Before You Buy an EHR, Ask the Hard Questions.
Hospitals spend billions on electronic health record systems that can shape patient care, hospital finances, medical records, and even careers. Before signing the contract, decision-makers deserve clear answers about cost, control, security, accountability, and who ultimately owns the data.
The Stakes Are Bigger Than Software
An electronic health record can become the operational nervous system of a hospital. It can influence how clinicians work, how information moves, how organizations are staffed, how billions of dollars are spent, and how readily a health system can change direction years later.
The question is not whether technology belongs in medicine. It does. The question is whether hospitals, taxpayers, clinicians, and patients understand what they are buying—and what control they may be surrendering.
The $49.8 Billion Question
When an EHR program can carry a projected life-cycle cost measured in tens of billions of dollars, asking hard questions is not obstruction. It is stewardship.
Questions Every Hospital Board Should Ask
Before committing an organization—and potentially generations of clinicians and patients—to an EHR platform, some questions deserve answers that are specific, documented, and independently verifiable.
Who ultimately controls the data?
Can the organization obtain a complete, usable copy of its information without continuing dependence on the vendor?
Can the audit trail itself be independently audited?
Which privileged users can alter clinical data, metadata, configuration, or audit-related information? What records are genuinely immutable?
What does it really cost?
Not merely the purchase price, but implementation, training, staffing, upgrades, interfaces, consulting, downtime, optimization, and long-term support.
What happens if we want to leave?
How difficult and expensive is migration? Are contracts, proprietary formats, certification requirements, or technical dependencies creating practical vendor lock-in?
Who controls the people who maintain it?
Does the vendor influence who may be trained, certified, hired, or assigned to critical technical roles—and what happens when a professional challenges the vendor?
What happens when something goes wrong?
Who can investigate independently? Can the organization reconstruct exactly what happened from trustworthy records without depending upon the vendor whose system is being examined?
These aren’t accusations. They’re architecture, governance, procurement, and accountability questions. Any system entrusted with patient care and billions of dollars should be able to withstand them.
Why This Site Exists
Avoid Epic exists because decisions about electronic health records are too consequential to be made on reputation, sales presentations, institutional momentum, or vendor promises alone.
Hospitals and governments deserve independent scrutiny of cost, architecture, security, interoperability, auditability, vendor dependence, workforce practices, and long-term consequences. Clinicians and patients deserve systems designed around their interests—not merely the interests of institutions and vendors.
This site will examine documented evidence, technical questions, public records, firsthand experience, and competing viewpoints. Where something is established fact, it will be presented as fact. Where it is analysis, opinion, allegation, or an unanswered question, it will be identified accordingly.