Anything related to defense will need to go to Genesis.
Morning Headlines 12/12/25
Texas Files Antitrust Suit Against Epic Systems Over Health Data
Texas Attorney General Ken Paxton files an antitrust and consumer protection petition alleging that Epic maintains monopoly power and that the company misleads Texas children’s hospitals about its parental access rules.
HHS health IT chief hints at a new approach to EHR certification
Assistant Secretary for Technology Policy and National Coordinator Thomas Keane, MD, MBA tells STAT he’s hoping his office will soon do away with 34 certification criteria for EHRs and modify seven, with an eye to regulating EHR interoperability APIs in the coming months.
OpenAI’s “State of Enterprise AI” report names healthcare as one of the fastest-growing business sectors for ChatGPT use.
As a former long time EHR salesperson for a competitor of Epic all I can say about the lawsuit is that it is about time. There were multiple instances where we actually beat the Community Connect system at a mid sized or critical access system in the demos and the deciding factor was patient records availability and prestige. When the system cared about autonomy more, and actually did their homework on the real cost of Epic, we won or another competitor did. What is sad is leaders of several systems who went with Community Connect told me later that they regretted the decision for a variety of reasons including the reality that the promise that they could run their system with less IT staff never came to fruition. In all cases they needed more staff to run the system than the one that was replaced. All EHR’s are like living breathing beasts that need to be constantly fed but Epic always needs more people and always costs more. This lawsuit likely one change much due to other factors but hopefully the light shined on the reality of Epic’s leverage (I carefully chose not to use the word monopoly) will open some eyes in the remaining non Epic hospitals to not buy into the myth that you have to be on Epic to thrive or survive.
If your core argument is that systems buying your product just didn’t have enough information to choose you, then you need a better sales team – full stop.
Perhaps, just maybe, there was more at play in how a system chooses from the (probably) CIO perspective.
Admittedly, I’m not sitting in any C-suites, but from the top of my head lets play out the autonomy thought process. If I want to stay independent, I might choose Epic so patients aren’t seeking a different system with MyChart or can take advantage of Care Everywhere with the larger system down the road. Choosing a solution that is losing market share in my area may make it harder for me to recruit doctors or spend more to bring in patients. Alternatively, if I want to position myself for an eventual merge or buy out, I might look more attractive to the big Epic shop up the street in a few years if my users are already experience and my data is more compatible.
None of these require any nefarious action from Epic, just market dynamics and network effects.
But hey, maybe it was just that the systems who didn’t choose you were fools. Could be that too.
EHRMusing – You make a lot of accurate statements about key factors in the selection process but the comment about “not having enough information” is off base. Even after an exhaustive selection process they chose to ignore the information they gathered based on one single factor: Interoperability. All those other factors you mentioned were discussed on some levels but when it came time to make a final decision multiple C suite executives either told me at the time it was the belief that interoperability was the most important factor or I was told that later. Either the vendor I was working for or the competitor actually won the selection process but that was the key differentiator. It’s just a fact that Epic if they chose could make their system more interoperable if they chose to. But they chose not to. That is their right and is frankly smart business if you can get away with it. They are.
I see a lot of people dislike what I said. I assume some don’t like it because what I said is true but I’d like to hear from people who disagree with what I said. One thing I’ve learned in my career is there is a “big decision effect” where once a huge decision is made it is in the best interests of the people who made the decision to ensure the view of their decision is only seen as positive and the best decision. This extends to the fact that there are I bet at least half a million people in this country whose careers are for the most part wholly invested in the continued success of Epic. This doesn’t just happen with Epic but it is the reality of the situation. Sure I’m a little biased here too but the reality is that Epic as the leader in this space has a huge responsibility and this environment where you can’t honestly assess Epic is not good for healthcare or the country.
I’ll bite on the disagreement side. 25+ years in EHR implementation, sales, and support.
First, regarding the decision effect. Sure, you make a major transformational decision for your organization and you want to be sure you made the right decision. That said, the community supporting you has a large impact as well. In my experience with Epic, Oracle Health, Meditech, athena, and Nextgen, beyond the annual vendor supported conferences, I have never had a CIO state they have a community of other customers to work with, bounce ideas off of, or share content with in any other EHR other than Epic. Perhaps I don’t run in those circles but the visibility for an up front customer going in is not there.
Second, the lawsuit. If you take the time to read the lawsuit, it claims that Epic is not configured out of the box to support Texas local laws and that Epic controls access to all of the patient data and is preventing it from being shared with competitors. Both of those have severe legal fallacies. The customers of Epic (health care systems) are responsible for the configuration and compliance with local laws – and Epic supports that configuration for proxy access if configured to do so. Regarding the data, the healthcare system controls the data and access and is restricted on sharing that data due to the federal HIPAA and HITECH acts. Lastly, regarding it being a monopoly, there are other choices, most organizations undergo a BOD approved selection prior to contracting, and Epic does not give preferential pricing or perks to win the business. It is a resource intensive system, it is costly, but it also is the only IP/OP system built all from native code (yes, OH’s new amb EHR is built from the ground up but to use it with IP, you need to connect it with a separate product). There was a lot of hype this year stating that Epic is going down the bolt-on road due to some of the ambient listening short term partnerships with MS. In the future, Epic will have a native solution in addition to supporting a providers chosen 3rd party: MS, abridge, etc. IMHO, both OH and Meditech shot themselves in the foot by producing new EHRs that require reinstalls vs upgrades. This often results in a new selection and when looking at a 10 year TCO, the numbers become pretty close across the board. The likelihood this filing gets dismissed is higher than it moving forward (not a lawyer though).
I’ve been in this business a long time. Choosing the “right” technology product is fraught, especially when it comes to long-lived systems like EHRs. Some of the selection factors include forecasting the future. And what you think will happen, doesn’t always happen.
We use tools like structured comparison charts to try to bring some order. RFIs and RFPs. None of it completely captures the process or the trade-offs. The most common failure is to identify an issue but fail to give it the appropriate weight (in hindsight, of course). Sometimes a dominant concern at selection time, simply fails to materialize.
Hanging over it all is the spectre of politics, personal relationships, and kickbacks. Condemn these all you want, but it’s a fool’s paradise to pretend they might not arise.
I’ve also seen customer configuration choices, completely justifiable at the time, eventually become an albatross that was never overcome.
I’ll tell you this for sure. The winning sales teams always think the customer made the right choice. And the losing sales teams always think the customer made the wrong choice.