Epic or Best-of-Breed? The Billion-Dollar Question

Posted on June 27, 2012 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Ah, the Judy Faulkner stories. They’re beginning to be as numerous, and, uh, epic as those of Microsoft and Apple’s early days.  Imagine the average-looking, middle-aged Faulkner — Epic’s CEO, of course — walking into a room of hospital CIOs and telling them she’d come “to decide who she wanted as customers.”  Kinda makes you want to admire Faulkner even if you don’t.

But more importantly, such behavior brings up the question of whether Epic brings enough to the table to make such grandstanding tolerable.  As Zina Moukheiber, a Forbes contributor, notes in a recent article, Epic has certainly convinced a lot of CIOs that the answer is yes, largely because it offers a single ecosystem hospitals can deploy across the enterprise.

But like myself, Moukheiber seems very skeptical that Epic has justified its astronomical prices, which include:

* Partners HealthCare and Duke University Health System, $700 million each
* University of California, San Francisco, $150 million
* Dartmouth-Hitchcock Medical Center, $80 million

I’d also drop in a casual mention of Kaiser Permanente’s Epic installation, which allegedly hit $4 billion-ish before it was done.

Of course, the issue isn’t merely whether Epic is expensive, but whether it gets the job done in a way which can’t be done by less expensive systems.  That, clearly, is the billion-dollar question.

In response, Moukheiber notes that in a recent New England Journal of Medicine piece, published earlier this month, two Boston Children’s Hospital Physicians argue that “diverse functionality needn’t reside within single EHR systems.”  Children’s uses Cerner, Epic and best of breed software as needed.

Yes, that’s  the heart of the matter, isn’t it. If you believe that there’s less risk and more chance of success implementing one system — thinking embraced by many hospital boards — Epic is likely to be a smash.

But if you’re a best-of-breed CIO, you’re probably astonished that anyone trusts their whole enterprise to a single vendor. Honestly, I am too.