Will Epic Interoperate With Other EMRs? Doesn’t Look Likely

Epic president Judith Faulkner has suggested more than once that her company’s system can interoperate with virtually every other system out there, including your grandmothers Pentium 286 with Windows 3.0 on it.  How?  Through the magic of the continuity of care document.

But what’s the real story?  If the informed commentary among a group of IT insiders on Google Plus is correct, Faulkner’s claims are, uh, exaggerated at best. Epic’s EpicCare Everywhere isn’t quite what it seems, the group concludes.

Vince Kuraitis noted that per Epic’s own technical manual, non-Epic institutions get an XML file containing the CCD, but the Epic institutions get an XML file containing Epic proprietary extensions to the CCD.  “This is consistent with Epic’s proprietary, one-vendor-shop,non-interoperability stance,” Kuraitis noted. “The statement that “any hospital can interoperate with EpicCare Everywhere – just so long as they are an Epic institution aptly summarizes this”

My colleague John Lynn notes that Epic says it will offer richer data exchange between two Epic hospitals, but will only interoperate with other EMRs that comply with industry standards. As John appropriately asks, which standards does Epic support?

Epic may get away with these ambiguities for now, but it may not do so for long, argued Dave Chase.  For one thing, he notes, even IBM was forced to embrace the open source gospel once it began to lose market share, and to some extent Microsoft.

Perhaps more significantly, some observers are beginning to question whether Epic’s locking up interoperability options could constitute a restraint of trade, putting them in the sights of not only the Federal Trade Commission but also the ONC. “To the extent that patients are being harmed, I would think that the ONC would have something to say,” Chase wrote. (I would tend to agree with him.

As is often the case where Epic is concerned, we’re left with a cloud of smoke even when smart people have smart discussions on the topic of the feckless Wisconsin giant. I sure hope someone holds them accountable, and soon.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.


  • Don’t get me wrong – I’m no fan of Epic, as a user or as an HIT pro. But the fact that they have achieved enviable success in the marketplace doesn’t mean that the government should step in and punish them.

    The author appropriately asked the (rhetorical?) question “which standards does Epic support?” It’s not an easy to question to answer, because the primary question is “What standards does the government support?” Since they’re driving the train, it would be potential folly for any EMR vendor to commit to a set of standards only to risk having the government later pull the rug out from under them. It’s just smart business for EPIC to take better care of their own customers, and other vendors should do so, too; absent a set of definite standards, they would be foolish to cooperate with other vendors beyond the extent they do now.

    Epic may be the 800# gorilla, but they’ve earned the title. Suggesting that the government should “cut them down to size” is irresponsible.

  • I do not think Epic plan to support HIE. What they want is more control and dominance. Epic has stopped vendors from developing tools to allow Epic to talk with other EMR’s application. If that is the case, how can they say they support inter-operate with other EMRs?

  • Just came across this article and had to comment: there is a difference between open standards and open source. The industry isn’t asking Epic or any other proprietary software vendor to embrace open source. Every health focused company I work with is – however – moving (or moved) to open standards (i.e. HL7).

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