Acquired
Acquired

Epic Systems (MyChart)

April 20, 2025

AI Summary

5 min read

In 1979, Judy Faulkner was a PhD student in computer science at the University of Wisconsin who had written a database for the medical center. She had no intention of starting a company. But doctors from other hospitals kept calling, asking if she could build the same system for them. She finally relented. She raised $70,000 from friends and family, took out a $70,000 bank loan to buy a mini-computer, and started Human Services Computing in the basement of an apartment building in Madison. Forty-seven years later, that company is Epic Systems, the dominant provider of electronic health record (EHR) software in the United States. It has never lost a customer, never raised venture capital, never made an acquisition, and never gone public. It does no marketing and almost no sales. Its founder, now 81, has structured the company so that it can never be sold. This is the story of how a quiet software factory in rural Wisconsin became the central nervous system of American healthcare.

The Problem: Paper, Payers, and the Need for a Single Database

Continue reading the full summary in the app — free to try.

Read Full Summary →

Free • No credit card required

Listen to Audio Summary Open in App

What you'll learn

  • 1 (00:00) **Introduction: The Quiet Giant of Rural Wisconsin** - Ben and David introduce Epic Systems, a 47-year-old private company in Verona, Wisconsin that dominates US healthcare with its MyChart patient portal and EMR software.
  • 2 (04:42) **Judy Faulkner's Origin Story** - The early life of Judy Faulkner (née Greenfield), from her childhood in New Jersey to her discovery of computer programming.
  • 3 (11:51) **The Birth of an Idea: From Grad School to Chronicles** - Judy pursues a PhD in computer science at the University of Wisconsin, where she takes a class on "Computers in Medicine."
  • 4 (15:04) **The Policy Context: Why Medical Records Matter** - A deep dive into the history of medical records and the US healthcare payment system, which created the existential need for standardized digital records.
  • 5 (28:19) **The Birth of MUMPS and the First EMRs** - The development of the first computerized medical record system (COSTAR) at Mass General Hospital, which led to the creation of the MUMPS programming language.
  • 6 (32:54) **Judy's Epiphany and the Founding of Epic** - Judy has a breakthrough idea for a single, integrated patient database called "Chronicles," which becomes the core of Epic.
  • 7 (39:14) **The Early Years: A Small Business in Madison** - Epic grows slowly for its first decade, focusing on clinical records before adding the critical billing module.

+ Full timestamped outline available in the app

Show Notes

What if we told you that the most important company in US healthcare was run from a farm in rural Wisconsin? And that farm contained the world’s largest subterranean auditorium, as well as Disneyland—style replicas of Hogwarts and the Emerald City? What if we told you that the person who started, runs and owns this establishment has legally ensured that it will never be sold, never go public and never acquire another company? And that this person, Judy Faulkner, is also likely the wealthiest and most successful self-made woman in history?

Welcome to the story of Epic Systems, the software company that underpins the majority of the American healthcare system today. Epic isn’t “just” an electronic medical record (the category it’s usually lumped into), or an online patient portal (which is how most of the US population interacts with it via its MyChart application). It’s more akin to a central nervous system for hospitals and health clinics. Almost everything in a hospital — from patient interactions to billing, staffing, scheduling, prescriptions and even research — happens on Epic’s platform, and over 90% of American medical schools’ graduating doctors, nurses and health administrative staff are trained on it during their educations. Tune in as we dive into the almost-unbelievable story of how this epic company came to be!

Sponsors:

Links:

Carve Outs: