Judy Faulkner's 25-to-50-year plan for Epic

Epic founder and CEO Judy Faulkner said the company is always looking decades ahead, whether that's expanding its headquarters, staff, or technology offerings to health systems.

"We try to make our decisions for 25 to 50 years in the future," Ms. Faulkner said at her executive address at Epic's Users Group Meeting in Verona, Wis.

On screen, she showed a picture of Epic's first headquarters, a basement of an apartment home in Madison, Wis., where the first of these meetings was held with a handful of people. She spoke Aug. 20 before an auditorium packed with 12,000 spectators. Outside, cranes rose above the Wisconsin fields where the EHR vendor continues to grow.

About 44,000 people attended the 45th annual Users Group Meeting, many of them virtually but an estimated 7,000 in person in Verona, joined by the roughly 12,500 Epic employees who work there. Attendees represented states across the U.S. as well as 16 other countries. The company now has similar meetings in Europe, the Middle East and (coming soon) Asia-Pacific.

Epic just had its biggest go-live ever, outside the U.S. no less, when 45,000 employees at London-based Guy's and St Thomas' NHS Foundation Trust started using Epic. The top previous go-lives were 34,000 people at Livonia, Mich.-based Trinity Health and 30,000 users at Atlanta-based Emory Healthcare. "Coming up are some even bigger ones," Ms. Faulkner said.

On the tech side, Epic continues to pivot to generative AI, she said.

AI generates over 1 million MyChart draft messages a month, a tool being used by over 150 health systems and medical offices, she said. AI charting is live in Epic at over 180 organizations. The EHR vendor has more than 100 generative AI projects, in various stages of release or development.

In the past year, 78 million clinicians changed an order for a medication based on an advisory in Epic, Ms. Faulkner said. "I think we probably saved a number of lives because of this," she said.

In Epic's Health Grid, more than half of its health system users are now connected directly to one or more payers, furthering the company's goals of automating prior authorizations and reducing denials, she said.

Epic's Aura precision medicine platform is tied in with specialty diagnostic labs to bring genomics and EHR data together and has expanded to medical devices, starting with wearable heart monitors and continuous glucose monitoring coming next.

Epic also just added, for the hospital setting, AI monitoring for cameras to help detect patients' fall risk and in-room experience hardware including smart TVs equipped with MyChart.

Ms. Faulkner asked the audience if they play New York Times games such as Wordle and Spelling Bee. "That's what we're trying to do for our software," she said. "Figure out how to turn them into a game, to make them more fun, to learn."

"You ain't seen nothing yet," she said, adding: "Now I'm the grammar person at Epic, and every staff meeting includes a grammar section, and that sentence was hard for me."

Later at the event, an Epic software engineer showed off an AI voice bot in development for MyChart — like Alexa or Siri for healthcare — that advised him on his recovery from a fictional wrist injury after he uploaded a live picture of his arm and answered and asked other questions including when he could play pickleball again.

Ms. Faulkner encouraged healthcare providers to share their computer screens with patients so they can both see them. "Otherwise the provider's back is to the patient, and it feels like the computer is getting all the attention," she said. "This isn't a software problem, folks."

She also recommended health systems preserve the MyChart name when they adopt the platform, as many patients look for MyChart when they move to a new city.

At its sprawling hub in Verona, with buildings themed after various fairy tales and sci-fi stories, an early forward-looking decision was to construct parking underground, which meant more space for future offices, Ms. Faulkner said. Ongoing construction includes the Creatures and Guilds buildings, and an entire new campus. "We will create our own worlds," she said.

But also more productivity, she said, as Epic staffers creating complex software applications thrive working in places that are quiet and where they won't be interrupted. "That's why we believe individual offices are so important, and we're building more buildings to allow our staff to have individual offices," she said. "We've been doing this since the company started, and so we can get things out to you as quickly as possible and done as well as possible." 

Still, despite all the construction, Epic spends the vast majority of its money on people, 82% compared to 8% for buildings and 10% for everything else, Ms. Faulkner said. In the past year, Epic hired just over 2,000 new employees (out of about 370,000 applicants), she said.

During her hour-plus talk, Ms. Faulkner dispensed advice, ranging from the technical to societal to personal.

"If I can leave you with a few things," she said in closing, "one, make decisions thinking 25 to 50 years ahead. Two, help grow the brains of infants by talking to children, reading to children, singing to children. Share this with your patients."

The theme of the Users Group Meeting was Storytime, and Ms. Faulkner was dressed as Lady Swan, her version of Mother Goose.

"Three, know what you bought and use it fully," she said. "Four, take advantage of Level Up," an Epic program where experts share software advice free of charge.

"And here's a new one: Think of GLAD. I do this many nights as I'm falling asleep, and it helps me fall asleep in a good frame of mind": What am I Grateful for? What did I Learn? What did I Accomplish? And what Delighted me? she said.

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