Epic-First Doesn’t Mean Epic-Only: Where Hospitals Are Still Buying from Startups

A survey of 112 health system executives shows Epic's dominance in hospital IT continues to grow, yet startups retain purchasing opportunities by addressing gaps Epic has not filled, delivering measurable ROI, or solving specific clinical or operational problems. The findings suggest a tiered procurement model where health systems prioritize Epic integration but remain open to best-of-breed vendors that complement rather than replace their core platform.