sales and marketing, according to a Forbes report.

48. In early 2015, Epic said it plans to add five buildings totaling one-half million square feet of office space to its campus. The first three buildings of the expansion are expected to open this year, according to Wisconsin State Journal.

49. Additionally, Epic is finishing its fourth campus expansion, called Wizards Academy, which is based on the aesthetic of historic university campuses like England's Oxford University and Hogwarts, the fictional school from the Harry Potter series. This expansion features five additional buildings, as well as a full-size cafeteria.

50. In response to employee growth,  a main road in Verona is being expanded this year to four lanes.


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