Re: Epic Seven Pc
Periandro Hawkins
Launched in 2018, Epic Seven offers a unique playtime for gamers. Explore the seventh world, experience intense 3v3 battles, and become the strongest guild by working steadfastly with other guild members.
BlueStacks 5, the latest software version, is faster and lighter than ever, providing a seamless mobile gaming experience on a larger screen. Its sleek and modern interface makes it easy to use and navigate, while the Advanced Keymapping and Instance Manager features are more intuitive and user-friendly than ever before.
But local advertising exclusivity is just one, tiny aspect of how Epic diligently promotes and protects its position, both as the tech giant in the greater Madison area and the leading electronic health record (EHR) system nationwide.
Taken together, these seven questionable business practices beg the question: Is Epic just being shrewdly competitive, or outright exclusionary, in the way in which it obtains and maintains its EHR market share, especially among large hospitals, health systems and academic medical centers (AMCs)? And, if the latter, what should happen next?
Several technology CEOs pointed to changes to how Epic allows third parties to work with and integrate with Epic following the introduction of Information Blocking rules. In several cases, while Epic allowed continued access to some information, it allegedly disallowed companies from accessing other previously accessible information, citing that the names of the products were protected intellectual property not to be shared with potential competitors.
The resulting effect for some is that some hospital customers must hire their own employee with knowledge of both Epic and third party products. This introduces friction and costs to both customer and companies, and increases project time to get started from 16 weeks to one year on average.
Epic also allegedly leverages its market power to place restrictions on hiring between third parties and Epic customers during periods when customers are implementing Epic. Given that Epic implementations last for 12 to 24 months on average, but can extend much longer for larger organizations, this restriction effectively limits job mobility for hospital IT staff for years on end.
Under the new regime, IT systems such as Epic are allowed to impose fees to third parties for accessing its system, but there are limitations. Fees must be (i) consistently applied, (ii) based on verifiable cost data, and (iii) not based on whether a requestor is a competitor.
Epic has updated its fee structure in at least one area based on the new rules. But the effect has been the opposite of what Congress was looking for in at least a few cases. Several industry executives pointed to these changes as increasing the costs of their transaction fees with Epic. In one case a company that has been working with Epic for years has reportedly seen API fees rise by 70X to >100X.
At the same time that Epic is (at least in some cases) increasing fees to third-party developers, it is going to mutual customers of those third-party developers and offering what appears to be below cost pricing for its competitive product. In many cases, it appears to be price bundling what it markets as new, distinct products, in with its core EHR software.
Epic has a history of seemingly leveraging the combination of its private status and its relationship with its customer base (more immediately below) to great, and perhaps anticompetitive, effect. The company has regularly announced future products it has not yet developed, but either intends to or has started development on.
The effect is understandable from a CIO perspective: it is the IT team who must manage multiple vendor relationships, integrations, and maintenance. Across hundreds of IT staff, the complexity can become overwhelming. If a CIO knows that Epic is bringing a new product to market in a year or two, the IT department will do its best to shut down attempts by clinician leaders or others to bring in another vendor that can address the issue today.
The Meaningful Use program demanded a massive investment in change management on behalf of providers, while simultaneously elevating the role of health system CIOs. Boards were interested in tracking progress; with everything digitized, system uptime is mission critical; with increased clinician enthusiasm for new solutions, system integration became paramount.
These may be good things, but two considerations are worth taking into account: first, the hospital IT department (and by extension, Epic) now effectively serves as the gatekeeper to (rather than developer or order-taker of) innovation efforts; and second, neither the CIO, nor the IT department, nor the hospital itself, is the end consumer. The end consumer is the patient.
Yet even if its actions attract scrutiny, most recent court rulings suggest that regulatory action may not be the answer. As seen in lawsuits filed against large technology platforms such as Meta, Microsoft, and Apple, rulings tend to be in favor of the companies.
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