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Applying Agile Principles to Epic System Maintenance

Updated: Nov 5, 2018



Maintaining an Epic system can be a significant drain on a healthcare organization’s resources. A typical upgrade can cost an average hospital $1M or more in total project costs. Since 2009, there have been 6 of these releases, occurring every 17 months, with the next scheduled for February of 2018. This accounts for $7M or more in cumulative maintenance cost over the 9-year period.

An alternative approach to the management of these upgrades could reduce this cost by as much as 25% while maintaining or improving the quality of the outcomes, yielding a combined savings of almost $2M.

Healthcare is undergoing drastic change. The rise of the Electronic Health Record (EHR) has had a profound impact on this transformation—improving access, quality and serving as a necessity for the transition to value-based care. Incorporating these enterprise information systems into the operations of the hospital has also given rise to perpetual and increasing amounts of spending on system maintenance at historically unseen amounts.

In our research, we analyzed the impact of one of the leading EHRs, Epic Systems Corporation (Epic), which has seen significant growth rates since its founding in 1979. Per the company’s website, “190 million patients have a current electronic record in Epic.” We analyzed the project methodology and project cost for a typical Epic customer to assess the methods used to manage the maintenance projects and to evaluate impact and opportunity (while the focus of our research was Epic, we saw similar costs and methodologies for other EHR vendors).


Our findings show that most maintenance programs fail to capture the value of the new features available in each release, that organizations are typically managing the cycles through a traditional waterfall approach with an emphasis on the go-live of the features without a realization of the benefit the feature could bring to the health systems outcomes achieved per dollar spent.

We propose that by applying an alternative management methodology to these projects, organizations could realize more business value in less time while also lowering the ongoing cost of these projects by as much as 25%.

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