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The pros and cons of Epic's growth for EHR systems

A recent WTN News report runs down some epic growth stats for electronic health record (EHR) systems vendor Epic Systems Corp. in Verona, Wis. The company continues to expand rapidly in an economy where growth is hard to come by, as shown by these stats:

  • 600 new hires last year.
  • 4 office buildings opened in the last 18 months, adding 1,650 single-occupancy offices.
  • A Learning Center building to be opened next year at the Verona campus, as well as a second dining facility.
  • More construction in the planning stages.
  • $600 million in revenue in 2009.
  • 5,300 attendees signed up to attend its user conference earlier this year.

After they digest those staggering numbers, the world must look a bit more homogeneous to market watchers hoping the recent federal push for a nationwide network of interconnected, interoperable medical records would promote diversity and competition among EHR vendors.

Anecdotally, we hear that IT leaders at hospitals are “going Epic” because it’s an established product. The company doesn’t necessarily target smaller hospitals, small group practices and solo physician practices; but it’s reaching into those market segments through its larger customers. The typical scenario: A region’s “alpha hospital” effectively becomes an Epic reseller by hooking smaller facilities into its system. Ambulatory practices hook in too, by either contracting with the alpha hospital to provide Epic software and support services or affiliating directly with the hospital and joining forces.

Diversity and competition will drive innovation more quickly in the EHR market, if it’s like most other capitalist endeavors. That makes Epic’s success seem like something of a downer. But EHR isn’t a completely Epic world yet; other vendors are scoring wins too. For example, eClinicalWorks today announced that the Ohio Regional Health Information Partnership, that state’s regional extension center, has named it a preferred vendor for eligible physicians installing new EHR systems.

Glass-half-full types — as well as Epic users we talk to, who do have a choice of vendor — will point out that if interoperability is the goal of the national health IT push, the more people are on Epic, the more interoperable and standardized our medical records will be. Faster. Cynics could go as far as pointing out that health information exchange is very difficult to mandate, fund and execute at the public level, but if everyone’s on Epic, HIE will build itself.

No matter what happens with Epic, at some point there will be an EHR vendor shakeout: The market just can’t support the hundreds of systems available today. Vendor failures, mergers and acquisitions are inevitable. Clearly, Epic’s doing just fine; and barring overexpansion, unforeseen software glitches or regulatory issues, it will be one of the last EHRs standing.