By Tom Still

VERONA, Wis. – There’s nothing small about Epic Systems, the Verona-based digital health records pioneer.

Certainly not its 1,048-acre campus and nearly 30 buildings, or its 12,361 total employees (11,000 in Verona alone) hailing from 50 states, the District of Columbia, Puerto Rico and 96 countries, or its 621 customers in the United States and 15 countries.

There’s nothing undersized, either, about Epic’s growing penetration rate in the evolving world of health information technology. There are 155 million people with active “MyChart” patient engagement accounts worldwide. In the United States alone, more than 40% of the population has a MyChart account.

And let no one dispute that Epic’s annual “User Group Meeting,” which got underway Tuesday in the company’s 11,400-seat Deep Space Auditorium, is anything less than made for the big screen.

With intricate graphics, carefully choreographed talks and costumed corporate leaders (founder Judy Faulkner came dressed as Amelia Earhart for this year’s “Midnight at the Museum” theme), UGM is a spectacle for customers and guests who trek from afar.

The biggest thing going on at Epic these days, however, is a renewed commitment to innovation through use of massive amounts of data to improve life for patients and providers alike. It comes at a time when post-pandemic birds of prey are coming home to roost in healthcare in the form of unprecedented red ink, mega-mergers, workforce challenges and quality concerns.

Here is another big number that may help: 5.7 billion de-identified patient encounters are recorded in the Epic universe.

“All of that data holds answers to a lot of mysteries,” Faulkner told a packed keynote session. A potentially life-saving example was announced the same morning.

A nationwide study conducted with Epic and University of Maryland researchers concluded just 5% of overdose patients in U.S. emergency rooms between 2017 and 2022 were tested for fentanyl. Testing for other opioids is 10 times more common, but fentanyl is a synthetic and 50 times more potent than morphine. In 2021, fentanyl overdoses were the leading cause of death for Americans aged 18 to 45. The study, powered by anonymous data from Epic’s Cosmos database, will likely lead to rapid changes in standard toxicology screenings across the nation.

Because Cosmos can draw on 162 million patient records (past and present) and, in the fentanyl example, 315,000 actual overdose cases, statistical reliability is high. It is the largest integrated database of clinical information in the United States and has been tapped for population studies ranging from cancer to firearm injuries, and from COVID-19 to eating disorders.

Epic is also expanding its use of such data for doctors and other providers who are working with patients with rare diseases. That helps clinicians find other needles in a digital haystack. The data is also being mined for personalized, often genomic-based treatments for more common diseases by drilling down into specific characteristics of “look-alike” patients.

Data can also make health systems and providers more efficient. Sensitive to complaints from doctors and other users who say they are tethered to their keyboards, Epic is introducing features such as “Ambient” to allow spoken dictation of outcomes from patient visits. Automated claims status updates, better check-in procedures, easier scheduling, better use of operating rooms, reduced service denials and physician “express lanes” are also up and running or in the works.

With worker shortages and burnout taking a toll, Epic customers were urged to automate routine functions that don’t require a human touch and to make best use of features that may already be available to them. Faulkner cited a free artificial intelligence tool that can help reduce the incidence of sepsis, a serious infection that sometimes starts after a medical procedure, if it is used. “Make sure you’re running the sepsis system,” she said.

“There may be other things you haven’t turned on,” she said. “If you need something, call us to check whether you already own it or if we’re developing it,” Faulkner said.

Epic has major competitors such as Oracle-Cerner, AllScripts and Meditech that are striving to make similar advances in health data; so are many emerging companies in the health IT space. However, the sheer size and diversity of the Epic database may explain why 175 healthcare systems are partnering with Epic Cosmos to improve and accelerate their research.

Experts have forecast for years that smart use of health data will reinvent medicine. Combined with the rise of genomic or “personalized” medicine, that prediction is becoming reality.

Still is president of the Wisconsin Technology Council. He can be reached at