Epic Systems, every mention

Epic Systems (MyChart) · Acquired Apr 21, 2025 · 100 mentions

• ▶ 1:07:51 David Rosenthal The company crosses fifty million in revenue.
• ▶ 1:07:55 David Rosenthal They feel like, okay, we're finally like ready for the big leagues.
• ▶ 1:07:59 Ben Gilbert And just to contextualize that fifty million of revenue, they're up to 88 health systems now, so they really are starting to penetrate the market just going one by one by one by one to all these different hospital systems and selling them…
• ▶ 1:08:13 David Rosenthal So they're ready for the big leagues, and then in 2003, they get a call not just from the biggest player in the biggest league,
• ▶ 1:08:26 David Rosenthal But before we tell the Kaiser story, which completely transformed the company.
• ▶ 1:13:11 David Rosenthal And Epic wins the deal.
• ▶ 1:13:14 Ben Gilbert And Epic was a little company just a few years before they were a fifty million dollar company.
• ▶ 1:13:19 David Rosenthal Yes, and after they signed Kaiser, they go to a hundred and sixty two million in annual revenue.
• ▶ 1:13:27 David Rosenthal Probably more than doubled their revenue overnight.
• ▶ 1:13:38 Ben Gilbert They call it a four billion dollar three-year project, and that Epic's portion is around four hundred million.
• ▶ 1:14:27 David Rosenthal But it's not like Epic got four billion dollars out of this.
• ▶ 1:14:35 Ben Gilbert Even if it's a small health system, three hundred million dollar project, and it ends up resulting in nowhere near that much money to Epic, but this is how the industry has decided to talk about the size of these deals.
• ▶ 1:16:01 David Rosenthal But this small little Portland region, they had started using Epic for their ambulatory clinics.
• ▶ 1:17:25 David Rosenthal Like, we've got this thing called Epic up in Portland that we're not even using at the hospital, and it's way better than the stuff that you're trying to build.
• ▶ 1:18:33 Ben Gilbert This sort of thing does happen in the hospital world, too, and Epic has bet the whole company on having a reputation for, we don't have failed implementations.
• ▶ 1:19:15 David Rosenthal I doubt that's even like a controversial statement probably at Epic themselves.
• ▶ 1:19:19 David Rosenthal I think they consider the customer to be the CEO, CIO, and CFO of their customers.
• ▶ 1:20:27 David Rosenthal So, okay, Kaiser's now got to rebid this project, and by this point in time, enough Portland doctors had come down to California and sung Epic's praises that they're like, alright, we should take this little company seriously.
• ▶ 1:20:38 David Rosenthal So they start the RFP, and it comes down to Epic and their big main rival, Cerner.
• ▶ 1:20:56 David Rosenthal I think it was started the same year as Epic, right?
• ▶ 1:21:03 David Rosenthal Unlike Epic, which took the no venture capital, no acquisitions, single platform, stay private forever route, Cerner took the
• ▶ 1:22:03 David Rosenthal So supposedly at one point they come to both companies, to Cerner and Epic, and they say, look, Cerner, we want to go with you for inpatient in the hospital, since that's your bread and butter.
• ▶ 1:22:20 David Rosenthal And Epic, hey, you've got inpatient now, but you only just launched that in 2001.
• ▶ 1:22:30 David Rosenthal We want to split the baby here and do one system with Epic for our outpatient clinics and one system with Cerner for our inpatient clinics.
• ▶ 1:23:12 David Rosenthal However, definitely super ballsy to do this, but she knew that Epic had a good product in both.
• ▶ 1:23:27 David Rosenthal I mean, Cerner's a billion in revenue at Epic is, like, somewhere slightly north of fifty million at this point in time.
• ▶ 1:24:31 David Rosenthal So the Epic team is doing their planning, you know, getting ready for all the preparation for this really big meeting.
• ▶ 1:24:37 David Rosenthal And the team had decided that the way they were going to handle this question was to do a theoretical presentation about how Epic's architecture worked, the single system, and theoretically how much load could the system handle all at once.
• ▶ 1:25:31 Ben Gilbert Epic had the advantage here, that they actually could, if they played it all the way out and really built out the spreadsheet, show, actually we're gonna be more performant for you.
• ▶ 1:26:06 David Rosenthal I think this was the moment when the tide turned that Epic was like, oh, yeah, we're gonna win this thing.
• ▶ 1:26:58 Ben Gilbert So then they come to Epic and they say.
• ▶ 1:26:59 David Rosenthal They come to Epic.
• ▶ 1:27:16 David Rosenthal And they still picked Epic in the end.
• ▶ 1:27:20 Ben Gilbert Through that, through the architecture bake-off, and through the no, you have to pick one of us, Epic still won out.
• ▶ 1:27:47 David Rosenthal Cause Epic is the only one that can offer that.
• ▶ 1:28:14 David Rosenthal This is why Epic wins.
• ▶ 1:28:26 David Rosenthal The Kaiser Epic system could become the Model T of its industry.
• ▶ 1:28:36 David Rosenthal Once this happens, Epic gets elevated to the new gold standard.
• ▶ 1:28:41 David Rosenthal If you're a hospital system, if you're a CIO or a CEO looking to rebid your EMR, well, Kaiser, the biggest system in the world, just chose Epic, and they chose it
• ▶ 1:28:52 David Rosenthal Over all of these reasons not to, there must be something really good in there, like, of course you're now going to consider Epic, and of course Epic is going to perform really well in these evaluations.
• ▶ 1:29:17 David Rosenthal Yep, so by 2007, Epic has hit five hundred million in revenue, so
• ▶ 1:29:51 David Rosenthal We'll bring us in a minute to Epic's epic, shall we say?
• ▶ 1:29:59 Ben Gilbert And one thing just for our storytelling narrative there we kind of skipped over was there's another thing that happened in the early 2000 that reads a little bit as a sort of alternate history for what could have happened at Epic.
• ▶ 1:31:18 Ben Gilbert The Dutch company comes to Epic and says, we want to do something focused on the radiology segment.
• ▶ 1:31:32 Ben Gilbert We, Philips, will get a license to Epic's whole IT system.
• ▶ 1:31:46 Ben Gilbert They're gonna buy a Philip-branded version of Epic.
• ▶ 1:31:57 Ben Gilbert Right, so Epic starts hiring people in the Netherlands, they build up this team, they spend multiple years, or at least a year, building it out.
• ▶ 1:32:18 Ben Gilbert Partnerships at this era to the Epic team means A, stuff I can't control outside my organization, B, big risk, C, never in our history do we have an example of it working.
• ▶ 1:32:44 Ben Gilbert And that's oversimplifying it, but I think it's still reasonable to say that some of the DNA of what Epic would become, and they would take tons of arrows for this, this closed, not interoperable, blah, blah, blah.
• ▶ 1:33:12 Ben Gilbert So at this point in the late 2000, Epic is eyes on the prize.
• ▶ 1:33:37 David Rosenthal So for the probably minority of you listening who know anything about Epic as a company or been involved with them in the past, if you have, you almost certainly know about their corporate campus.
• ▶ 1:35:28 David Rosenthal Just like Microsoft kind of owns Redmond, Epic owns Verona, spiritually.
• ▶ 1:35:44 Ben Gilbert A thing that was already happening at Epic was this fairy tale, whimsical thing that you can kind of see in their product names.
• ▶ 1:35:56 David Rosenthal Ok, so this is the second story of the Epic Campus.
• ▶ 1:37:28 Ben Gilbert Just Google pictures of the Verona campus for Epic, and we'll link to some of the show notes too.
• ▶ 1:37:47 Ben Gilbert And Epic is this sort of
• ▶ 1:39:59 David Rosenthal All right, I think now is the right time while we're talking about the campus and Epic Culture to really talk about Epic Culture.
• ▶ 1:40:53 David Rosenthal So while we're on culture here, one of the most amazing things about the campus is Epic
• ▶ 1:41:04 David Rosenthal So the epic 10 Commandments is like, you know, Moses in the Bible here.
• ▶ 1:44:01 Ben Gilbert We can sort of trust that once we squeeze you through the Epic system, when you come out the other side, you are able to operate in a way that works really, really, really well
• ▶ 1:44:53 Ben Gilbert So at my company, we're not going to have budgets like that.
• ▶ 1:45:27 Ben Gilbert Epic's been doing this forever.
• ▶ 1:45:28 Ben Gilbert This is the Epic way.
• ▶ 1:45:30 Ben Gilbert That I think the rest of the world sort of woke up to when startups internalized as doctrine, but every person in the company spending time in medical settings, talking to customers, hugely valuable.
• ▶ 1:47:19 Ben Gilbert The work done as an implementation person at the company is insane.
• ▶ 1:48:44 Ben Gilbert That plus the whimsy encapsulates pretty well the epic culture, and the result of that is it becomes the number one thing in your life.
• ▶ 1:49:05 Ben Gilbert They make it very easy for your whole life to become epic.
• ▶ 1:50:29 David Rosenthal His involvement in the company actually predates him becoming a programmer at Microsoft or even an adult.
• ▶ 1:51:05 David Rosenthal Do you think you could write one of these types of tests for me and I can use it at Epic and test software developers as we're hiring them and see if they're any good?
• ▶ 1:51:15 Ben Gilbert And for 18 years, listeners, that was how they tested to determine if someone should work at Epic.
• ▶ 1:51:48 David Rosenthal For every role in the company.
• ▶ 1:52:24 Ben Gilbert The Epic culture is completely customer obsessed, and I mean that the way we talked about customer before.
• ▶ 1:52:38 Ben Gilbert He says, you get what you pay for a hundred percent of the time, despite Epic being, quote, not cheap.
• ▶ 1:52:54 Ben Gilbert At this point, no one gets fired for buying Epic the same way it used to be true about IBM.
• ▶ 1:53:18 David Rosenthal There are basically only three roles at the company.
• ▶ 1:53:35 David Rosenthal There are eight or so salespeople, quote unquote, in the company who only react to inbound requests and they all came from either project management or technical specialists.
• ▶ 1:53:48 David Rosenthal The technical specialists are the biggest group in the company.
• ▶ 1:53:50 David Rosenthal Every single customer of the, 607, whatever hospital system customers that Epic has, every single customer has their own
• ▶ 1:54:26 David Rosenthal Who is a single person within Epic and their sole job, their only job is to make sure that you as a customer are successful with their products.
• ▶ 1:54:35 David Rosenthal So this means they do things like they grade you as a customer every year, benchmarked relative to what other customers are doing and how you're doing with the Epic tools.
• ▶ 1:55:19 Ben Gilbert When the customer wants to do something a certain way and Epic wants to do something a certain way, ultimately Epic is customer focused, so they will do whatever the customer wants.
• ▶ 1:55:46 Ben Gilbert Epic is highly opinionated.
• ▶ 1:56:24 David Rosenthal To your point about the standard implementations, I believe this is the only way that you can get discounts on pricing with Epic is by doing either fully or mostly standard.
• ▶ 1:56:52 David Rosenthal So all of this sounds sort of Epic accruing power for Epic, which it is.
• ▶ 1:56:58 David Rosenthal There is also this almost altruistic part of the company and their customer relationships.
• ▶ 1:57:12 Ben Gilbert Ultra value maximizing altruistic capitalism is kind of like how I would describe the company.
• ▶ 1:57:17 David Rosenthal Yeah, I think that's how you sum up Epic.
• ▶ 1:58:04 Ben Gilbert But yes, of course, it's to do what's in Epic's long-term interest.
• ▶ 1:58:10 Ben Gilbert The reason you pick Epic is to turn an interaction with a patient into as many dollars as possible for the health system without risking downside.
• ▶ 1:58:23 Ben Gilbert And what is Epic trying to do?
• ▶ 1:58:25 Ben Gilbert Epic is trying to win deals and stay in forever and achieve world domination.
• ▶ 1:58:40 Ben Gilbert Like, they'll recommend alternative third party new pieces of software to their customers.
• ▶ 1:59:06 Ben Gilbert So you're certainly not going to go around shopping for some new thing when you know that it's just going to come for free to you, and you're not going to take it right away because it's going to be too bare bones, but at some point it'll…
• ▶ 1:59:32 Ben Gilbert Because in the long term, that is the right thing to do for Epic also.
• ▶ 1:59:56 Ben Gilbert Epic is absolutely customer obsessed, again, CEO, CIO of hospital systems.
• ▶ 2:00:02 Ben Gilbert Because if you deliver for them, you deliver for Epic in the long run.
• ▶ 2:00:36 Ben Gilbert And it's like this cutesy thing that most journalists who write about the company kind of latch on to.
• ▶ 2:03:24 Ben Gilbert We just got through the Verona campus, you know everything about Epic's culture now, or at least everything that we could discern from the outside anyway, and we're in this pretty interesting era in 2006.
• ▶ 2:06:19 Ben Gilbert Because this word comes up every time EPIC comes up, or any EHR comes up, and it's worth knowing sort of the buckets.
• ▶ 2:06:25 Ben Gilbert So there's the first and easiest interoperability, which is EPIC to EPIC at a different hospital.