podcasters Ben Gilbert and David Rosenthal That's
Epic!

September 10, 2025 -- Love it or hate it... Few lack strong opinions.

For us nurses, it's the air we breathe. Our shifts start and end with it, and we must use it frequently in between. We put up with it, of course. Many complain.

Some of us do something about it. I built NurseAssess to better fit EHRs into our workflows. I connected it to Epic. Now nurses can enter their patient assessments on the fly, using devices they carry in their pockets. It's a breakthrough! But I digress.

Here in the Bay Area where I'm based, every hospital I've worked at in recent years (the Sutter and Kaiser networks, the VA, and the independents, too) runs on Epic or intends to. They spend years planning for "go-live" day. At UCSF, for example, go-live had a multi-million dollar budget and was executed like a military operation, with a command center and roving field operatives. Over the last two decades we have gone from almost no US hospitals having them to all of them having them.

Perhaps the best overview of Epic the company (based in Verona, WI, to which I have made a pilgrimage) is by Acquired, one of my favorite podcasts. Their motto: "Every company has a story." Here is Epic's.

One of many fascinating observations by its hosts, Ben Gilbert and David Rosenthal:

Ben: You know who else doesn't love [Epic]? In 2017, Obama himself told [journalists] that he felt that the HITECH legislation did not live up to what he wanted. Here's his quote: "The fact that there are still just mountains of paperwork, and the doctors still have to input stuff, and the nurses are spending all their time on this administrative work, we put a big slug of money into trying to encourage everyone to digitize, to catch up with the rest of the world, and that's been harder than we expected."

Indeed! HITECH and Obamacare were in many ways enlightened legislation but it was uncharted territory, impossible to predict. Here are some afterthoughts.

Looking at the dark side is this excellent article by Robert Kuttner in The American Prospect, An Epic Dystopia:

...In practice, clinical needs are often sacrificed to profit maximization. The demands by Epic's system on physician time have increasingly taken over the practice of medicine. Astonishingly, studies show that entering required data into the Epic system consumes about two hours of doctor time for every one hour spent providing hands-on patient care. The result has been an epidemic of doctor burnout and early retirements.

In other words, doctors feel about it the same as nurses do. Is it Epic's fault?

Let's remember that the push toward EHRs is driven largely by charge capture (financial survival) and regulation (legal survival). Quality of care is almost a by-product. Epic nimbly met these mandates; it didn't create them.

Judy Faulkner, Epic's CEO, was in the right place at the right time and executed brilliant strategies. The company she's built is extraordinary. (Hey, she's not the only one. I wrote the code and built a real, working EHR as my graduate school thesis ten years before Ms. Faulkner did... timing is everything... but I digress...)

So what's the verdict? Listen to the podcast and read the article and decide for yourself.

Go cyber-equipped hospitals! Go tech-savvy nurses and doctors!