Epic vs athenahealth: an objective comparison

For most of their existence EHR vendors, Epic Systems and athenahealth have occupied their own respective spaces in the EHR market. As the third largest, EHR vendor according to Kalorama Information, Epic focuses on serving large healthcare companies whereas athenahealth has focused its efforts on offering products for the ambulatory care market.

The disparity between the market shares of these two vendors, particularly in the acute care market, is significant. According to a 2017 report from KLAS Research, citing 2016 market data  Epic held about one-quarter of the acute care hospital EHR market share while athenahealth only held 1.6%. However, a shift is occurring that will likely place these two vendors in direct competition for the same target markets.

The KLAS report mentioned above notes that athenahealth’s “expansion is continuing to disrupt the small hospital market, the KLAS report finds. The number of hospitals that contracted with athenahealth more than doubled in 2016, with one-third of those being hospitals with over 25 beds.” Epic has also begun to venture out of its traditional market space by beginning to focus more general ambulatory and specialty care practices. Traditionally known for its large and expensive systems, Epic is now targeting opportunities in smaller practices with Utility and Sonnet, smaller versions of its larger system.

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As such unlike in the past practices in a variety of settings will likely be faced with the task of weighing these two vendors offerings during the selection. Therefore, now is an appropriate time to present an objective comparison of the two companies given they are now earnestly seeking to win the favor of the same target markets.     

Deployment and scalability

As noted by KLAS research, athenahealth’s “web-based platform, unique cost structure (percent of collections), and inpatient/outpatient integration are all a draw to providers.” Further, the report notes that athenahealth’s web-based platform lends itself better to practices looking to scale up their operations. Epic server-based deployment may present a barrier to practices who are looking to scale up their operations or for those who do not want to invest in the hardware infrastructure needed to run a server-based EHR.


Although price data was not readily available for the range of products offered anecdotal evidence indicates that Epic’s product costs considerably more to implement and maintain over the long term than athenahealth’s software, given latter’s reliance on a web-based deployment. This saves money in infrastructure and maintenance costs and that athenhealth’s pricing is tied to a collections-based fee structure.  

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Customer rating

A recent report from research firm Reaction Data, which analyzed responses from thousands of physicians across the country on the subject of EHR satisfaction, found that 39% of physicians were happy with athenahealth’s platform. Of these respondents, 50% were in the ambulatory setting, while only 13% of its acute care physicians had similar satisfaction. Among those surveyed 19% expressed mixed feelings regarding the product.

Epic performed better on the satisfaction metric than athenahealth with 45% of users expressing they were happy with the EHR.  48% of those respondents working the acute setting and 41% in ambulatory care. Around 22% expressed mixed feelings.

The Epic versus athenahealth question ultimately hinges on context. Epic still maintains a significant market share advantage among acute care organizations, with a great deal of positive customer sentiment in this area, however, athenahealth’s more scalable design and lower price point makes it a more attractive option for both smaller acute care providers and for the ambulatory market.

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Jeff Green

About the author…

Jeff Green, MPH, JD works as a freelance writer and consultant in the Healthcare information Technology Space.

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Jeff Green