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Is Epic any different than other software vendors?

November 24, 2008
by Suresh Gunasekaran
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Like many other healthcare organizations around the country, my healthcare organization has made implementation of information systems a major strategic priority. To that end, we have effectively pursued a single-vendor strategy over the last several years with Epic Systems as that single vendor. Our single vendor strategy is partially the product of our executives preferring that there is value from all of our systems being “pre-integrated” and partially the product of the success that we’ve had with Epic Systems.

As a former Gartner analyst, I’ve watched the industry for many years and seen many vendors gain and lose market share. In the late 1980’s, SMS (now Siemens) and HBOC (now McKesson) solidified their market share as the major hospital systems players as Meditech established itself as the solution for the masses. Throughout the 1990’s, Cerner and Eclypsis gained tremendous momentum in the clinical space, and ultimately delivered their Millennium and Sunrise suites which were greeted with much sales success. Each of these vendors, during their time, was much hyped and promised to be the single vendor of choice for the future.

Although all of these vendors and their customers enjoy success today, Epic Systems has shifted to the forefront of the buzz, and is most often cited as the one-stop shop of the future. I think this is because Epic has been better at going from the Ambulatory to Inpatient product sphere gracefully, where many of the others have not been able to go the reverse routed without many failed promises.

Let me put my biases on the table. We’ve invested millions of dollars in Epic products. My career is definitely enhanced through the continued success of our Epic partnership. This is now the second organization in which I’ve used Epic products. However, to be candid, the Epic bet was placed on the table before I took my present job 4 years ago. My job was to make the bet pay off.

I still believe today that a single vendor solution is limited at the current state of product development. I would have preferred a core clinical systems vendor and a separate revenue cycle systems vendor. Our organization budget and management team would never have allowed me to pursue that direction with my current organization. As CIO, my job is to deal in realities first, and possibilities second (especially in the middle of a financial turnaround).

That being said, I’m often asked (and I ask myself), what makes Epic different from the market leaders in the past? There are no simple answers…

1. Their products work. For the most part, Epic’s greatest strength is fundamentally sound engineering. Their marketing never goes further than their product capabilities. Anything that is released works. The history of this industry is littered with systems that have been released before their maturity.

2. Youth is served. The average age of the Epic employee has to be lower than any other major IT vendor. That is good because this staff is very intelligent, knowledgeable on their products, hard working, committed to drinking “the Kool-Aid,” and for the most part fearless. That is bad because many of the staff seem green at the beginning of installs, don’t “click” with lifelong nurses, and lack some of the people facilitation skills that are necessary for organizational change that is necessary with any major system install.

3. Verona is the center of the universe. First off, the staff is excessively proud of the headquarters campus (with the kind of exuberance that .com employees used to rave about their offices in the Valley). On a serious note, the campus is an interesting metaphor for Epic’s approach to their business and their customers. First, they have only one office in the country and all of their employees are there: their attempt to have one culture and one tight-knit company (a little tough with all of their employees). Second, they bring all of their customers there for all training sessions and user group meetings: a sincere attempt to connect your customers to your company, but also a reminder that the convenience factor for the company comes before the convenience of customers (still no regional training centers).

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What makes EPIC different is that the listened to the customers. Users had been saying for years (I was one of them) that we needed a seamless enterprise solution for both business and clinical applications. Most vendors stuck to the premise that they were going to be either really good at the business side or really good at clinicals. Along comes EPIC and says, "I can give you both and make it work."
From a CIO perspective you end up with one solution that you have to train your folks to support, one phone call to the vendor and very little finger pointing when something goes wrong. A true single vendor solution.
The flip side is that EPIC (under the covers) has the same functionality as everyone else and uses behind the scenes interfaces. They have users make a heavy investment in hardware to make sure your fully redundant and decrease the chance of "their" system going down.
It comes down to your organizational strategy. However, for the vendors out there doing a death spiral, they need to get out of their cubicles and see why customers are flocking to EPIC. Of course they could always dust off their customer satisfaction surveys for the last 5 years and actually deliver on some of those suggestions. Harsh? Maybe...but that's reality.

I have read both blogs by Mr. Guerra and this most recent one by Ms. Gunasekaran. I am about to embark on my third EPIC project and I have to say from a clinical perspective, yes it works. However, EPIC is a software that each organization has to build to meet the end-users expectations. This is not a an easy task.

I have worked with both Nursing and Physicians and I can tell you there were many "OIC" moments. I am a big supporter of the EPIC suite and its functionality. Many of the TS support and Implementers from EPIC are truly great.

I will state, however, that the EPIC software is only the beginning, and much of the credit should go the builders who tweak the content (at each organization) and the Implementers (both EPIC and the organization) that support the "go-live."

Hi Suresh,

First off, welcome to our blogging community. As far as Epic goes, I wanted to make sure you’ve read the extensive story we did on the company earlier this year. I also made some comments about it in my edit memo of that issue. I’d love to hear your thoughts. Thanks

I am learning about health informatics. Just wondering if EPIC is a monolithic system. Is is a classic single vendor or best of breed? I understand the difference, but not sure where EPIC falls.
Thanks.

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Suresh Gunasekaran

CIO

Suresh Gunasekaran's blog provides musings from the CIO of an academic health...