Epic in Healthcare: Everything You Need to Know About the Leading EHR System

The modern-day healthcare landscape is rapidly shifting and evolving, making processes such as digital transformation a necessity instead of a suggestion. Healthcare providers continue to face pressure to deliver the highest possible level of patient care while also managing patient information, controlling costs, and maintaining regulatory compliance. There is one system that managed to fundamentally transform the way medical information is managed and shared, and that system is called Epic.

Good understanding of how Epic fits in a modern-day healthcare industry is paramount not only for healthcare professionals but also for administrators, IT specialists, and even someone who is just interested in the way healthcare operates nowadays. The influence of this system on healthcare delivery is very hard to overestimate considering the fact that at least 250 million patient records are housed in Epic systems all over the planet.

What Is Epic Software in Healthcare?

Epic Systems Corporation was founded by Judy Faulkner in 1979, slowly evolving from a de-facto basement startup into the dominant solution on the market of Electronic Health Record systems. It has spread extensively across the United States and is also getting slowly adopted throughout the rest of the global healthcare market. Epic provides a comprehensive, integrated platform capable of connecting practically every aspect of patient care, which makes it stand out a lot on the market filled with fragmented solutions that only address single functions or departments.

Epic is the digital backbone of healthcare operations, creating a unified patient record system that replaces paper charts and disconnected computer systems, offering access to authorized providers from practically any location imaginable. It can cover appointment scheduling, pharmacy management, clinical documentation, patient engagement tools, billing, and more.

However, the overall variety of features is not the feature variety alone, but an emphasis on forming a consistent ecosystem that simplifies information flows between departments or facilities. That way, Epic helps eliminate various information gaps that once have been a massive issue for medical care.

The most noteworthy components of Epic as a software include:

• Care Everywhere – a specialized network that simplifies the exchange of health-related information between different organizations using Epic or compatible environments.
• Cogito – the integrated analytics platform that can analyze raw clinical data and turn it into actionable insights.
• MyChart – a patient portal that makes it possible for an individual to see their medical records, request prescription refills, schedule appointments, and even communicate with service providers directly.

Epic is also great at adapting to specialized care environments using focused modules that are custom-fit for different medical specialties and service lines – pediatricians, oncologists, cardiologists, etc. The entire architectural philosophy of the solution is about a single patient-centric database that ensures a complete picture of each patient’s health status, preventing contradictory treatments and duplicate testing, along with other potential inefficiencies.

The implementation of Epic for a healthcare organization is a substantial investment that shapes their operational capabilities in years to come. Epic is complex and varied, making adoption to it an organization-wide transformation – something that has to be carefully planned and executed.

How Is Epic Used in Hospitals?

Epic often operates as the proverbial central nervous system of the medical environment, connecting separate hospital functions into a single environment. Nurses are stationed behind workstations-on-wheels to document vital signs and assessments directly at the bedside. Physicians review patient histories and diagnostics in an electronic form. There is even an entire clinical decision support tool that guides providers toward evidence-based practices without the necessity to completely replace professional judgment on the topic.

It is also a great tool in emergency settings, offering a bird’s eye view of current department status and the needs of critical patients when applicable. Automatic notifications can be triggered for appropriate specialists when certain symptoms suggest stroke, sepsis, or some other time-sensitive condition.

The behind-the-scenes side of Epic is just as varied, helping with quality measurements, regulatory reporting, capacity management, revenue cycle optimization, resource allocation, and claims processing. It also bridges communication gaps between departments that often operate in isolation, which might be its biggest advantage overall. Information can travel seamlessly along with the patient when they are moved from one segment of the medical service to another, eliminating various handoff errors from the get-go.

In teaching hospitals, Epic can offer robust security controls that keep the necessary access levels of residents and students while maintaining supervision, tracking which providers access which records to create accountability.

Epic also turned out to be a great option for situations such as the pandemic, with the telehealth capabilities greatly improving the virtual care capabilities of medical facilities. Such flexibility is a good way to show how deeply integrated Epic is in modern healthcare delivery – supporting not only existing workflows but also making it possible to incorporate completely new ways of care when there is a need for them.

Is Epic an EMR or EHR? Key Differences Explained

There are two different acronyms that are usually associated with Epic – EMR and EHR. The confusion between the two is understandable, but it is important to call Epic what it really is – an Electronic Health Record system or EHR – in order to understand the scope of its capabilities.

An Electronic Medical Record – EMR – is the digital version of a paper chart from a provider. EMR systems focus mostly on diagnosis and treatment within the same organization or practice. The best way to describe EMRs is as clinic-centered tools for tracking patient data over time, monitoring quality metrics, and identifying patients due for preventive screenings.

An Electronic Health Record – EHR – encompasses the entire health situation of a patient, generating records meant for different organizations outside of the one that collects the information to begin with. EHRs are designed with interoperability as the primary principle – sharing information with clinics, emergency facilities, pharmacies, other healthcare providers, and even the patients themselves.

That is exactly how Epic operates. There are multiple capabilities that elevate it from EMR to EHR status:

• Information accessible to all providers that are involved in the care of a patient.
• Standardized data exchange protocols to facilitate improved coordination.
• Data that can move with the patient across different healthcare settings and environments.
• Patient participation capabilities using portals such as the aforementioned MyChart.

The EHR philosophy is further exemplified by another system we mentioned earlier – Care Everywhere, which enables clinicians to view records from other organizations that use Epic to increase their participation in health information exchanges. This way, patients with complex conditions that require multiple specialists or someone who falls ill while traveling far from their regular healthcare providers can still get the best out of the shared medical environment no matter where they are.

Even though the terms EMR and EHR are somewhat blurred in casual usage, Epic’s classification as an EHR is important, reflecting its comprehensive approach to managing health information in the context of long-term health story instead of isolated medical encounters.

How Does Epic EMR Work?

As we mentioned before, Epic is an EHR at its foundation. However, that also means that it can operate as an EMR to a certain degree, providing its own core clinical documentation approach. Better understanding of such basic capabilities of the solution can help explain why Epic is considered so revolutionary in the healthcare department.

Epic can capture patient information using free text fields, structured forms, and template-based notes that can be customized for specific workflow preferences. It does not force clinicians into rigid documentation patterns, making it possible to introduce a certain degree of personalization while retaining the structure and organization of information within the same facility.

Behind the scenes, Epic uses a single database model that stores all the patient data in the same comprehensive repository instead of segregating it into multiple silos. Such unified approach means that a single action can automatically trigger multiple subsequent processes, greatly improving patient’s user experience. For example, when a physician orders a medication for the patient, the following actions can occur almost immediately:

• The pharmacy module receives the order.
• The billing system captures the charge.
• The medical history of a patient gets updated in accordance with the new changes.

The modular design of Epic’s environment is a big reason why it is so versatile. Individual departments can activate only specific components of Epic instead of activating the entire platform at once, personalizing the experience and introducing less overhead at the same time.

All of the modules Epic has also operate seamlessly with each other, removing the necessity to navigate between them as separate systems. Such integration creates a convenient experience where information can be entered once and then it is propagated everywhere it is necessary in the future, reducing the burden of documentation while also improving accuracy. These modules that Epic operates with are also going to be the next focus in this article.

Essential Epic EHR Modules You Should Know

As a comprehensive platform, Epic is a combination of many different modules that are all specialized to work toward a specific goal in the healthcare delivery sphere. A complete installation of the platform can include dozens of components, but it is not necessary whatsoever thanks to Epic’s modular approach, as we mentioned before. As such, we would like to only go over a few core modules that form the backbone of most Epic implementations:

1. Epic Hyperspace is the main clinical interface that can review records, document encounters, and place orders. It operates as a central hub for navigating the system, customizing templates, and creating shortcuts for individual practice patterns. It uses a dashboard-style layout with relevant information at a glance, simplifying navigation.
2. MyChart is a module that transforms patient engagement via creating a secure digital gateway between healthcare providers and their patients. It not only allows access to basic health records of each patient but also allows for secure messaging, telehealth visits, appointment scheduling, questionnaire completion, and even bill payment. It was instrumental during the COVID-19 pandemic for testing and vaccination campaigns across the entirety of the United States.
3. Epic Inpatient is a hospital-oriented module that manages bed assignments, nursing documentation, admission workflows, medication administration, and discharge planning. It uses an interdisciplinary approach to ensure that all nurses, pharmacists, physicians, and case managers would have the same kind of view on each patient’s needs and progress.
4. The revenue cycle suite of Epic consists of Cadence for scheduling, Prelude for registration, and Resolute for billing. It all streamlines administrative processes from creating an appointment down to posting a payment. The philosophy of integration that Epic uses is represented in these modules, with clinical information being able to generate appropriate billing codes automatically while being able to reduce claim rejections and improve financial performance.
5. Healthy Planet is supposed to be the tool for population health management, helping organizations identify and address healthcare gaps across patient populations. It uses standardized protocols for chronic disease management and tracks various quality metrics necessary for value-based payment models. The point of this module is to shift focus from reactive care to proactive health maintenance.
6. Epic Research has a self-explanatory goal of assisting healthcare organizations that participate in various research efforts. It facilitates clinical trial recruitment, data collection, and the ability to integrate with institutional review board workflows.

As we have mentioned before, these are just a few examples of Epic modules that are integral for most use cases. In the following sections we are also going to cover a few other modules that are relevant because of their context.

Epic Chronicles: What It Is and How It Works

The architectural core of Epic as a platform is Chronicles – the proprietary database technology that operates on the entire platform. It uses a unique object-oriented approach designed specifically to handle the complex and interconnected nature of healthcare data. Such a completely different approach to information management helps Epic maintain a single comprehensive record about each patient instead of a multitude of fragmented information elements across systems or tables.

Chronicles uses a hierarchical structure for data storage, with each patient’s record functioning as a cohesive narrative of sorts. It is eerily similar to the way clinicians think about their patients – as an individual with ongoing health status on different fronts. Each time a provider enters information, Chronicles can intelligently link it with relevant medications, historical data, diagnoses, care plans, and so on. That way, a complex relationship between information elements is created, improving clinical decision-making and reducing the number of duplicates in documentation.

This database is also the reason for Epic’s impressive scalability, with support for both small clinics and massive health networks, with everything in-between. The architecture can handle transactional processing and analytical queries at the same time with no performance degradation – which is, in itself, a technical marvel and the reason for Epic’s popularity.

How Epic Connects to Clarity for Data Insights

Where Chronicles supports day-to-day operations of Epic, another module called Clarity is responsible for providing powerful analytical capabilities to drive strategic decision-making and various improvement initiatives. It can transform raw clinical data into actionable insights, operating as a separate but synchronized environment that receives regular data extracts from Chronicles using an automated process that usually runs outside of peak load hours.

Clarity employs a relational database architecture that is optimized for complex queries and report generation from the get-go, which makes it different from Chronicles in this regard. Healthcare analysts can access Clarity using one of many familiar tools, such as Tableau, Crystal Reports, or SQL in order to investigate quality metrics, financial performance, operational efficiency, and general population health trends. Such accessibility made it possible for numerous communities to appear where companies are free to share benchmark performances and reporting strategies.

The ecosystem of Clarity extends beyond the database to also include Caboodle – a data warehouse environment that reshapes information for enterprise analytics. There’s also SlicerDicer – a self-service tool that helps civilians explore patterns in patient populations. All these components are the way Epic responds to the ever-growing appetite for data-driven insights, and they have proven themselves extremely valuable for many businesses, showcasing another aspect of the industry’s evolution to value-based care models with complex measurement and monitoring environments.

Is Epic Software Difficult to Learn?

The fact that Epic as a whole has a substantial learning curve is a known fact for most of the professionals in the field. Initial encounters with the solution are often described as overwhelming and confusing due to an abundance of customization options and functions. This depth makes Epic powerful, but it also creates extensive complexity that often necessitates the creation of multi-week training programs before an average user can be granted system access with some degree of competence.

Of course, the actual curve is also going to vary depending on the role and specialty of the individual. It is not uncommon for physicians to receive 8-16 hours of training in total, while nurses and advanced practice providers might have to go through 20 or more hours of custom-tailored instructions for their specific workflows.

Luckily, the entire system becomes a lot more intuitive once the underlying logic of the platform is sufficiently grasped. The active use of the at-the-elbow support model when experienced users can guide colleagues using real-world scenarios have also contributed greatly in terms of accelerating the learning experience. Yet, organizations still have to maintain robust ongoing education programs in order to receive better utilization of Epic’s capabilities and higher satisfaction rates across the board.

Why Backup Matters in Epic EHR Systems

The world of healthcare delivery is considered high-stakes due to its handling of sensitive patient information. Systems like Epic hold the digital lifeblood of medical operations with medication lists, treatment plans, patient histories, billing records, and other information that has to remain accessible 24/7 with virtually no downtime. A single hour of downtime has the potential to affect thousands of patients at once while compromising clinical decision-making and costing businesses millions in recovery expenses and lost revenue.

Additionally, there is also the topic of legal and regulatory implications under HIPAA, which mandates comprehensive security measures for electronic Protected Health Information, as well as rigorous business continuity protocols and substantial consequences for businesses that do not adhere to these regulations (reputational damages, regulatory fines, and even the possibility of legal action). Since Epic is often the only repository for critical patient data that does not rely on paper whatsoever – robust backup strategies become completely mandatory to maintain information safety.

How Epic Handles Data Backup and Recovery

Epic’s approach to data protection is a comprehensive framework – a combination of native functionality and third-party integration options. It starts off with a clear understanding that no single backup strategy can be sufficient enough to secure mission-critical clinical environments.

At the database level, Epic uses Chronicles’ redundancy capabilities such as continuous replication, transaction logging, and mirroring in order to form the baseline of further measures. A lot of organizations use at least three data copies – production, “hot”, and archival. The purpose of the “hot” copy is supposed to be on standby for immediate failover.

Outside of the database protection measures, Epic also provides orchestrated recovery procedures for DR purposes that cover application servers, interface engines, and ancillary systems. The company recommends using geographically dispersed data centers with automated failover pathways that ensure continuity even during regional disasters. The Business Continuity Access that Epic offers can be used as a fallback method for accessing critical patient data during a network outage by accessing the recent snapshot of essential clinical data on local workstations.

Epic also recognizes that technology alone is not a guarantee for successful recovery, which is why there is a substantial emphasis on organizational readiness via mandatory disaster recovery testing protocols. Client organizations should demonstrate their ability to restore operations after various failure scenarios, conducting quarterly simulated outages that verify staff preparedness alongside technical process validity. Such rigorous exercise is necessary to reveal dependencies and vulnerabilities that can be improved upon before an actual emergency, boosting the effectiveness of future disaster recovery efforts.

Top Backup and Disaster Recovery Tools for Epic

As mentioned before, Epic’s native resilience is strong, but not nearly powerful enough to counter any potential disaster. As such, the usage of specialized third-party solutions to improve data protection capabilities is much more common than what one might expect.

Commvault Cloud

Commvault Cloud provides a comprehensive approach to Epic data protection, with its app-aware backups and scalable infrastructure that can support an organization of any size. It is easily integratable with different cloud storage providers for cost-effective tiered backup configurations, and there are also a number of Epic-specific features – like specialized deduplication algorithms, automated validation processes, and so on.

Customer ratings (at the time of writing):

• Capterra – 4.6/5 points based on 47 customer reviews
• TrustRadius – 7.6/10 points based on 227 customer reviews
• G2 – 4.4/5 points based on 160 customer reviews
• PeerSpot – 4.3/5 points based on 108 customer reviews
• Gartner – 4.5/5 points based on 570 customer reviews

Advantages:

• Extensive feature set with a strong emphasis on collaboration and information exchange.
• Support for many infrastructure types and storage variations, including Epic’s unconventional database structure.
• Backup configuration sequences with sufficient flexibility and user-friendliness.

Shortcomings:

• User interface cannot be considered user-friendly, even experienced users have difficulties navigating the software’s feature range.
• Logging and reporting capabilities are very standardized and not particularly complex.
• The first-time configuration process can prove itself extremely challenging depending on a variety of factors.

Pricing information (at the time of writing): 

• No official public pricing information can be found on Commvault’s website.

A personal opinion of the author:

Commvault is a good example of a versatile solution that supports many different storage types or infrastructure variations. It is fast, flexible, and can work in almost any environment imaginable. Such versatility does come at the cost of a high degree of complexity, and neither logging nor reporting in the solution are particularly impressive, either. It is a good option for Epic environments with multiple specialized features and support for tiered backups with many cloud storage environments, but it would definitely take some time to set up and configure before becoming truly effective.

Bacula Enterprise

Bacula Enterprise presents a compelling alternative for healthcare organizations who seek open-source flexibility in combination with enterprise-grade reliability. Built on a modular architecture, Bacula provides exceptional customization options that allow IT teams to customize backup strategies to the unique requirements of their Epic infrastructure. The platform’s catalog-driven approach enables granular control over backup operations across diverse infrastructure types, from traditional on-premises data centers to hybrid cloud environments. Originally developed as an open-source project, Bacula Enterprise is a combination of community-driven innovation with commercial-grade support, with features designed specifically for mission-critical healthcare applications.

Customer ratings (at the time of writing):

• TrustRadius – 9.5/10 points based on 63 customer reviews
• G2 – 4.7/5 points based on 56 customer reviews
• PeerSpot – 4.4/5 points based on 10 customer reviews
• Gartner – 4.7/5 points based on 5 customer reviews

Advantages:

• Advanced deduplication and compression capabilities that optimize storage utilization and reduce infrastructure costs
• Native support for tape libraries, appealing to organizations maintaining archival strategies for long-term retention requirements
• Exceptional flexibility for complex Epic deployments spanning multiple data centers or cloud environments
• Fine-grained control over backup schedules, retention policies, and recovery procedures

Shortcomings:

• Requires more technical expertise to configure and maintain compared to turnkey commercial solutions, potentially increasing the burden on already-stretched IT teams
• Smaller ecosystem of third-party integrations compared to market-leading competitors

Pricing information (at the time of writing): 

• Contacting Bacula directly and requesting a quote is the only way of acquiring official pricing information, since it is not available on the official website publicly.
• There are six main subscription tiers to choose from:
  • Standard
  • Bronze
  • Silver
  • Gold
  • Platinum
• One consistent parameter that changes from one subscription tier to another is the number of agents the solution can work with (up to 5,000 for Platinum). The expected customer support response time varies a lot using the same logic.

A personal opinion of the author:

For healthcare organizations with strong internal IT capabilities and a commitment to avoiding vendor lock-in, Bacula represents an excellent choice that delivers enterprise-grade protection without the recurring licensing costs that can balloon over time. However, smaller facilities or those lacking dedicated backup expertise may find the implementation and ongoing management requirements overwhelming, making more user-friendly alternatives worth the premium pricing.

Rubrik

Rubrik can deliver impressive performance via its innovative approach to backup architecture. It uses continuous data replication processes to allow for granular point-in-time recovery and minimal data loss. It can provide a simplified management interface to reduce operational overhead, and its immutable backup capabilities are particularly valued among healthcare organizations that already use Epic due to the ability to create tamper-proof snapshots that are secure against practically any ransomware attack.

Customer ratings (at the time of writing):

• Capterra – 4.8/5 points based on 74 customer reviews
• TrustRadius – 7.8/10 points based on 234 customer reviews
• G2 – 4.6/5 points based on 94 customer reviews
• PeerSpot – 4.6/5 points based on 89 customer reviews
• Gartner – 4.7/5 points based on 763 customer reviews

Advantages:

• Flexible and user-friendly administrative interface.
• Substantial number of automation-related features with plenty of customization.
• Extensive integration with cloud storage, contributing to the support of multi-cloud infrastructures and hybrid storage frameworks.

Shortcomings:

• Rigid capabilities in very specific circumstances.
• Challenging and time-consuming initial configuration.
• Limited options when it comes to official documentation or any other sources that can offer information about the capabilities of each software.

Pricing information (at the time of writing): 

• Rubrik does not offer much in terms of its licensing model or pricing information on the official website. What it does offer is a suggestion to request a personalized quote that would also include custom-tailored pricing points for each client.

A personal opinion of the author:

Rubrik uses a very unconventional approach to backup processes due to its reliance on continuous replication capabilities for most of the tasks. It is fast and effective, and the existing feature range makes it a valid option in many circumstances, including Epic environments. With that being said, Rubrik is not an easy solution to set up in most cases, and finding specific information about its feature set can prove very challenging due to limitations in official documentation available to end users.

Veeam

Veeam is another curious option – often cited as one of the most popular backup solutions on the entire backup and recovery market. It gained significant traction in Epic environments due to its combination of performance, reliability, and cost-effectiveness. The SureBackup technology can test recovery processes in isolated instances automatically, while the overall feature set is great at performing orchestrated recovery to restore interdependent Epic components in the correct order with barely any human intervention.

Customer ratings (at the time of writing):

• Capterra – 4.8/5 points based on 75 customer reviews
• TrustRadius – 8.9/10 points based on 1,605 customer reviews
• G2 – 4.6/5 points based on 636 customer reviews
• PeerSpot – 4.3/5 points based on 422 customer reviews
• Gartner – 4.6/5 points based on 1,787 customer reviews

Advantages:

• Proven and tested reputation of the solution with years of positive reviews from all kinds of customers.
• The first-time configuration process is mostly user-friendly and not particularly complex.
• A lot of the basic capabilities of the platform can be acquired for free with strict limitations in terms of the number of projects supported – Veeam’s contribution to supporting small businesses.

Shortcomings:

• Interface navigation is a long-running problem of Veeam that even experienced users tend to struggle with.
• Substantial time and resource contributions are necessary to learn every feature Veeam can offer.
• The pricing of the solution was originally created for larger businesses, making Veeam less than accessible for SMBs.

Pricing information (at the time of writing): 

• The only licensing information available on Veeam’s public website is its pricing calculator page that helps users create a custom form to send to Veeam in order to receive a personalized quote.

A personal opinion of the author:

Veeam is a great solution for a variety of purposes, not just Epic-related backup or recovery tasks. It is a long-running backup solution with a substantial focus on virtualization that has been offering many features in a convenient package for years now. It can be compatible with many different environments when necessary, but its licensing model does suffer from being primarily enterprise-oriented, and the overall interface navigation can be a challenge. Of course, it also supports Epic backups, providing reliable and efficient backup and recovery processes with a significant degree of automation.

There are not that many options to choose from when it comes to third-party Epic backup software, but each option has something unique it can bring to the table. As such, the priority should be to understand what your organization needs from a backup solution before deciding which one is the best option.

Ensuring Compliance: Backup Strategies for HIPAA and Security

The Security Rule of HIPAA establishes specific requirements for securing something called electronic Protected Health Information, with an emphasis on contingency planning. These requirements directly affect Epic implementations, since they now have to implement policies and procedures for data backup, disaster recovery, and emergency operations that can work with administrative protocols and technical safeguards at the same time.

A lot of Epic-using organizations document comprehensive backup architectures as part of their formal security management sequence, with detailed retention periods, access controls, testing frequencies, and so on.

Outside of regulatory mandates, proper backup implementation would also have to address the known triad of confidentiality, integrity, and availability that is at the root of any modern security framework. Organizations would have to use encryption for both at-rest and mid-transit information, along with strict access controls for backup management and immutable audit logs in order to protect sensitive patient information in a sufficient manner.

Epic also has its own certification requirements that intersect with compliance considerations. Specific data protection measures have to be implemented as a condition for ongoing support, including minimum RPOs and RTOs, as well as regular technical assessments to evaluate backup structure.

It is not uncommon for these requirements to dramatically exceed the baseline of HIPAA expectations. However, they also serve as the foundation for simplified regulatory compliance in the future, improving operational resilience of the client in the process. Such an alignment between vendor requirements and regulatory frameworks is a demonstration of how thoroughly data protection considerations are already integrated into the core system architecture of Epic itself.

Frequently Asked Questions

Why do so many hospitals and healthcare systems choose Epic over other EHRs?

Epic’s comprehensive integration capabilities across all aspects of patient care and administration are the primary reason for its popularity. Fragmentation has been a very prominent issue on the market before Epic and its Care Everywhere module were introduced with seamless information exchange between any healthcare entities, creating a network of coordinated care that benefits both patients and service providers.

What are the biggest challenges healthcare providers face when implementing Epic?

The primary implementation challenge for Epic has always been organizational change, including resistance to workflow adjustments and notable productivity decreases during the transition periods. Substantial upfront investments are also a pain point for many clients, making it more difficult to convince businesses of the effectiveness of the purchase in the long run.

How does Epic ensure patient data security and HIPAA compliance?

Epic uses layered security measures in its design, including comprehensive audit logging, advanced encryption, role-based access controls, and more. The authentication framework of the environment supports SSO, access monitoring, and multifactor authentication to look for unusual patterns in user behavior. Epic even has a dedicated compliance team that regularly updates existing security features in response to the evolution of threats and regulatory changes, along with offering implementation guidance for maintaining alignment with current standards.