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Introduction and Philanthropy Goals

Today in Health IT, we're going to talk about EPIC and whether it's getting too big. My name is Kate Gamble. I'm Managing Editor at This Week Health, where we host a set of channels and events dedicated to transform healthcare, one connection at a time.

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Epic's Market Influence and Antitrust Concerns

Today we're discussing whether Epic is getting too big. I'm joined by Sarah. So Sarah, can you summarize this article and give us some thoughts? Yeah, of course, Kate. And by the way, welcome to This Week Health. You've been here just over a month and a day, and we're just thrilled that you're here. So here's what's so fascinating about this article is it explores the concerns that Epic, which is one of the largest EHR vendors, may be growing too large with the potential for antitrust risks.

With Epic now having over 50 percent of U. S. hospital beds under its system, people talk about market However, legal experts suggest that unless EPIC engages in extreme behavior, government action is unlikely. So, couple things that stood out to me about this is that While they have 50 percent of US hospital beds, we're not seeing a slowdown in conversions to their platforms.

And when we ask people, who's your favorite vendor, or who do you enjoy doing business with, irrespective of cost and complexity, etc. People say EPIC, like this doesn't concern the CIOs, the CISOs, the CMIOs, the thick, you know, letter in between. They don't seem that concerned with it. And I do love that they are investing heavily in AI projects with the massive database Cosmos, which may also face scrutiny for interoperability practices.

Interoperability Challenges and Strategic Considerations

Okay, so here's where it gets really interesting for CIOs. They, the EPICS approach to interoperability, while improving, it still faces a lot of challenges, and it makes it hard for CIOs to integrate systems from other vendors without incurring those high costs.

So, what are your thoughts on this? You build it in. To the expectation. So yes, the, if you have, you know, different Epic instances, you're gonna be able to share the data more effectively, but you realize when you're going to be either making a move to a new platform or you're going to be pulling in data from new aspects, that's going to hit your governance models, that's going to be part of the conversation that it takes to.

What does it take to keep the machine running? And what are the things we need to be thinking about one or two years ahead of time? So we already know that interoperability at any level can be complex and expensive. It's always been true. And so why is it different? Because now your EMR is the center of the universe in some of these conversations.

I believe that you plan for it and you keep these conversations front and center. Of course, always there's a lot of talk about the high, the high costs of switching associated with EPIC, um, that makes it difficult for hospitals to transition to other systems and limits flexibility for CIOs.

Do you think this is still the case? I believe it's going to be a case for Huge systems. Like I came from HCA once upon a time, and they're primarily Meditech because it makes sense for them to have that partnership and to be deploying Expanse over the next few years and doing all of that research development and innovation with them.

I also came at one time from a smaller hospital system, and there are always going to be options for you that are not Epic centric. So if you're worried about vendor lock in, yeah, that could be true. But what I love about the whole model is that. While maybe a couple of the other behemoths have started to lose market share, you don't hear as many conversations about the other systems also being as much at risk because for those EMRs that are not Epic or not Oracle that play well in either rural, critical access, or mid market spaces, those are still very viable options.

And, uh, I'm hopeful that CIOs don't feel like they have to have a plan to move to EPIC or to have that experience to still be viable in both their health systems and in their careers. So this one's going to get a little interesting because the articles implies that as Epic continues to dominate the market, CIOs need to carefully consider the long term implications of being tied to a vendor with such market influence, especially concerning innovation and cost control.

It seems that some, that maybe the opposite is true, or maybe not the opposite, but that It is not a bad thing to be tied to Epic and have that Epic experience at all. So I took debate in high school. I could tell you both sides of the equation and I'll give you a quick version on both. If I was to say, why is it a good thing?

It's a good thing because you can look at your roadmap and align it with their roadmap and decide, do I make investments in some of these new innovations in my own product development and other aspects of things? People are asking for it because is it worth two years if it's going to be part of what Epic is going to deliver for me?

So you're having real conversations about when do I deploy certain technologies? Because what I know is already coming from my primary vendor. I'll argue the other side pretty easily too, which is all your eggs in one basket always freaks me out. When I have conversations with Drex about the security posture or the threat landscape, it's like, okay, so you've got Epic and you've got Workday and you've got ServiceNow.

All products that we know and love well, and if you've got most of your data and your analytics and your decision making all coming from three core systems, is that actually limiting what your capabilities could be when you have all the other technology out there that goes back to what we started with, which is the interoperability capabilities.

And if you don't know, If that's the right date, then at least understand what it's going to mean for you or the team that you are planning for succession as a part of all of this. Because if you walk out the door for that CEO role. And you leave a train wreck behind that train wreck will follow you in your reputation.

If you think you're going to be holding on to this team for long periods of time, you want to make it easier for yourself in the longterm. So all of that strategies is important about your vendor management. Is it about your total landscape within your health system? That's some food for thought. You were probably really good at debate team.

I'm glad I didn't go up against you. So thanks so much for joining us. Don't forget to share this podcast with a friend or colleague. Um, and that's a wrap. Thanks for listening.