It's certainly hard to pick a single thing. I'd point to one factor and one event that, to me, stand out for Epic.
Factor: Epic far-and-away has the most comprehensive offering on the market. How many EHRs are good at ambulatory clinicals, inpatient clinicals, and revenue cycle? Epic enables health systems to consolidate around an anchor product/vendor and reduce the number of point solutions, and it gives users (e.g., providers who practice in the clinic and in the hospital) a consistent user experience. That's a powerful selling point over competitors who are ambulatory-only (e.g., NextGen), who struggle with revenue cycle (e.g., Oracle Cerner), etc.
Event: Twenty years ago, Kaiser Permanente chose Epic. That, I believe, changed the trajectory of the whole company and gave Epic the cachet it needed to earn the business of other large/prestigious organizations. Only Marty McFly knows what would have happened if KP hadn't gone to Epic.
HIT "Veteran", please change your moniker. You can't possibly be an HIT veteran, and regurgitate the bovine excrement that Bill Gurley thickly spread in his video. Each point has been rebuked on Histalk, and the facts directly contradict his made up implications.
An actual HIT veteran would know all this and won't embarrass themselves with repeating these hallucinations.
Bill Gurley said it best: The topic sounds dense, but trust me, he gives you everyday examples that affect your life... starting with why we don't have free telecom in cities, to the price and availability of COVID tests, and ending with a sharp warning about upcoming attempts to regulate BigTech and AI. [NOTE: this is not me endorsing zero regulation, but an undeniable warning about letting incumbents in the room when you draft that regulation. We should not take BigTech inviting DC to regulate them as a genuine motivation.]
TL;DR: (Epic case study starts at min 11) - https://lnkd.in/g8Wcq_Gd
"[Epic CEO Judy Faulkner] was the ONLY corporate representative on Obama's Health IT council in 2009"
"They came up with a brilliant idea, and I have to assume she helped. Doctors would receive $44K each if they bought software. $38B, you can look it up."
"The second phase, they got paid $17K more to prove they were using it. It was called 'Meaningful Use'."
"The ONC decided the threshold that software would need to comply with this mandate, and I'm assuming they took Epic's feature set and plowed it into this spreadsheet."
"They had 3 record fines -- $155M, $57M, $145M -- against the lesser competitors of Epic."
"If you've studied the innovators' dilemma, the way startups disrupt is they come out with lower feature products, but one that's really meaningful to the user and then they grow... they put a brick wall there so they couldn't come up."
"You may ask, am I unhappy with Judith? I'm disgusted with it. BUT, if I were a judge in the Olympic Regulator Competition, I'd give her a 10!"
I think people tend to overlook the underlying software architecture of the Epic system as a key driver for success. It turns out that due to some early decisions that were, in retrospect brilliant, Epic is able to make changes and add on new features much faster and with higher quality than other vendors. Therefore, even if they didn't think of it first, they can implement it very quickly and much more reliably than anyone else. This makes their customers very happy.
I think you missed the mark with the available answers. The list looks like all of the standard things every vendor says about itself (which may or may not be true). But, to me, the real reason Epic is dominating the market is because they always try to do the right thing, whether it makes them more money or not. In my experience with them, there were a couple of times they could have stood their ground and made "justifiable" reasons why they wouldn't want to honor something but they never took the path that 100% of the other vendors have taken in similar situations, and that "do the right thing" approach makes the biggest difference between them and their competition. Of course, their projects and services are superior, but their unwillingness to act like the other vendors is what makes the difference.
Dave Dillehunt (retired CIO, FirstHealth of the Carolinas)
Monkey see, monkey do, but strategically.
As a longtime healthcare professional and now as a caregiver to my family i can say without any reservation i love the fact that whether we are at queens in hawaii, ARC in Austin, methodist in Houston and at KU in Kansas City. the connectivity and coordination between all these facilities utilizing Epic the experience is less challenging even though complex. All caregivers physicians and hospitals have access to the data It simply takes a lot of stress as a result of all providers having access to the data relieves a lot of stress.
Founder led …Judy is still active and her vision and mission continues. This seems to be the only large HIT that hasn’t flipped owners or gone public.
When we chose Epic, our systems were hobbled together diverse systems from McKesson and other vendors. Reporting was very difficult and a single database was a huge factor in our decision. We had only a few vendor choices at the time and we chose Epic. Epic is simply the best vendor I've ever worked with. Not perfect, but the best.
Sudhakar & JCraft do have a point. However, Epic was once a small niche player too, and they clearly were doing some things right to take on the entrenched incumbents and win. Now that they're dominant, it remains to be seen if they can continue to earn their dominance, or if someone else figures out how to do it better.
Sudhakar & JCraft are right. Having installed other EHRs and worked at an Epic site, it's not that they are better than other companies or more innovative or anything. It's all FOMO.
It's all about people. They're a machine when it comes to hiring really smart people and getting them to work incredibly hard for customers. It fuels all l all of their success: implementation, product, innovation, customer sat, etc. Huge credit to their recruiting team.
Epic updated the status quo of the paper chart without trying to revolutionize it. For physicians, it functions mainly as a free text documentation environment with computerized order entry and well structured and accessible, comprehensive and organized laboratory and imaging. You can work on your text report on one part of the screen and look up necessary information on another simultaneously, rather than be trapped in hierarchical database hell. Yes, it has a problem list that’s an absurd mess which gets ignored by the working clinicians. Those that work by problem list just do it themselves in their text reports.
One reason no one wants to speak openly but is a well known secret is the lack of courage of CTOs and CIOs to try any other vendor. Epic is a safe bet for them, no one will fire them if they pick Epic, even if the implementation goes much beyond budget, even if the product configuration and training is screwed up etc. Cowardly attitudes like this stifle innovation in the market.
I think strong implementation success should be an option.
I would have to add marketing. Not in a public advertising way, but in an invite your friends sort of way. Creating a desire to become part of an exclusive club. Even now, the products for smaller hospitals and groups are tied up in a desire to link to larger groups and hospitals already part of the Epic family. This has also led to innovative engagement with large organizations who have the resources to contribute to moving their products forward.
They implement better than anyone. I was part of the leadership team that implemented 3 different EMRs in my career. Epic’s implementation methodology from essentially restructuring the IT department to integration with key clinical decision making committees is head & shoulders above what other companies thought about doing.