In the early 1980s, there was a national healthcare crisis in the United States. Healthcare professionals were more dedicated than ever to caring for their patients, but there was gross lack of coordination among physicians, clinics, hospitals and healthcare organizations. This led to redundancies and massive waste in all areas of healthcare and as a result healthcare cost increased exponentially. Advances in digital technology that allowed development of electronic health records (EHR) seemed to be the solution. Prior to the EHR era, healthcare professionals kept handwritten records of all interactions with patients and stored data on test results, imaging, and treatment courses in hard paper files, which made it very difficult to share information on patients. Consequently, doctors routinely repeated prior tests due to difficulty of finding information. With healthcare cost making up ~18% of GDP, this inefficiency of medical record keeping propagated throughout the entire U.S. healthcare system driving cost through the roof.
Many companies emerged with the focus of designing EHRs that will allow healthcare professionals to easily record, store, access, and share patient information efficiently in an effort to reduce cost. While many showed promise, none has been as successful as Epic Systems. Founded in 1979 by Judy Faulkner, Epic Systems is a privately held healthcare software company that aimed at solving the EHR problem in healthcare by designing software that makes healthcare professionals work more efficiently.[1,2] The company’s customer promise is to develop and supplying EHR software, systems, training, and support frameworks that allow its customers to manage their patient data. Since its founding, Epic systems has grown from a small company in the Madison, Wisconsin to a multibillion dollar private company that employs over 10,000 people with new offices all over the world. Presently, Epic Systems holds the medical record of 54% of patients in the United States (over 127 million people), several folds larger than its closest competitor.
Epic System’s success is predicated on its simple business model of developing excellent software that their customers want; software that will help customers perform tasks more efficiently. The Epic Systems operating model is to find the best and talented people all over the world and provide them with a platform to design healthcare related software that meets customers’ need. Today, Epic is the EHR software used by the most prominent medical institutions in the U.S. such as Mayo Clinic, Cleveland Clinic, Johns Hopkins Hospitals and Partners Healthcare.
Before Epic, healthcare professionals had idiosyncratic ways of recording patient data. With Epic, the process of recording patient data became standardized, and information readily retrievable. Epic has a built-in ability for patient information to be readily accessed in any hospital in the world. Epic also designed “Haiku”, a mobile app that allows access of patient information on a mobile device. Doctors can now review imaging findings of new patients on their phones and render diagnoses and treatment on their phones. All of these digital technological advances made Epic very successful and profitable, making Epic one of the most promising and rapidly growing healthcare IT companies in the world.
Digital transformation allowed Epic Systems to deliver great value to its customers by providing an avenue for cost savings in healthcare. As government regulations and healthcare reimbursement requirement evolve, however, Epic’s constant goal of modifying its software to meet the needs of its customers now threatens to make a once efficient EHR system cumbersome to use. Healthcare professionals now struggle to document simple patient encounters on Epic so as to meet regulatory and payment criteria. In trying to allow healthcare professional to capture more billable events, Epic has lost its ease of use. Doctors and nurses now spend a majority of their time interacting with Epic on a computer or mobile device and very little time actually talking to patients. Another issue relates to information overload in Epic and inherent difficulties with finding patient information in a timely manner to deliver care.
Epic Systems is currently trying to address these issues by revamping the customer promise of designing good software that helps customers perform tasks efficiently. Thus, today multiple Epic employees are deployed to hospitals all over the world to see the direct impact of Epic EHR on patient care delivery. Insights from site visits continue to guide Epic Systems to design innovative products that addresses the needs of customers in ways that do not hinder proper patient care. As Epic Systems addresses these issues and continues to expand, it is unclear what role government should play given that more than half the US patient population have health records on Epic. Cyber security and protection of patient information also continues to be an issue. How will Epic Systems address these pressing challenges going forward?
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