Multi-site physician services platform

EMR Decision Build

A once-in-a-hold platform decision run on ten criteria and ten-year cost models: $30M in projected savings, positive NPV, breakeven in year four.

The situation

By late 2023, provider dissatisfaction with the existing EMR and its growing limits on growth execution had forced a decision the platform could only get wrong once. There were three options: optimize what was already there, migrate to a competing system, or implement Epic. Each carried a different cost structure, implementation risk, clinical capability, and strategic ceiling. The decision would consume the remaining committed capital and shape the next decade, and getting it wrong was not recoverable inside the hold.

What I built

An evaluation framework across ten criteria: cost, clinical workflows, value-based care capability, interoperability, patient experience, and strategic extensibility among them. The criteria were set before the options were scored, so the answer could not be written backwards from a preference.

A cross-functional assessment across clinical, operational, financial, and IT stakeholders, with physician and staff feedback synthesized across the provider base rather than sampled from the loudest.

Ten-year total cost of ownership models for each platform, and a board recommendation carrying the full supporting analysis and the reasoning, so the board approved a decision rather than ratifying a conclusion.

The result

Board approved Epic in late 2024

$30M in projected ten-year savings over the leading alternative, despite higher upfront implementation cost

Positive NPV, breakeven in year four

The remaining committed capital went to the long-term platform with full board confidence

Where is the platform stuck?

Facing a decision the platform can only get wrong once? Tell me where the platform is stuck, and I'll tell you if I can help.

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