After billions spent, lack of interoperability among electronic health record providers like Epic still hampers data exchange for many doctors
Epic is like the Microsoft Office of health care software—more comprehensive than its competitors, even if its individual parts are kind of meh.
Context & Ripple Effects
This Mother Jones piece sits at the start of an arc the corpus keeps returning to: Epic Systems has grown into a privately held Wisconsin company whose records cover more than half of US patients, yet the software those hospitals bought with federal digitization money doesn't talk across vendors. The scale of that bet is documented in a later report tallying $36B spent digitizing health records — alongside thousands of glitch-linked patient-safety reports.
What makes the interoperability gap durable rather than incidental is Epic's own behavior: by early 2020 the company was actively urging large hospital systems to oppose proposed US rules designed to open up access to patient records. A vendor holding majority share of the record market lobbying against open access turns 'meh parts, comprehensive suite' from a design quirk into a competitive strategy.
First-order effects
- Doctors at non-Epic hospitals remain unable to pull complete patient records when someone crosses between systems, so data exchange failures land directly on clinical workflows and on the physicians doing manual workarounds.
Second-order effects
- Hospitals locked into Epic's suite face high switching costs, reinforcing the vendor's pricing power, while smaller EHR rivals must differentiate on openness rather than breadth because they cannot match the suite.
Third-order effects
- If regulators keep pushing access rules against incumbent resistance, interoperability itself becomes the battleground where Epic's suite moat is either preserved or eroded — and the safety problems already tied to rushed deployments suggest openness will have to arrive alongside better-built software, not instead of it.
The trend: Health IT is moving from closed-suite lock-in toward mandated data portability, with the largest vendor's resistance shaping how fast that shift happens.