“Everybody is scared to talk about Epic, because Judy can kill your company.” An established health tech CEO who does business with Epic and mutual hospital customers.
If you’ve ever visited Epic Systems’ sprawling, 1,100-acre campus in Verona, Wis., you may have been surprised by how rural its surroundings are, maybe even chuckling at the stark contrast between the pace of life happening inside the organization versus out.
The peaceful, bucolic farmlands would’ve likely stolen your gaze on the drive in, with one reporter describing “a meandering road through countryside, dotted with Queen Anne’s lace and farm equipment” when speaking of a 2018 Epic visit.
Yes, you’ll have seen plenty of scenes that evoke calm and serenity as those country roads take you to Epic’s home.
What you probably wouldn’t have seen upon your approach to Epic’s headquarters — or anywhere within a 50-mile radius of the organization, for that matter — are billboards, or any other form of advertising for any other healthcare technology company besides Epic. This is because, like affluent homeowners in the Hollywood Hills who buy “air rights” to ensure there is no obstruction of views, Epic utilizes its dominant market position to contractually limit any marketing or advertising from any organization who has any form of relationship with Epic (or its customers, effectively).
Epic has created a complex web of contractual constraints that prevent employees, customers, … [+]
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Yes, seriously.
But local advertising exclusivity is just one, tiny aspect of how Epic diligently promotes and protects its position, both as the tech giant in the greater Madison area and the leading electronic health record (EHR) system nationwide.
In follow up to the first article in this series — Epic’s Antitrust Paradox: Who Should Control The Levers Of Healthcare Innovation? — part two below digs into seven aspects of Epic’s behavior that should raise antitrust eyebrows.
Taken together, these seven seemingly anticompetitive sins beg the question: Is Epic just being shrewdly competitive, or outright exclusionary, in the way in which it obtains and maintains its EHR market dominance, especially among large hospitals, health systems and academic medical centers (AMCs)? And, if the latter, what should happen next?
Seven Levers Preserving Epic’s Dominant Position
When does competition cross over to an unfair monopolistic advantage? For Epic, there are seven areas worth the public’s consideration and exploration, including policymakers, EHR customers and users (including institutions, clinicians, third-party vendors and patients), and the healthcare innovation community writ large.
1. Artificially Increasing Third-Party Developer Costs
Until recently, Epic allowed its customers to provision limited access to contracted third party developers. The third-party and its employees would be required to sign non-disclosure agreements (NDAs), non-compete agreements. Each third party employee was limited to only work on a single customer’s Epic instance. As one CEO who has many mutual customers with Epic explained, “This limited how effective my staff could be. It meant I had to hire a new employee for each customer using Epic, which is costly.”