Epic Systems (MyChart)
Ben Gilbert and David Rosenthal profile Epic Systems—the legally un-sellable $100B+ private company that controls the majority of US hospital records and has never permanently lost a customer in 47 years.
- Epic has 607 health system customers across 3,200 hospitals and has never permanently lost one in 47 years; one customer left for 6 months then returned.
- 2024 revenue was $5.7B growing 16% YoY; hosts estimate a minimum $100B fair value if the company could be acquired, which it legally cannot.
- Judy Faulkner, 81, owns ~50% via a family foundation and has structured voting-share trusts to permanently block any sale or IPO; GE, Microsoft, and Google have all reportedly tried to acquire the company.
- Epic’s single Chronicles database underpins every module—clinical records, billing (Resolute), scheduling (Cadence)—giving reliability competitors assembled via M&A cannot match.
- US healthcare is 18% of GDP versus 11% in the UK and 6% in Singapore; third-party Medicare/Medicaid payment structure psychologically disconnects patients from costs and is cited as the primary cause.
- Cosmos aggregates anonymized data from 295M patients across 15B encounters, free to any contributing Epic customer; it was used to detect the Flint, Michigan water contamination crisis.
- MyChart launched in 2000 as the first integrated patient web portal—a full decade before most healthcare IT peers attempted consumer-facing digital records.
- Ambient AI scribing tools (Microsoft/Nuance, Abridge, Suki) integrate with Epic and are seen as the largest near-term growth catalyst, with one CIO speculating the EHR interface itself could eventually fade into an AI operating system.
2025-04-21 · Watch on YouTube
