Epic Costs $1.46M Over 5 Years. Find the Right Fit Without Documentation Burden.
Independent practices (2-20 providers) save $1.32M-$2.16M over 5 years with right-sized technology. Choose systems that reduce burnout, not increase it. Epic excels for health systems; small practices need different economics.
$1.46M-$2.3M
Epic 5-year cost (10 providers)
$143K
OrbDoc 5-year cost (10 providers)
$1.32M-$2.16M
Savings over 5 years
923%-1,511%
ROI compared to Epic
Built for Independent Practices (2-20 Providers) That Enterprise Solutions Overlook
Practices outgrowing small EHRs need full features without Epic-level complexity. Practices considering Epic switch need honest cost comparison. Practices adding AI documentation need systems that work WITH existing investments.
The True Cost of Enterprise EHR for Small Practices
Epic is excellent for health systems with 500+ providers and dedicated IT teams. For independent practices (2-20 providers), the economics differ: $300K-$500K Epic implementation vs $50K-$100K cloud EHR, plus ongoing IT overhead.
Implementation Costs
$1.2M-$1.8M upfront for 10-provider Epic implementation before seeing any benefit
Annual Maintenance
$250K-$500K yearly for support, upgrades, and customization that never ends
Enterprise Complexity
IT department required, rigid workflows, expensive changes. Built for hospitals, not small practices.
Vendor Lock-In
5-10 year contracts, difficult to switch, rising costs. You're committed even if needs change.
What Independent Practices Actually Need: Right-Sized Technology
Right-Sized Economics
$199/month vs $5K-$8K/month per provider. Same clinical documentation, fraction of the cost.
Practice Independence
No vendor lock-in, month-to-month flexibility. Switch if your needs change without losing millions.
Custom Workflows
Practice-configurable templates and forms without $50K-$200K customization fees.
No IT Department
Practice manager can configure and manage. No dedicated IT staff salaries ($150K-$250K annually).
Fast Implementation
Days not months. Start seeing ROI immediately, not after 18-month disruption.
Transparent Pricing
Fixed monthly rate, no hidden fees or escalators. Know exactly what you'll pay for 5 years.
Real Practice Scenarios: Epic vs Right-Sized Solution
Growing Practice
Start with 5 providers, add 5 more as practice grows
Epic Approach
Epic requires $500K+ re-implementation, 6-month disruption, additional licensing
OrbDoc Approach
Add 5 more OrbDoc licenses ($995/month), configure in days, no disruption
Save $480K+ in scaling costs
Workflow Changes
New specialty needs custom templates and documentation flow
Epic Approach
$50K customization fee, 3-6 month timeline, consultant engagement required
OrbDoc Approach
Practice manager configures new template in OrbDoc, 2-3 days
Save $48K per customization
Exit Strategy
Needs change or better technology becomes available in 3 years
Epic Approach
Locked into 10-year contract, early termination penalties, lost implementation investment
OrbDoc Approach
Month-to-month contract, switch anytime, minimal switching cost
Preserve flexibility and capital
When Epic Makes Sense vs When OrbDoc Makes Sense
This is about fit and economics, not which system is "better." Epic excels in its context, OrbDoc excels in ours.
The Honest Truth
Epic is an exceptional EHR built for health systems with complex interoperability needs. Its hospital-focused design excels for 500+ provider organizations with dedicated IT departments. For 5-10 provider independent practices, the economics don't scale: $1.46M over 5 years vs $143K for right-sized alternatives. That's not a flaw; it's finding the right fit.
True Cost of Ownership Comparison
Implementation Costs
Epic (Hospital-Focused)
$500K - $2M
- • Software licensing: $200K-$800K
- • Hardware/infrastructure: $100K-$300K
- • Consulting/customization: $150K-$500K
- • Training: $50K-$200K
- • Data migration: $50K-$200K
Right-Sized Cloud EHR
$40K - $80K
- • Setup/configuration: $15K-$30K
- • Training: $10K-$20K
- • Data migration: $10K-$20K
- • Custom templates: $5K-$10K
Annual Operating Costs
Epic (Hospital-Focused)
$50K - $150K
- • Software licensing: $20K-$60K
- • IT staff (2-3 FTE): $150K-$250K
- • Support/maintenance: $15K-$40K
- • Upgrades/updates: $10K-$30K
Right-Sized Cloud EHR
$15K - $35K
- • Subscription fees: $12K-$25K
- • Support (included): $0
- • Updates (automatic): $0
- • Minimal IT needs: $3K-$10K
Success Patterns from Independent Practices
Practices Outgrowing Small EHR
Practices with 5-10 providers outgrowing basic EHR systems but not needing hospital-level complexity report:
- $1.1M-$1.9M savings vs Epic over 5 years
- 4-8 week implementation vs 12-18 months
- No IT department overhead ($750K-$1.25M saved)
Practices Considering Epic Switch
Independent practices evaluating Epic migration but concerned about complexity report:
- $1.32M-$2.16M cost avoidance with cloud EHR
- Vendor-managed updates vs ongoing IT maintenance
- Month-to-month flexibility vs 5-10 year lock-in
Practices Adding AI Documentation
Practices keeping existing EHR but adding AI layer for documentation report:
- $11,940/year (10 providers) vs $500K+ EHR replacement
- 40-60% reduction in EHR click burden
- Works with Epic, Athena, eCW, NextGen, Cerner
Hidden Costs Beyond Implementation: Total 5-Year Impact
Epic's $300K-$500K implementation is just the start. True cost of ownership includes IT staffing ($750K-$1.25M), training time ($60K-$150K), productivity disruption ($150K-$400K), and ongoing customization fees.
| Hidden Cost Factor | Epic Reality | Cloud EHR Reality | 5-Year Impact |
|---|---|---|---|
| Implementation Time Lost | 12-18 months of productivity disruption, workflow adjustments, staff frustration | 4-8 weeks minimal disruption, rapid adoption | $150K-$400K (Epic productivity loss) |
| Training Burden | 40-80 hours per provider, ongoing complexity, steep learning curve | 8-12 hours per provider, intuitive interfaces | $60K-$150K (Epic training time) |
| IT Staffing | 2-3 full-time IT staff required ($150K-$250K annually) | No dedicated IT staff needed, vendor-managed updates | $750K-$1.25M over 5 years (Epic IT staff) |
| Customization Costs | $50K-$200K for workflow customization, templates, specialty modules | Customization included in subscription, no extra fees | $50K-$200K (Epic customization) |
5-Year Total Cost of Ownership
| Practice Size | Providers | Epic 5-Year TCO | Cloud EHR 5-Year TCO | Your Savings | Notes |
|---|---|---|---|---|---|
| Solo Practitioner | 1 | $180K-$350K | $35K-$60K | $145K-$290K | Epic rarely sold to solo practices |
| Small Practice | 5 | $800K-$1.5M | $200K-$350K | $600K-$1.15M | Most common independent practice size |
| Medium Practice | 10 | $1.5M-$2.5M | $400K-$600K | $1.1M-$1.9M | Right-sized EHR still viable |
| Large Practice | 20 | $2.5M-$4M | $700K-$1M | $1.8M-$3M | Consider mid-market options |
$1.46M
Median savings (10 providers)
Based on Epic vs cloud EHR 5-year TCO
12-18 mo
Time to productivity (Epic)
vs 4-8 weeks for cloud EHR
2-3 FTE
IT staff Epic requires
$750K-$1.25M over 5 years
When Epic Makes Perfect Sense
Epic is an exceptional EHR for the right use case. Here's when it's the correct choice:
Part of Health System
Already using Epic at hospital level, need seamless patient record sharing across facilities
50+ Provider Organization
Scale justifies implementation cost, have dedicated IT department to support complexity
Complex Specialty Workflows
Highly specialized workflows (oncology, transplant, cardiology) requiring Epic-specific modules
Regulatory Requirements
ACO contracts or health system partnerships mandating Epic interoperability
Important: If you're part of a health system, need hospital integration, or have 50+ providers with dedicated IT staff, Epic is likely the right choice. It's built for exactly these scenarios and excels at them.
When Right-Sized Cloud EHR Makes Sense
For independent practices, a cloud EHR matched to your size offers better economics and faster implementation:
2-20 Provider Practice
Independent practice needing full EHR features without hospital-level complexity
Limited IT Resources
No dedicated IT staff, need vendor-managed cloud solution with automatic updates
Fast Implementation
Can't afford 12-18 month disruption, need to go live in 4-8 weeks
Budget Constraints
Implementation budget under $100K, annual budget under $50K
Key Advantage: Right-sized cloud EHRs (Athena, eClinicalWorks, NextGen, DrChrono, etc.) offer full EHR functionality at 1/3 to 1/5 the cost, with 4-8 week implementation versus 12-18 months.
OrbDoc: The EHR-Agnostic AI Documentation Layer
Already invested in an EHR? Keep it. OrbDoc works WITH any system - Epic, Athena, eClinicalWorks, NextGen, Cerner, and more.
Works with ANY EHR
Epic, Athena, eClinicalWorks, NextGen, Cerner - OrbDoc is EHR-agnostic
Reduces EHR Click Burden
Voice documentation means less time fighting your EHR interface
Affordable Addition
$199/mo/provider vs $500K+ EHR replacement cost
Keeps Your Investment
Already invested in EHR? Keep it. OrbDoc makes it better.
The Economic Reality
$1.5M-$2.5M
Epic replacement (10 providers, 5 years)
$400K-$600K
Cloud EHR replacement (10 providers, 5 years)
$11,940/year
OrbDoc AI layer (10 providers @ $199/mo)
Smart Strategy: Keep Your EHR, Add AI Documentation
OrbDoc reduces EHR click burden by 40-60% without the disruption and cost of EHR replacement. Works with your existing investment.
Real-World Decision: 8-Provider Family Medicine Practice
❌ Path A: Epic Implementation
- • Implementation: $800K-$1.2M upfront, 12-18 months disruption
- • Staffing: Hire 2 IT staff ($150K-$250K annually)
- • Training: 40-80 hours per provider, steep learning curve
- • Annual Costs: $80K-$120K ongoing licensing, maintenance, support
- • 5-Year TCO: $1.8M-$2.8M total investment
✓ Path B: Cloud EHR + OrbDoc
- • Implementation: $50K-$70K upfront, 4-8 weeks to go-live
- • Staffing: No dedicated IT staff needed (vendor-managed)
- • Training: 8-12 hours per provider, intuitive interface
- • Annual Costs: $25K EHR + $19K OrbDoc = $44K total
- • 5-Year TCO: $270K-$320K total investment
Path B Saves $1.5M-$2.5M Over 5 Years
Same EHR functionality, better documentation (with AI), faster implementation, no IT overhead. The choice was clear.
Outcome
Live in 6 weeks, not 16 months
Productivity
2-3 hours daily saved per provider
Capital
$1.5M+ reinvested in patient care
Your EHR Decision Checklist
Questions to Ask Yourself
- Are we part of a health system requiring Epic interoperability?
- Do we have 50+ providers justifying enterprise-level complexity?
- Do we have dedicated IT staff (2-3 FTE) to support the system?
- Can we afford $500K-$2M implementation cost?
- Can we tolerate 12-18 months of implementation disruption?
- Do we have $50K-$150K annual budget for EHR ongoing costs?
If you checked 3+ boxes:
Epic or enterprise EHR likely makes sense for your organization
Independent Practice Reality
- We're an independent practice (2-20 providers)
- We don't have dedicated IT staff or budget for IT hires
- Our implementation budget is under $100K
- We need to go live in weeks, not years
- Our annual EHR budget is under $50K
- We want vendor-managed cloud solution with automatic updates
If you checked 3+ boxes:
Right-sized cloud EHR + OrbDoc likely offers better economics and fit
Practice Scenarios: Total Cost of Ownership Comparison
Primary Care 2-10 Providers
5-year savings vs Epic
Cloud EHR + OrbDoc: $200K-$350K total vs Epic: $800K-$1.5M
Specialty Practices 3-15 Providers
5-year savings vs Epic
Right-sized EHR: $300K-$500K vs Epic: $1.1M-$2.1M
Multi-Specialty 10-20 Providers
5-year savings vs Epic
Cloud EHR + AI layer: $400K-$600K vs Epic: $1.5M-$2.5M
$1.46M Epic Cost Avoidance
Independent practices choosing right-sized cloud EHR + OrbDoc AI documentation layer save $1.32M-$2.16M over 5 years vs Epic implementation, with 4-8 week go-live vs 12-18 months disruption.
No IT Department
$750K-$1.25M saved over 5 years
Faster ROI
4-8 weeks vs 12-18 months to productivity
Month-to-Month
No 5-10 year contract lock-in
"We almost signed a $1.4M Epic contract. Realized we needed documentation without enterprise complexity. Right-sized EHR + OrbDoc saved us $1.26M over 5 years and we're live in 6 weeks, not 16 months."
7-Provider Multi-Specialty Group
Independent practice, suburban location
Related Resources
Custom Workflows
Practice-configurable templates without Epic-level customization fees
OrbDoc vs Nuance DAX
See how OrbDoc compares in Epic integration context
Solo Practice
Technology economics for one-person practices
Pricing
Transparent pricing and 5-year TCO calculator
Find Right-Fit Technology Without Documentation Burden
Schedule a consultation to understand your true 5-year EHR costs. Explore options that match your practice size (2-20 providers), eliminate documentation burden, and save $1.32M-$2.16M vs Epic over 5 years.
No sales pressure. Honest advisor helping you find the right fit for your practice economics.