Epic used its developer conference to open more of its platform to outside AI and apps, and to remind those developers that the traffic they generate lands on health systems’ infrastructure.
The second annual Open@Epic ran Oct. 21-22 at the company’s Verona, Wis., headquarters. More than 1,000 people attended the first one in 2025, according to a conference preview from Epic.
Seth Howard, executive vice president of research and development at Epic, opened the conference by citing the volume already moving through the company’s network: “26 million records exchanged daily, and over half of those records are between Epic and non-Epic systems,” along with “over 3,000 apps that are live.”
The conference also brought news on prescription prices, veterans’ access to specialists and digital IDs for patients.
Here are 10 takeaways:
1. Outside developers can plug into Epic’s AI agents.
Epic is letting developers build Connectors that link their software to Agent Factory, its platform for building and running AI agents.
“We are creating Agent Factory connectors, so Epic AI agents in Factory can communicate with external software,” Mr. Howard said.
“We’ll have customers as early adopters starting as soon as next month, and we expect that Q1 of next year you’ll be able to start building those connectors and listing them on Showroom,” he said.
2. Epic built an MCP server for developers’ AI coding tools.
MCP servers give AI coding assistants a way to pull from outside knowledge sources.
“Our team created an MCP server that sits on top of Open.Epic. And so in fact, our vendor services staff have been using that as part of Claude [Anthropic’s AI assistant] to help answer your questions,” Mr. Howard said. He added that “at the end of this month, we’ll have a new MCP server that you can connect to access that information.”
3. Consumer chatbots are adding traffic to health system EHRs.
Mr. Howard addressed the load that patient-facing apps, including AI chatbots, place on health system infrastructure.
“This is only increasing. Our customers are definitely noticing the extra traffic,” he said.
Epic’s answer is FHIR notifications, automatic alerts sent when something changes in a patient’s record, according to the conference preview. FHIR is a common standard health software uses to share data.
“But the goal is to help you efficiently build apps that don’t need to just constantly ask, ‘Is there anything new? Is there anything new?'” Mr. Howard said.
4. Big data exports get faster, but the hardware isn’t free.
Bulk FHIR is the standard used to export many patients’ records at once. Epic’s preview says its improvements will transfer large amounts of data up to five times faster.
“So with the November 26 versions that’s coming out this year, customers will now have the option to set up Bulk FHIR to run against a dedicated report server that supports multi-threading, so that they can have more performant use of Bulk FHIR without competing for hardware resources for those users, the clinicians and the patients,” Mr. Howard said. “Now, keep in mind, Bulk FHIR as a technology is freely available. This is an open standard, but the extra hardware is not free to health systems.”
Kit, Epic’s tool for analytics and large-scale data access beyond standards-based exchange, is also expanding.
“It gives you a scalable SQL-based access to most of the items in the Epic database,” Mr. Howard said.
“Kit is growing by 3.5 times in regards to the number of columns that are available with the November 2026 version,” he said.
5. Epic built its own fix for sharing medical images.
“And while we want to help solve the problem, the challenge is that the images aren’t typically stored in the EHR. They’re in a vendor-neutral archive or PACS,” Mr. Howard said. “… So we needed a solution, and we built a solution from the ground up using standards like FHIR and DICOM to enable treatment-based exchange of diagnostic quality images between Epic and non-Epic health systems.”
He said Epic’s community “will also be the first to go live with that diagnostic image exchange later this year.”
6. Patients will be able to sign up for MyChart with a phone-based ID.
Mobile driver’s licenses are state-issued digital IDs stored on smartphones.
“MDL is nice because it provides digital identity at no cost to patients, no cost to the apps, and no cost to health systems,” Mr. Howard said. “So, starting early next year, patients with the digital ID using the standard will be able to use it to easily sign up for MyChart and then share their record using the interoperability frameworks that I’ve been talking about.”
Presenters from Apple and Epic were scheduled to cover mobile driver’s license and passport-derived digital ID support in MyChart sign-up, including IDs stored in Apple Wallet, on the conference’s second day.
7. Most EHR vendors in CMS’ tech pledge are still piloting, Epic says.
Epic was among the first to sign CMS’ Health Tech Ecosystem pledge, a voluntary effort to speed data sharing among apps, health systems and payers.
“So we’ve moved beyond pilots for some of these examples, like prior auth and ditch the disk, which is diagnostic image exchange,” Mr. Howard said. “Turns out that less than a third of the groups that have pledged, the EHR groups, have moved past that pilot phase.”
Payers are also getting a new on-ramp to TEFCA.
TEFCA is the federal framework for nationwide health data exchange.
“We also have seen over 100 Epic organizations live exchanging government benefits with Social Security Administration, and next we’re working to connect that with the VA, and starting next year, payers using Epic can join TEFCA to exchange data for treatment and care coordination,” Mr. Howard said.
8. The VA is booking veterans directly into community specialists’ schedules.
Scheduling tools and a new eligibility API are getting veterans into specialty care faster, Epic said ahead of a panel with the VA, Evansville, Ind.-based Deaconess Health System and scheduling vendor WellHive.
Deaconess Illinois became the first health system in that state to let staff at the Marion VA Medical Center book appointments directly with its specialists, using WellHive’s scheduling technology. Deaconess connected that technology to its Epic EHR, and the VA is pushing more outside providers to adopt it, Nextgov/FCW reported Oct. 19.
9. Pharmacies must close the loop to list cash prices.
Epic’s Prescription Marketplace will show pharmacies’ cash prices alongside insurance prices when clinicians prescribe. Participating pharmacies will have to report back to prescribers.
“So to participate in this marketplace, pharmacies do need to close the loop with the prescriber using those industry standards,” said Chris Soverns, who leads Epic’s Willow pharmacy applications.
“Any time a prescriber writes a prescription, they send it along with a hope and a prayer that you actually go get it, right?” said Ricky Li, assistant vice president of pharmacy at Costco, during a panel on the marketplace.
10. Costco pharmacies get 1,000 AI agent calls a day.
Mr. Li offered a warning for developers building AI tools for healthcare.
“We get about 1,000 phone calls a day from AI agents looking for access and quantity of controlled substances,” he said. “For anybody that’s a pharmacist in the room, and I’m a pharmacist, you’ll know that’s a terrible idea. It’s a great intention, all the right reasons for building it, but it’s not the right execution.”
“There are a bunch of better ways to do it because there’s rules and regulations, and you don’t want the DEA problem either,” Mr. Li said.
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