Profile of Epic Systems, a privately held healthcare software company based in Wisconsin that claims to hold medical records for more than 50% of US patients
The engineers at Epic Systems work on a campus full of childish whimsy but also sit in on open-heart surgery. Tweets: @chrissyfarr , @katekelly , @joycenovacek , @fdmts , @nytimes , @stevecase , @david_t_macknet , @joycenovacek , @indievc , and @farzad_md Tweets: Christina Farr / @chrissyfarr : I wish I had written this -> “Epic's coders often leave campus to embed in operating and recovery rooms, where they watch nurses ripping the tops off blood bags and surgeons opening up people's chest cavities...(Some) faint at the sight of beating hearts.” http://www.nytimes.com/... Kate Kelly / @katekelly : A slide down from Heaven, an elevator to Hell, an Indiana Jones tunnel and hundreds of millions of patient medical records. My journey to Verona, Wisconsin to meet the most important tech company you've never heard of http://www.nytimes.com/... Joyce Novacek Ragard / @joycenovacek : I worked at Epic for 3.5 yrs & I think the way Epic treats its (thousands of) employees deserves more attention. The turnover rate for non-developers is ridiculous. I felt thrown into the fire, and since I was 22 and it was my first job, I didn't know I deserved better. Chris Dwan / @fdmts : Epic's outright hostility to software interoperability, coupled with their 1970s style monolithic mainframe style data design are a big part of why precision and personalized medicine are so slow to arrive. But hey! A whimsical campus! http://www.nytimes.com/... @nytimes : Epic's headquarters is full of childish whimsy. It's also a health care services provider with $2.7 billion in annual revenue. Is this the indulgence of an oddball founder, or a better way to run an IT company? http://www.nytimes.com/... Steve Case / @stevecase : Willy Wonka and the Medical Software Factory http://www.nytimes.com/... “In the farm country of southern Wisconsin, 12 miles from Madison, is one of the nation's biggest tech companies — and almost certainly the quirkiest” #RiseOfRest http://twitter.com/... Dr. David T. Macknet / @david_t_macknet : “All employees have offices, because studies show that workers in open floor plans get interrupted frequently.” http://www.nytimes.com/... Joyce Novacek Ragard / @joycenovacek : As an employee, the monthly staff meetings were a consistent impediment to me getting work done. And rumor has it that underground auditorium cost $600 million. It must be asked: is this a responsible use of healthcare money? @indievc : A rare look behind the curtain at Epic Systems. Bootstrapped to nearly $3B in revenue in one of the most capital intensive, competitive and regulated industries on the planet. With a company mandate to always remain private. http://www.nytimes.com/... Farzad Mostashari / @farzad_md : Cute article about Epic the EHR company, and their quirky campus, but this excuse for lack of information sharing (we don't have technical standards) is nonsense The problem is perverse incentives of vendors and hospitals, not lack of technical standards http://www.nytimes.com/... http://twitter.com/...
Context & Ripple Effects
This New York Times profile lands in the middle of a decade-long argument about electronic health records. Critics had already flagged the lack of interoperability among EHR providers like Epic as a reason billions in federal digitization spending left doctors unable to exchange data, and the profile's details — engineers embedded in operating rooms, a mandate to stay private, an estimated $2.7 billion in revenue — explain how a Verona, Wisconsin company came to hold records for more than half of US patients without ever going public.
The portrait also sets up what came next: within two years Epic was publicly [[a:949893|calling on large hospitals to oppose proposed US rules that would open up access to patient records]], consistent with the hostility-to-interoperability accusations in the coverage, while reporting tied thousands of deaths and injury reports to EHR glitches across the $36B US health-record digitization effort.
First-order effects
- Hospitals running Epic get a vendor whose engineers observe surgeons and nurses firsthand — a workflow-driven design loop that deepens switching costs for the majority of US patients whose records sit in its system.
Second-order effects
- Rival EHR vendors and regulators face a consolidated incumbent whose private ownership insulates it from shareholder pressure, forcing the interoperability fight into policy arenas rather than markets.
Third-order effects
- If the pattern holds — one privately held vendor anchoring most US medical records while resisting data-sharing mandates — federal rules on patient-record access become the decisive lever shaping the entire EHR market, a tension still visible in profiles of Judy Faulkner's decades-long leadership.
The trend: US health-record infrastructure is consolidating around a single privately held incumbent, pushing questions of data access and patient safety from competition into regulation.