scripod.com

Epic Systems (MyChart)

Acquired

2025/04/21
Acquired

Acquired

2025/04/21

Shownote

What if we told you that the most important company in US healthcare was run from a farm in rural Wisconsin? And that farm contained the world’s largest subterranean auditorium, as well as Disneyland—style replicas of Hogwarts and the Emerald City? What if we told you that the person who started, runs and owns this establishment has legally ensured that it will never be sold, never go public and never acquire another company? And that this person, Judy Faulkner, is also likely the wealthiest and most successful self-made woman in history? Welcome to the story of Epic Systems, the software company that underpins the majority of the American healthcare system today. Epic isn’t “just” an electronic medical record (the category it’s usually lumped into), or an online patient portal (which is how most of the US population interacts with it via its MyChart application). It’s more akin to a central nervous system for hospitals and health clinics. Almost everything in a hospital — from patient interactions to billing, staffing, scheduling, prescriptions and even research — happens on Epic’s platform, and over 90% of American medical schools’ graduating doctors, nurses and health administrative staff are trained on it during their educations. Tune in as we dive into the almost-unbelievable story of how this epic company came to be! Sponsors: Rippling: https://bit.ly/acquiredrippling [https://bit.ly/acquiredrippling] Statsig: https://bit.ly/acquiredstatsig25 [https://bit.ly/acquiredstatsig25] Odd Lots: https://bit.ly/acquiredoddlots [https://bit.ly/acquiredoddlots] ServiceNow: https://bit.ly/acquiredsn [https://bit.ly/acquiredsn] Links: * Save the date, July 15 in NYC! [http://acquired.fm/nyc] * Epic’s Verona campus [https://www.epic.com/visiting/] * Worldly Partners’ Multi-Decade Epic Systems Study [https://worldlypartners.com/businesshistory] * Episode sources [https://docs.google.com/document/d/1uuw2GygyesM-0nM4ZHVL95XQYhntAnXqRLiHNx8v7RU/edit?usp=sharing] Carve Outs: * Ken Block in San Francisco [https://youtu.be/LuDN2bCIyus?si=rHU8CjPAoeHck0uK] * Nintendo Switch 2 [https://www.nintendo.com/us/gaming-systems/switch-2/?srsltid=AfmBOoq-kZTYsNm0_if1ONE-8GV0k1x77Nv41aWbkSpgrqSU9zcyQAog] * Knives Out [https://www.imdb.com/title/tt8946378/] * Brat by Charli xcx [https://open.spotify.com/album/2lIZef4lzdvZkiiCzvPKj7?si=bdGrTidgRIKMMBNvjHzbWQ] * Music To Refine To: A Remix Companion to Severance by ODESZA [https://open.spotify.com/album/7bNj7hUkbRbZzn36MdyvUk?si=tL7uLI15QVasFLXuRaKkZQ] More Acquired! * Get email updates [https://www.acquired.fm/email] with hints on next episode and follow-ups from recent episodes * Join the Slack [http://acquired.fm/slack] * Subscribe to ACQ2 [https://pod.link/acquiredlp] * Merch Store [https://www.acquired.fm/store]! © Copyright 2015-2025 ACQ, LLC ‍Note: Acquired hosts and guests may hold assets discussed in this episode. This podcast is not investment advice, and is intended for informational and entertainment purposes only. You should do your own research and make your own independent decisions when considering any financial transactions.

Highlights

Epic Systems, a software giant headquartered in rural Wisconsin, plays an integral role in the U.S. healthcare system. Founded by Judy Faulkner, this privately-held company has revolutionized electronic medical records with its MyChart application and comprehensive hospital management solutions. Its unique business model emphasizes customer focus and innovation while avoiding public markets or acquisitions.
27:37
Epic uses a modern descendant of MUMPS, called Cache, as its de facto standard.
40:25
Epic started with only $70,000 in equity and $70,000 in debt.
1:04:25
MyChart was cutting-edge, allowing patients remote access to medical records.
1:24:19
Epic's team pulled an all-nighter to model Kaiser's transaction flow in Excel.
1:46:39
Epic emphasizes bug-free software due to the high stakes in healthcare.
2:09:16
Interoperability in healthcare is hindered by complex systems and business interests.
2:20:19
Data interoperability was not prioritized in legislation, favoring Epic.
2:44:02
Epic secured all top 20 academic hospitals in U.S. News rankings.
2:58:33
Cosmos provides free access to anonymized data for contributing customers.
3:27:11
Judy Faulkner's leadership is a key factor in Epic's success.
3:46:40
Epic is considered the most valuable vertical market software company globally.

Chapters

How Did a Rural Farmhouse Spawn a Healthcare Revolution?
00:00
From Teaching Herself Fortran to Building a Tech Empire
31:11
Expanding Beyond Clinical Records: The Birth of Epicare
51:47
Winning Big with Kaiser Permanente: A Turning Point
1:10:04
A Whimsical Campus Cultivates High-Trust Culture
1:32:55
Standardizing Care Through Customer-Focused Strategy
1:55:12
HITECH Act Sparks Widespread Adoption but Brings Challenges
2:11:58
Epic vs. Cerner: Competing Visions in Healthcare IT
2:34:46
Scaling Globally While Harnessing Data for Better Outcomes
2:49:39
Unpacking Epic’s Unique Business Model and Market Power
3:10:37
Can AI Transform the Future of Electronic Health Records?
3:32:50

Transcript

Ben Gilbert: The answer is somewhere in the middle. David Rosenthal: Well, you texted me last night that you've made it to Singapore. Ben Gilbert: I made it to Singapore, yes. Anytime you are researching anything in U.S. Healthcare, you know it is time t...