Today in Health IT, we're going to do a fresh eyes project on Epic UGM. I'm going to explain what that is in just a minute, but before that, my name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, a set of podcast channels and events dedicated to keeping health IT staff current and engaged.

All right. Here's what I'm going to do. I'm going to put on studio sound. To this recording to take out some of the background noise. So, even though it was recorded in the car, it's going to sound like it was recorded in the studio. This is the magic of AI back to the show.

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All right, here's what we're going to do.

We're going to do a fresh eyes project for Epic UGM, and there is a resource that is diminishing. Every day a staff member is with your organization, and it is an outsider's perspective. From the first day you start orientation, you start bringing them up to speed. The lens with which they look at your company becomes, , more and more tainted by an insider's view.

It starts to go from an outsider's view to an insider's view, and there is value in an outsider's view. And so what you're gonna get from me today is an outsider's view of epic u g m and Epic in general because there's some of that stuff that I will cover because I don't have a completely outsider's view.

I've been in this industry for a while now. I've covered things. I've sat down and had. Lunches and breakfasts with Judy , big staff members. I've interviewed Seth Hain a couple of times. I'm not a complete newbie to the world, but to the extent that, , I can, I'm gonna give you, outsider's perspective.

Because this was my first UGM, and invariably what happened is I would meet with CIOs throughout the week, and I would tell them it's my first UGM, and they would ask me this question. What's your perspective? What do you see? What do you think? And so that's somewhat what you're going to hear, in this today.

I'm going to start before UGM to give you some, , some background of my perspective. What Epic has been able to do in this industry is pretty amazing. , I think it starts with meaningful use, really accelerated their growth. They were a plucky startup, let's call it back then, with, , a couple buildings on that campus, which is now pretty significant, pretty massive.

But, , then, back early on in the Meaningful Use days, what they had was a competitive advantage. And that competitive advantage was that they had an integrated ambulatory and acute EHR. I believe culture is the reason they had that. And I'm going to keep coming back to culture because that was my main takeaway from this.

Let me give you a little background on what I was able to do. One is, I was able to get a tour of the campus from somebody who was a project manager and a BFF, and we'll cover what a BFF is in a minute, because I think EPIC has their own language, and I think that's part of the culture, and it's pretty interesting.

I got to spend some time with HR, and that was also very interesting, and I had an opportunity to find out. What kind of people are successful at Epic and what makes them successful. And I spent some time with marketing and some of the other people at Epic. During my time I was able to have conversations with them while I was there.

And plus, I was able to talk to some of the CIOs as well. So that, was my UGM. Let me go back to why I think they were successful. Because . If you go back to that early times and meaningful use, it's not like there are companies that didn't have good software and good leadership teams and those kind of things.

But I think the culture that's been created at Epic is really distinct and really powerful. And let me start with, one of the stories that I think indicates an ethos that allows Epic to thrive. And that is... You go back about 16 years. It was not uncommon to see headlines in the newspaper about failed EHR implementations and leadership teams being escorted to the door

you wouldn't be able to generate bills, you wouldn't be able to see patients, you'd have to close your doors. They were bad stories of implementations. And in comes Epic, and Epic's approach is very prescriptive. And their prescriptive approach is, hey, if you're going to buy our software, this is what it takes to be successful.

And they will spell it out. Not only be successful in implementation, but be successful long term. And you will agree to these things. Keep in mind, they were a startup at one point. And they would sit across from these billion dollar organizations and they would say, If you want our software, you have to agree to these things.

And if you don't agree to these things, we're going to walk. Think about that. Think about what it takes. That's an ethos. That's a culture that says, look, we want you to be successful. We want the people associated with us to be successful. We want to put our staff in the best position to be successful. We don't want to, we don't want to burden our staff with projects that don't have a high probability of success.

So they came in at that time. And that was a very bold and courageous thing to do back then. But that's part of their ethos. The other thing is, you will find people with with stories, epic stories all over the place.

They could be Judy stories, they could be Carl stories. They could be Summit stories, quite frankly. And they could be BFF stories. People will tell you stories all, all over the place. About EPIC and so you have this lore that's been created and that's a great culture has a lore. A great culture has a language associated with it and a great culture celebrates.

So I'm going to go through a little bit of my path that I took and I'll come back to some of that stuff. So the first thing you notice coming on campus is, and somebody said this to me, it's as if corporate America and Disney had a baby and it is the EPIC campus. It's the EPIC Intergalactic Headquarters.

And that's, again, part of the, it's a playful spirit, but it's also a I don't know. I don't know what it is. I'd love to sit down with Judy and just talk culture for an hour or so. I think it would be fascinating, and the next opportunity I have to be in the room with her, I probably will do that.

As you're driving around campus, it's the epic intergalactic headquarters. And everything's really playful and fun. And I think it creates that environment. I think it helps in recruiting. I think that's one of the reasons you do it. I think it's a place where people want to come to work. You have people who visit Disney World and they go, Oh my gosh, it would be great to work here.

And then you talk to people who work at Disney and they're like, Eh, it's not as great as you think to work here. I don't get that sense from the Epic staff. I'm sure I could find some people that are disgruntled and have left the organization. That's true of every organization. But everyone I interacted with, smiles, happy, outgoing, friendly.

I think part of that is the Midwest. You, they recruit heavily from the Midwest, from the Big Ten schools. I think that's somewhat, again, to ensure success. I'm sure there's some people who have moved from New York City and L. A. to come to Madison and live here. It is beautiful, it's amazing.

But, at the end of the day, if you recruit from Nebraska, Michigan Penn State, and the Big Ten schools, they're gonna have a higher degree of success. That's one of the conversations I had with HR and, trying to figure out, what it takes, how they evaluate people, what does their interview process look like, what does their orientation process look like, and that was really fascinating.

But, let me boil this down, because I could ramble on here for a while. The campus is special, they have a carousel, they have all these things, it's a playful, fun environment and I think that creates an environment that people like to be in, and communicates something. I think the other thing you'll notice is there's no above ground parking.

It's beautiful. The campus is beautiful. The greenery. The amount of money they invested in the greenery alone. I'm not sure the staff recognizes it, but somebody does. Somebody made the decision, you know what, this is going to cost us money. To have these kinds of flowers, these kinds of areas, and this kind of stuff.

But it's worth it. It communicates, hey, we care about you. We know it's cold. In Madison, Wisconsin, we're going to give you a spot to park underground. So everybody essentially has covered parking. You're immediately in a covered area. And you can get from one end of the campus to the other.

I think they built a new building. But I think you can get from one end to the other underground. At least we did. We stayed inside most of the tour that I was given. The the other thing is you'll notice that everybody has an office. It's either a double or a single. I think those are the only two types.

Again, you're getting a fresh eyes project. Some of the things I say could be wrong. This is my perspective being on campus, getting this tour, my first UGM. As it was portrayed to me, they did the research, and people are more productive in offices. And it would be interesting.

I'd love to see that research and compare it to the research that was done in Silicon Valley that said, Hey, bullpens with picnic tables. Even the CEO sits out amongst the the people and it's more of a level playing field and that kind of stuff. I'd love to see the comparison. I'd like to see somebody honestly look at the productivity.

And, now we have a new environment. We have this remote environment to compare it to. I think it's worth an analysis. Regardless, I sidetrack. But and it almost felt like dorm rooms. I walked into one of them and two people working. They had their, each had their desk and they had their posters on the wall and the things that sort of reminded them of home and their family and the things they love and that kind of stuff.

Regardless, I'm going to go on from the campus because you could talk about the campus for a long time. I'm going to go to culture and some of the marks of culture. One is the person who gave me the tour, again, was a BFF and a project manager. And He was relating the story of the fact that when people come to visit him over Christmas, he gives people tours of the campus.

Think about that. How many of you have said, Oh, you know what? You have to come by my office. I'd like to give you a tour of the office over Christmas. There's a certain amount of pride that goes along with that. And by the way, he gave the tour like he was a tour guide at Disney World.

He knew like all these anecdotes and stories . I don't know if it's part of the onboarding. I doubt it's part of the onboarding. Maybe it is part of the onboarding. But it was a professional level tour that I was given of the campus. It was really impressive.

Anyway so I, by the way, I want to thank everybody, I want to thank everybody for the invite. And I want to thank everybody who gave me time and walked me around. Let me talk about culture and really hone in on this. You'll see marks of the culture. The Conference Center, which is called Deep Space.

When you are with EPIC for 10 years, you will put your hands in plaster. Something like what your kid did when they were in kindergarten or first grade.

And they'd do that little plaster thing. And, I think we still have our kids things. From that. And that's the point, right? It's a marker. So it's a 10 year marker and it's special. It creates meaning and it almost signifies that they've been a part of building the organization.

And so there's a there's markers in the culture there's there's a language. We've talked about that. There's the there's the listening to the clients.

The BFF concept of assigning an individual to every client should be replicated by any organization that can possibly do it. That has the resources to do it. And even if you don't have the resources to do it, every client should have an individual. That's identified as their advocate, as their person that you go to, that you hear from, that is invested in your success.

It is an interesting model. And I think the power of that is that Epic listens to every client. Most organizations when they're going to listen to their clients, they create a client advisory board. And the Client Advisory Board is representative of all their clients, right? And it's one of my pet peeves that we treat healthcare like it's homogenous, and it's not.

Rural healthcare, federally qualified health clinics, IDNs, large IDNs, individual hospitals academic medical centers. These are organizations that have very distinct business models, very distinct patients, very distinct staff. and staffing requirements and needs. And the ability to have a person assigned to every organization and getting feedback from that organization and providing a conduit for getting the most important things out to those clients is really distinct.

I think Harvard Business Review, I think anyone who could write a book about this should write a book about it. don't think that's the most powerful thing about Epic. Clearly culture, I think, is one of the most powerful things, but I don't think it's the culture they've created internally.

I think it's that they have figured out a way to make their clients a part of their culture and a part of their ethos. I know of no other organization... Where the clients identify so much with a partner. It really is amazing. It really is fascinating.

Again, this is a fresh eyes project. So some of what I might say might be wrong, but Here's the things I observed. One, They have stars on the ground in the in deep space in the conference center for each one of the clients and I think the dates on there were their go lives and so it's like that brick thing that you have when you gave money to a, an institution and they were building a new building and there's a brick, and you go to that institution and you want to take your family and your kids and show them, it's hey, look, here's our brick, kind of thing.

Every institution has that star on the ground that you can see. I think another one is the banners. They celebrate their clients successes. And there were banners. Not the kind of banners that you go to Speedy Sinorama and, just have something cheaply printed up. These are banners like you would hoist in the rafters at a college or university for a national championship.

And they're really professional looking and great banners. And they celebrate things like a HIMSS Debut Award or a Stage 7 or a STARS. Epic has a STARS program and they celebrate those kinds of things. And so you have that kind of stuff. In the keynote, there was a fair amount of time dedicated to celebrating the successes of the partners, of the clients.

And I know of nobody else, no other organization that has been able to extend their culture to their clients in the way that Epic has done. And again, I'll give you a couple of little examples. One is... There are nuanced points where I might disagree with something Judy has said in the press.

I will get emails almost immediately oh, you don't understand, and they will come to defense and aid. I could do that for every other company in the industry and no one will gimme a phone call. Like no one will send me an email and say, Hey. You don't understand their perspective or where they're coming from.

I will say

Just when you think can anyone else go to Epic? I talked to WellSpan , and they're moving to Epic. I talked to UPFC, and they're moving to Epic. And Northwell's moving to Epic. These are not small clients. There are still... Significant clients moving to Epic, and I think a lot of that has to do with their culture of listening and their culture of hiring smart people and hiring well with people who understand an ethos of being connected, vested in the client's success.

That's part of my Fresh Eyes project. If you gave me another half hour, I could probably talk about a couple more things. I think it's really... Interesting. I think Harvard Business Review should be over there writing articles. It would be very hard for someone to take a bunch of this stuff and implement it and succeed.

I think it does take a long term play. I think Judy is a special person. Somebody asked me, what do you think makes Judy successful? And I'll close with this. I think the thing that makes Judy successful is, first of all, she is a caring person. Core motivator, and that's not terminology you hear it that often, but I think at the core of everybody there is there's certain drivers, and this is not original with me it's with somebody who wrote a book, Vision for Your Life, and there's core motivators, and he had eight core motivators, and caring was one of them, and the minute I read it, I said, that's Judy Faulkner.

Judy Faulkner, at her core, cares. She cares about her clients, to the point of, Every one of them knows if they send her an email, she will respond to that email.

They know she cares. She's invested with them. She will be on phone calls. I talked to one CIO who did an implementation, and he said Judy was on a bunch of our phone calls. I doubt Larry Ellison's going to be on any implementation phone calls now, granted, he's not over healthcare specifically for Oracle, but, it's just a different ethos.

They know she cares. She cares about them, she cares about their health system, she cares about healthcare. We may not agree, we have nuanced disagreements but I would never doubt innovation. It is from a point of carrying. So that's one of the things I think that differentiates Judy. And I think the other thing, is playing the long game. There's no chasing of money.

I doubt that Judy has in Corporate Jet. Now if she does, I don't think it changes this comment at all. I don't see her chasing money. .. It's not a public company. She's not chasing the results.

But, she really does care about the culture. She cares about the next hundred years at Epic. And what that's going to be. And how it's going to be able to serve the community. And . There's not a race for for profit.

There's not a race for the next shiny toy or anything like that. And I sense no ego that you would get from a lot of organizations and companies. I'm not sure how you teach that. It would be refreshing if more and more companies had this kind of ethos. I think even the companies that sort of portray this, Hey, we're a giving back, we care about our employees.

In some sense, and maybe I'm too cynical here, but the leader read a couple of articles and they, attended a class, heard a lecture, and they're like I guess you have to do this. I don't think that's EPIC and I don't think that's Judy at all.

I think at their core, it's genuine. And I think people sense that genuine nature. It's different. And I think part of it is what I talked about this morning. There's a sense in which they know that Judy cares about them.

And they know the ethos of Epic is about. Giving back to the community, their clients, and serving them well.

There you go. That's my Fresh Eyes project. If you have comments about it, shoot me a note.

Bill at ThisWeekHealth. com. And that's all for today. Wow, I still have another hour and 57 minute drive. Wish you could be with me the rest of the way. But that's all I have for this morning. If you want to support the show, the best way to do that, tell a friend you're listening to it, have them listen to it with you, and have conversations about it.

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