Top 10 Tech Trends: The Urge to Merge

• “There aren’t a lot of vendors offering the kind of integration that Epic does. That is why they are winning so much new business. Other vendors are taking that approach and working on it, but Epic has it now. And it can offer interoperability not just within an enterprise. There are pockets geographically where it can help providers share data with others. One question is: is their success sustainable as they continue to grow?” —Brad Boyd

• “Epic made a bet and built a better mousetrap. Other vendors tried the acquisition and roll-up strategy. I joke that some of these systems are integrated at the invoice level, but when you look underneath the covers, they aren’t really integrated.” —Dan Kinsella

• “On the ambulatory side, the smaller players have been buoyed somewhat by the meaningful use financial infusion. But when it comes time to for provider customers to renew their technology, many of these players are not going to make enough profit to survive. On the inpatient side, the vendors have this old, aging code base on obsolete architectures, and providers are looking at who can update that code the quickest and help them meet meaningful use. It is a Herculean task, and so far Epic has just done that better than everyone else. One concern is that down the road, with no meaningful use dollars, the total cost of ownership with Epic is going to be unsustainable for a lot of providers when it comes time to renew. At that point, I think we will see a second round of players—cloud-based ones—that will shake this market up, but it may be after 2016. Right now the whole industry is overpaying.” —Judy Hanover