I think we are familiar with the HUGE institutions that have selected Epic. The most famous of these is the Kaiser implementation of Epic which started at $1.2 Billion and was projected to cost $4 Billion. Yes, that is Billion with a capital B for an EHR implementation. I haven’t done any in depth research on the average cost of an Epic installation, but I can’t remember seeing one lower than a few hundred million at the least.

As I consider these numbers, the following question keeps nagging at me: What’s the ROI for an Epic installation?

Don’t get me wrong. I already know about the many EMR benefits. Although, billions or even hundreds of millions of dollars is a lot of money to make up.

The problem is that covering the EMR space as long as I have, I have yet to see someone do a ROI analysis of an Epic installation. If there’s one out there that I don’t know about, I’d love to take a look. Maybe Epic has some, but it’s part of their tightly controlled process for selling their EHR. Although, if the ROI was so good, it makes you wonder why they wouldn’t want that information in the public domain.

A part of me wonders if hospital CIO’s really care about the ROI of an Epic EHR install. Epic seems to be similar to what enterprises use to say about IBM: “Nobody ever gets fired for buying IBM.” Do many hospital CIOs see it as “Nobody ever gets fired that buys Epic”?

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • 1. Small hospitals for any EHR do not seem to do a BCase or ROI at all so would not know.
    2. If they did they would see it was negative as so many of the “Big” names are over priced with business boom distorted by incentives

  • John,

    I’ve been wondering when someone would reuse the famous IBM quote in regards to EPIC. That does seem to be the feeling out there. Yet there is an irony; no one I’ve read of or talked to actually likes EPIC. Though there seems to be a myriad of reasons behind that. Some relate to attitudes they experience from the firm, though some are related to the traditional problem of a botched in some way implementation.

    I had a conversation today with a doctor I know fairly well; her practice is attached to a big, famous hospital that started going to EPIC several years ago, and rolled out EPIC Ambulatory about 2 years ago (though oddly I never saw it in use until today even though I was there several months ago). I asked her what she thought of it; ‘I hate it’. I pushed a bit with specific questions and got this; 1. When entering information for a patient during an exam, you are constantly having to switch pages / screens. Nothing was done to match it to the actual workflow. 2. Training was inadequate. 3. It is easy to ePrescribe meds at a pharmacy that does not have the medication in stock or is even able to get it. 4. When you do have to print prescriptions, lots and lots of paper (special RX paper) is wasted.

    None of this is really specific to EPIC; to me it is an issue with the implementation, which BTW, the hospital is extremely proud of, so much so that it has numerous web pages on it.

    Even more disturbing; on the way out the door with the patient, we inquired about a patient portal. We were given the ‘paperwork’ to connect, but we were told it didn’t do very much and ONLY 4 OTHER PATIENTS had asked about it in 2 years. I’ve no clue who to blame here; perhaps EPIC for not putting enough into the portal (but probably meeting MU requirements), the hospital / group for not pushing it, etc.

    This practice has very good doctors, but like most they are extremely busy, and among other issues, only get back to patients on test results if they are ‘bad’. Hmm – the portal could really help them here!

    BTW, one suspects that the ROI on this implementation is not all that great!

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