Epic's Grand AI Gamble: Can the EHR Giant Truly Build a Connected Healthcare Universe?

Epic announced the rollout of hundreds of new AI-infused services and tools, all designed to bring everyone into its orbit and improve the healthcare experience for consumers and providers. But what about those on the outside?

Epic has never shied away from bold declarations, and this year's UGM was no exception.

The company unveiled a sweeping vision of a healthcare universe tethered together by hundreds of AI-infused tools and services; each promising to streamline workflows, elevate patient experiences, and keep providers firmly within the Epic orbit.

But as the company leans into its role as the industry's gravitational force, the critical question looms: can Epic's vision extend beyond its own vast ecosystem?

For health systems outside its network, interoperability, openness, and true innovation remain unproven. As AI redefines the future of digital health, Epic's ambition to be both platform and gatekeeper may either accelerate transformation or wall off progress.

UGM rundown

EHR giant Epic offered its own rosy glimpse into the future Tuesday at its user's conference in Verona, Wisconsin, dazzling attendees with a vast assortment of AI solutions and tools rolling out now and in the future. Company CEO Judy Faulkner touted the hundreds of tools already available, alongside hundreds of capabilities being introduced or in the planning stages.

Among the biggest announcements was an ambient AI tool, developed in a rare partnership with Microsoft, a move that's designed to counter the hundreds of solutions already on the

market and prod health systems and hospitals who have contracted with vendors to ditch those deals and embrace Epic's product, which is already baked into the EHR.

Epic's vision for the connected health network centers on a trio of generative AI Co-pilots: Emmie, a MyChart bot designed to help patients with tasks like scheduling, navigation and education; Art, designed to help clinicians with administrative tasks, data retrieval and summarizations; and Penny, designed for revenue cycle operations.

The announcements put Epic squarely in the middle of an innovation juggernaut, but some question whether the industry can stay ahead of the technology. One lingering possibility is that the democratization of AI, and its growth in other areas, could create a marketplace that propels healthcare organizations away from traditional vendors and EHR providers to develop their own customized tools. At the far end of this concept is the idea that AI could eventually make EHRs obsolete.

A Nod to Inclusion

In any case, the theme of Epic's presentation was that membership in the Epic network will lead to continued benefits as the company rolls out more solutions and the network grows. Indeed, the biggest, splashiest part of the three-hour show – and an annual occurrence -- was the celebration of health systems and hospitals that had ditched their previous EHR platform to join Epic.

And Faulker was more than happy to talk about how her company is ahead of the curve.

"Please take notes (so that) you know what the future will bring," she said at the beginning of the morning.

Dressed in bright garb to accentuate the science fiction theme and gamely fighting through a dry throat, Faulkner did open her presentation by pointing out one thing that so many seem to be forgetting: AI isn't new.

"AI alone has been around for decades," she pointed out, adding that artificial intelligence is being replaced by the more advanced term of healthcare intelligence. "It is what a lot of software does."

She also said Epic "started working with generative AI quietly with some of the companies who were inventing it well before the world knew about it." The insinuation is that Epic, as the biggest EHR provider, has the resources and clout to make the best out of AI. The key here may be in how much leeway health systems and hospitals have to personalize those tools to fit very specific needs.

Faulkner and other Epic executives involved in the presentation repeatedly emphasized the connected ecosystem built around the EHR and Epic's Cosmos data repository. But while they built up the idea of being in that network, would this mean those outside the network are suffering by comparison? That would put the company at odds with the idea of interoperability.

Indeed, the July 30 announcement of a federal data-sharing platform supported by top AI and tech companies and a wide range of healthcare organizations is based on the idea that patients and providers will be able to access data anywhere. And Faulkner even noted that Epic is participating in what is being called the CMS Interoperability Framework. But will that mean providers outside the Epic orbit will be able to interact with those on the Epic platform?

Adding to the Network, and Tackling the Rural Care Dilemma

Epic has long been the biggest fish in the EHR pond, and it's still growing. The company has a roughly 42% share of the acute care EHR market, according to KLAS Research, and is reportedly the only company to gain clients over the past year. But companies like Oracle, which took over Cerner in 2022 and recently rolled out its own AI enhancements, Meditech, Altera (formerly Allscripts and Medhost), Trubridge (formerly CPSI), athenahealth and eClinicalWorks are still in the game. And some of them have been rolling out AI tools before Epic.

That's why Epic is also making a play for getting its products into the hands of smaller providers who aren't customers, presented as a means of helping remote and rural health systems improve their tech platforms and stave off closure. Faulkner noted that Washington is the first state in the country to embrace the Epic Community Connect platform, which extends the EHR to small and independent providers.

She offered three suggestions to improve rural access to healthcare technology, all tied to Epic:

• · Create a statewide Community Connect platform
• · Have a state host a shared instance of Epic with help from participating health systems
• · Have rural providers collaborate to share an Epic platform

Faulkner also noted that despite the hype around consumer-facing healthcare tools and the push to give consumers a bigger role in their healthcare choices, Epic is shifting the AI dynamic to put more emphasis on the provider. This is in response to the epidemic of clinician burnout and stress coming out of the pandemic, as well as the ongoing critical

nature of financial sustainability. She said providers need to ensure their own stability, emotionally and financially, so that they can treat patients.

At What Cost?

To that end, Faulkner said she recognizes that being in the Epic ecosystem can be costly, especially for smaller providers.

"We are trying to keep prices low enough so that you can get the advantages without the financial hardship," she pointed out.

She then said hospitals and health systems can reduce their expenses – by buying Epic products that address the revenue cycle and administrative efficiency.

At the end of the day, Epic is the front-runner and a formidable organization – healthcare executives have often said they wait for Epic's EHR enhancements rather than look for similar tools from other vendors because they know the products will be good. But AI is an altogether different technology, and it's growing fast. Epic will be challenged to maintain its pace in quality as well as quantity.

Finally, the healthcare industry needs to foster competition and collaboration to keep costs down and give innovation an opportunity to flourish. Will Epic's strategy get in the way of interoperability?