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
@nytimes 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. 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? 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/... 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/... 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/... 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/... @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/... 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/...
Context & Ripple Effects
This profile lands mid-arc in a long-running argument about Epic Systems. The interoperability gap that has hampered data exchange since at least 2015 framed Epic as the industry's walled garden; this piece adds an inside view of how the company runs itself — high turnover among non-developer staff, monthly all-staff meetings, and campus spending like the reported underground auditorium — while it holds records for more than 50% of US patients on $2.7 billion in revenue.
What makes the portrait consequential is what follows from it: within a year, reporting tied the US's $36 billion digitization push to thousands of patient-safety incidents, and by early 2020 Epic was [[a:949893|publicly urging large hospitals to oppose proposed rules opening up access to patient records]]. The profile supplies the cultural and governance backdrop — private ownership, Judy Faulkner's control — against which those fights play out.
First-order effects
- Former employees' accounts of burnout and turnover among non-developer staff put Epic's hiring-and-grind model under public scrutiny just as it competes for technical talent against public tech companies that can pay in stock.
- Questions about campus spending — including the rumored $600 million underground auditorium — land on a company whose customers are hospitals and health systems operating on thin margins and federal incentive money.
Second-order effects
- Epic's hospital customers inherit the reputational exposure: every interoperability or safety critique of the software now attaches to the health systems that chose it, strengthening the hand of rivals willing to compete on open data exchange.
- The privacy-holdout structure — no public listing, no outside shareholders — means criticism lands on Faulkner personally rather than a board, raising pressure on her succession planning as she passes four decades running the company.
Third-order effects
- If the pattern holds, the EHR market consolidates around a few privately controlled incumbents whose incentives (lock-in, closed records) run directly against policymakers' interoperability agenda — making regulation, not competition, the main force that opens patient data.
- Sustained scrutiny of working conditions at dominant healthcare-software vendors points toward labor practices becoming part of procurement calculus for hospitals, not just product features and price.
The trend: US electronic health records are concentrating into a handful of privately held platforms, pushing the fight over patient-data access from the market into regulation.