The Number That Explains Everything
Somewhere in America right now — in a fluorescent-lit exam room in Cleveland, a neonatal ICU in Houston, an oncology clinic in Boston, a rural urgent care in Montana — a doctor is clicking through a patient's chart. The interface is familiar: a particular shade of blue, a specific arrangement of tabs, a distinctive way of rendering lab values and medication lists. The odds are overwhelming that this doctor is clicking through Epic.
Three hundred and twenty-five million patients. That's the number Epic Systems claims for its current electronic health record database — roughly the population of the entire United States, minus children too young to have seen a physician and adults who have somehow avoided the healthcare system entirely. The company holds, by its own accounting, medical records covering approximately 90% of all Americans. It commands 42% of the acute care hospital market. Among large academic medical centers — the institutions that train the next generation of physicians, that conduct the clinical trials, that treat the sickest patients — Epic's share is closer to 58%. In 2024 alone, the company added 176 facilities and nearly 30,000 hospital beds to its network, its largest annual gain on record.
And yet Epic Systems has never been public. It has never taken a dollar of venture capital. It has never made an acquisition. It has no debt. It has 14,000 employees working on a 1,670-acre campus in Verona, Wisconsin — population 16,400 — where buildings are themed after
The Wizard of Oz,
Harry Potter, and
Charlie and the Chocolate Factory, and where a yellow brick road winds through emerald-green hallways. Its 82-year-old founder and CEO,
Judy Faulkner, took the stage at the company's 2024 annual Users Group Meeting dressed as a swan, complete with a plume of feathers in her hair.
This is the company that runs American healthcare's central nervous system.
By the Numbers
The Epic Empire
$5.7BRevenue in 2024
325MPatient records worldwide
42%U.S. acute care hospital market share
3,300+Hospitals on Epic
71,000+Clinics on Epic
14,000Employees
$0Venture capital raised, ever
1979Year founded in a Wisconsin basement
A Basement on University Avenue
The origin is almost too perfect in its modesty. In 1979, Judith Faulkner — a computer programmer with a master's degree from the University of Wisconsin-Madison, daughter of a pharmacist father and a mother who directed Oregon Physicians for Social Responsibility — co-founded Human Services Computing, Inc. in a basement at 2020 University Avenue in Madison, Wisconsin. The startup capital was $70,000, raised from friends and family. The staff consisted of a handful of part-time employees. Faulkner wrote the original code herself, on a Data General Eclipse 16-bit minicomputer about the size of a refrigerator, which used magnetic tape for storage.
The idea had germinated in graduate school, where Faulkner had taken what she believes may have been the first "computers in medicine" course ever offered in the world. One of her professors, Warner
Slack — a pioneer of computerized patient interviewing — asked her to join his research team. She said yes. The intersection captivated her: healthcare, one of the most consequential domains of human activity, meeting information technology, a field that was mentally stimulating and creatively boundless. "Sometimes I think it's a river you're floating down," Faulkner later told the
Capital Times. "Life just takes you different places."
Her co-founder, Dr. John Greist, a psychiatrist, shared an early vision for applying computing to patient data. But within four years, a fundamental disagreement surfaced. Greist wanted to bring in venture capital, to build faster. Faulkner refused. The argument was not merely tactical — it was philosophical, and it would define the next four decades. Greist stepped down from the board in 1983, retaining some shares, and Faulkner was left in sole command.
The company she began building was, from the outset, an expression of a particular personality: disciplined, idiosyncratic, allergic to outside influence, obsessive about customer service, and stubbornly committed to writing every line of code in-house. It was renamed Epic Systems Corporation in 1983, the same year it introduced its first patient scheduling software. By 1992, the company launched EpicCare, the industry's first Windows-based electronic medical records system — a bet on a platform that most of healthcare IT was still ignoring.
If we take good care of our customers, they take good care of the patients, and our job is to help the customers take good care of the patients. So it's indirect.
The Ten Commandments of Verona
Walk into any bathroom or breakroom on Epic's campus and you will encounter the company's Ten Commandments. The first three tell you almost everything:
- Do not go public.
- Do not acquire or be acquired.
- Software must work.
These are not aspirational statements. They are operating constraints that have shaped every major strategic decision the company has made. The prohibition against going public is not a preference — it is scripture. The refusal to acquire is not a limitation of ambition — it is a theory of software development. The insistence that software must work is not a platitude — it is a competitive weapon in an industry where implementations routinely fail, where rival systems crash for days, where hospitals have been forced to return to paper records after botched deployments.
Faulkner has been remarkably consistent in articulating why. "Why be owned by people whose interest is primarily return of equity?" she said in a 2025 interview with CNBC. The logic cascades: if you go public, you answer to shareholders on a quarterly cadence, which distorts long-term decision-making. If you acquire, you inherit different codebases, different cultures, different technical debt — and you lose the coherence that comes from building everything yourself. If your software doesn't work, nothing else matters, because a hospital system installation is, as one observer put it, "like doing a massive house renovation while the house is still occupied."
The commandments create a self-reinforcing system. Because Epic doesn't go public, it doesn't need to optimize for quarterly revenue recognition, which means it can invest in multi-year implementation projects without Wall Street pressure. Because it doesn't acquire, it maintains a unified codebase, which means fewer integration failures and more reliable deployments. Because it builds everything in-house, it controls quality. And because the software works — reliably, on time, with fewer catastrophic failures than competitors — hospitals keep choosing Epic, generating the revenue that allows the company to remain private and keep building in-house.
This is the flywheel. It has been spinning for 46 years.
The Stimulus That Changed Everything
For the first three decades of its existence, Epic grew steadily but slowly, serving a niche market of forward-thinking hospitals willing to invest in electronic records when most of healthcare still ran on paper. By 1995, the company had 100 clients and 125 employees. By 2000, revenue was approximately $47 million with a workforce of 396.
Then, in 2003, came the deal that announced Epic's arrival as a major force: Kaiser Permanente, the largest managed care consortium in the United States, selected Epic for its 30 hospitals and more than 11,000 physicians. The contract was enormous, and its signal value was greater still — if Kaiser, with its reputation for operational rigor, chose Epic, the product had passed the most demanding test in American healthcare.
But the true inflection point came from Washington. On February 17, 2009, President Obama signed the American Recovery and Reinvestment Act, which included the HITECH Act — $36 billion in federal incentives for hospitals and physicians to adopt electronic health records. The legislation transformed EHR adoption from a gradual, optional modernization into something approaching a mandate. In 2008, only 1.5% of U.S. hospitals had a comprehensive electronic records system implemented across all major clinical units. Less than 10% had even a basic system in one unit.
The money arrived, and the gold rush began.
How federal policy transformed Epic's addressable market
2003Kaiser Permanente selects Epic for 30 hospitals and 11,000+ physicians — the signature deal of Epic's pre-HITECH era.
2008Epic revenue reaches $600M, up from $500M in 2007. Only 1.5% of U.S. hospitals have comprehensive EHR systems.
2009HITECH Act passes, providing $36B in federal incentives for EHR adoption. The entire industry accelerates.
201475.5% of U.S. hospitals have at least a basic electronic records system, up from under 10% in 2008.
2016Epic employs approximately 9,500 people and earns revenues of roughly $1.8 billion.
2024Epic revenue hits $5.7 billion. The company holds 42% of the acute care hospital market.
A prevalent narrative holds that Epic engineered the HITECH Act for its own benefit — that Faulkner, through political connections and lobbying, manipulated the regulatory framework to favor Epic's products. The reality is more nuanced and, arguably, more interesting. HITECH didn't specifically advantage Epic over competitors. The certification requirements applied equally to all vendors. What HITECH did was massively expand the addressable market in a compressed timeframe, and in a sudden gold rush, the vendor with the best reputation for reliability and the most battle-tested product at large hospitals won a disproportionate share. Epic was winning approximately 40% of new contracts at major hospitals even before HITECH passed, according to Klas Enterprises. The stimulus didn't create Epic's advantage. It amplified it.
By 2008, Epic's revenue was $600 million. By 2016, it had tripled to $1.8 billion. By 2024, it reached $5.7 billion. The curve is not exponential — it is the steady, compounding growth of a company that captures an increasing share of an expanding market, one multi-million-dollar hospital contract at a time.
The Woman in the Basement
To understand Epic, you have to understand Faulkner — which is difficult, because she doesn't especially want to be understood. She rarely gives interviews. She has never written a memoir. The company, for years, had no public relations department at all; calls to Epic were returned, when they were returned, by an outside agency. Forbes once tried to verify her age and couldn't. In 2009, Faulkner was described as "traveling and unavailable" when a reporter sought comment. The company once put up a billboard that read: "Marketing Sucks ... Epic Systems."
What is known: born Judith Greenfield in August 1943, raised in the Erlton neighborhood of Cherry Hill, New Jersey. Graduated from Moorestown Friends School in 1961. Bachelor's degree from Dickinson College. Master's in computer science from the University of Wisconsin-Madison — the degree that led to the Warner Slack connection and, ultimately, to everything. Married to Dr. Gordon Faulkner, a pediatrician. Three children, none of whom work at Epic. Liberal politics. A collector of quirky artwork for the campus. An obsessive reader of science fiction. Forbes estimates her net worth at $7.8 billion, based on an estimated 43% ownership of Epic. In 2015, she signed the Giving Pledge, committing 99% of her assets to philanthropy. She reportedly sells approximately $100 million of her shares annually back to the company, with proceeds going to the Roots & Wings Foundation, a charitable organization she established with her husband.
I've described her as a female cross between
Bill Gates and Willy Wonka.
The Willy Wonka comparison lands because of the campus, but the Gates comparison is more analytically precise. Like Gates, Faulkner is a programmer-CEO who built a category-defining software company, maintained an iron grip on product direction, refused to cede strategic control to outside investors, and proved willing to compete ruthlessly behind a veneer of mission-driven earnestness. Like Gates, she understood early that in enterprise software, the product that achieves critical mass becomes the standard — and that switching costs in her market are not merely high but effectively infinite. A hospital that has spent $20 to $30 million and two or more years implementing Epic's system, retraining thousands of clinicians, migrating millions of patient records, and rewiring every clinical workflow from pharmacy to radiology — that hospital is not switching. Period.
The succession question looms. Faulkner turned 82 in August 2025 and has said she still has more to accomplish as CEO. She has split her stock into voting shares (which cannot be sold and have gone into a trust controlled by family and employees) and nonvoting shares (which will go to the Roots & Wings Foundation). The structure ensures that Epic will not be acquired after her departure — the voting control prevents it. In August 2024, she named Sumit Rana as president, and sources have identified him as the likely successor. But Faulkner shows no sign of stepping aside. At 81, she dressed as a swan. At 82, she is still running the company she started with $70,000 and a refrigerator-sized computer.
The Cathedral and the Bazaar
The most consequential strategic choice Epic ever made — more consequential than staying private, more consequential than refusing acquisitions — is the decision to build everything itself. Every module. Every feature. Every integration. One codebase. One architecture. One development team in Verona, Wisconsin.
In software, this is the cathedral model — as opposed to the bazaar of open-source, modular, API-driven platforms where third-party developers build on top of a core system. Most of the technology industry has converged on the bazaar. Apple has its App Store. Salesforce has its AppExchange. Even Oracle, Epic's largest competitor in EHR, allows (and encourages) third-party development. Epic took the opposite path.
The reasons are partly historical. In the company's early years, Faulkner and her team had several formative experiences with partners and competitors who, in their view, stole or misappropriated Epic's intellectual property. These experiences — which included aggressive patent disputes and partnerships gone wrong — created a deep institutional suspicion of external developers. Epic became fiercely protective of its code, its documentation, and its interfaces. No direct sandbox access for developers. Proprietary API documentation. Until recently, an almost complete absence of direct partnerships.
The benefits of this approach are real. A unified codebase means that every module — scheduling, billing, clinical documentation, pharmacy, radiology, lab, patient portal — talks to every other module natively, without the fragile middleware and integration layers that plague multi-vendor hospital systems. When a physician in an Epic hospital orders a medication, the pharmacy module sees it immediately. When a lab result comes back, it flows directly into the patient's chart. When a billing code is generated, it maps to the clinical documentation without manual reconciliation. This seamless integration is Epic's core product advantage, and it exists precisely because Epic builds everything itself.
The costs are also real. Epic's user interface, designed in-house, has been criticized by clinicians for decades as clunky, click-heavy, and contributing to burnout. The company's resistance to third-party innovation means that startups with better ideas for specific clinical workflows — ambient listening for clinical documentation, specialized AI tools for radiology, more intuitive patient-facing interfaces — face enormous barriers to integration. And Epic's control over its platform gives it extraordinary power over the healthcare technology ecosystem: it can effectively decide which innovations reach clinicians and which don't.
This is the paradox at the center of Epic's strategy. The same architectural choice that makes the software reliable also makes it rigid. The same control that ensures quality also stifles innovation. The same walls that protect intellectual property also create a walled garden that some hospitals, startups, and policy-makers increasingly view as a monopoly.
The Oracle at Redwood Shores
For most of its history, Epic's primary competitor was Cerner Corporation, founded in 1979 — the same year as Epic — in Kansas City, Missouri. Where Epic stayed private, Cerner went public in 1986. Where Epic refused acquisitions, Cerner grew through them. Where Epic built everything in Verona, Cerner assembled capabilities through purchases. The rivalry was fierce, personal, and defining for both companies.
Then, in 2022, Oracle acquired Cerner for approximately $28 billion — the largest acquisition in Oracle's history — and the competitive landscape transformed.
On paper, Oracle Health (as Cerner was rebranded) should be a formidable challenger. It contributed $5.9 billion in revenue to Oracle's fiscal 2023, putting it in the same revenue neighborhood as Epic. Oracle's founder,
Larry Ellison, has made healthcare a personal priority, spending extensive time at the company's annual Health Summit talking up AI-powered EHR capabilities. "Our user interface is so different than Epic's," Ellison told investors on a quarterly earnings call in September 2024.
The reality on the ground has been less impressive. In 2024, Oracle Health lost 74 hospital sites and 17,232 beds — while Epic gained 176 facilities and 29,399. For the first time, Oracle declined to share its list of new contracts with Klas Research, the industry's standard-bearer for vendor analysis, forcing Klas to estimate Oracle's market share. Customer loyalty ratings dropped more than 10 points after the Oracle acquisition, with hospital systems citing "poor partnership and a lack of follow-through on promises" as primary concerns.
Oracle's EHR software has been plagued by outages and rocky deployments. In one episode, Oracle engineers mistakenly caused a five-day software outage at several Community Health Systems hospitals, forcing facilities to activate downtime procedures and temporarily return to paper-based patient records. "Over the last decade, Epic has been the only vendor chosen by large health systems making go-forward EHR decisions," the Klas report concluded.
Beyond strictly technological considerations, Epic's reputation for customer partnership has brought them to the forefront of most EHR considerations.
The irony is thick. Oracle spent $28 billion to acquire Epic's chief rival, and the acquisition appears to have accelerated Cerner's decline. The integration challenges, the culture clash between Silicon Valley database engineers and Kansas City healthcare specialists, the distraction of merging systems — all of it created openings that Epic exploited. Ellison's ambition in healthcare is genuine, and Oracle's cloud infrastructure and AI capabilities are formidable. But enterprise healthcare software is not a database problem. It is a relationship problem, a workflow problem, a trust problem — and in those dimensions, Epic's 46-year head start and obsessive customer focus have proven nearly impossible to replicate.
The Cosmos Gambit
If Epic's first strategic era was building the best EHR, its second may be building the best data asset in healthcare.
In 2019, Epic launched Cosmos — a de-identified clinical data research platform that aggregates data from across Epic's customer base. The numbers are staggering: because Epic's software touches 325 million patient records across thousands of hospitals and clinics, Cosmos offers researchers, public health officials, and life sciences companies access to one of the largest longitudinal clinical datasets ever assembled. During the COVID-19 pandemic, Cosmos became a critical tool for tracking disease spread, treatment efficacy, and vaccination outcomes in near-real time.
The strategic implications go beyond research. As AI and machine learning reshape healthcare — in clinical decision support, drug discovery, population health management, and operational efficiency — the value of training data increases exponentially. Epic sits on a data asset that is, by at least one measure, unmatched: the most comprehensive, longitudinal, multi-specialty clinical dataset in the United States, possibly the world.
This is where Epic's flywheel takes on a new dimension. Every hospital that joins Epic adds its patient data to the network. Every patient record that flows through Epic's system enriches the Cosmos dataset. Every researcher or pharmaceutical company that uses Cosmos validates the platform's value, which makes Epic more attractive to the next hospital considering an EHR purchase. The data becomes a moat within a moat — a competitive advantage that compounds with every new customer, and one that no competitor can replicate without first achieving comparable market share.
The question is whether Epic will be an open steward of this data or a gatekeeper. The company's history suggests the latter. In 2024, Particle Health, a health data startup, filed an antitrust lawsuit against Epic, alleging that the company had blocked access to patient data through proprietary interfaces and restrictive practices. The lawsuit touched a nerve: the tension between Epic's role as the custodian of the nation's health data and its instincts as a private company protecting its competitive position is perhaps the defining tension of its next decade.
The Campus as Culture
Epic's 1,670-acre headquarters in Verona is not merely a workplace. It is a physical manifestation of Faulkner's worldview — a controlled environment designed to attract, retain, and acculturate a very specific type of employee.
The themed buildings — an Oz-inspired complex with a yellow brick road, a chocolate factory with giant chocolate chips at the entry, a Wizards Academy, a structure guarded by life-sized playing cards — are the most visible expression of Epic's culture, but they are not the most important. More telling are the practices: the mandatory monthly all-hands meetings in an underground auditorium called Deep Space (which some employees jokingly call "work church"), where executives discuss company news, objectives, and — remarkably — conduct grammar lessons on prepositions and pronoun usage. The promote-from-within policy, which means nearly every senior leader at Epic started as a recent college graduate in Verona. The expectation that employees live near campus. The rejection of remote work.
Faulkner noted during her 2024 keynote that the campus buildings and their upkeep account for 8% of the company's total expenses — a number she presented not as extravagance but as efficiency. It's cheaper to build in Verona than in San Francisco, Seattle, or New York. And in this small midwestern town, far from the churn and poaching of tech hubs, employees are less likely to leave.
The culture has its critics. Former employees describe an environment that can feel insular, even cultish — a sealed ecosystem where young recruits are immersed in Epic's way of doing things before they've had the opportunity to develop alternative frameworks. The promote-from-within policy, while creating deep institutional knowledge, also means that fresh perspectives from outside the Epic bubble are rare. And the centralization in Verona, while reducing costs and improving coordination, limits the diversity of the talent pool.
But the results are hard to argue with. Epic's employee retention, while not publicly disclosed, is widely regarded as exceptional for the tech industry. The company's ability to execute complex, multi-year hospital implementations — which require deep domain expertise, institutional continuity, and enormous coordination — is directly linked to a workforce that has spent years, sometimes decades, learning the Epic system from the inside. The campus is a factory for producing the specific type of human capital that Epic's business model requires.
Interoperability and Its Discontents
The single most politically charged word in healthcare technology is interoperability — the ability of different software systems to exchange patient data seamlessly. The ideal is that a patient's records should follow them wherever they go: from their primary care physician (on Epic) to an emergency room (on Oracle Health) to a specialist (on Athenahealth) to a rehab facility (on MEDITECH). The reality has been, for most of healthcare's digital era, a mess.
Epic's critics argue that the company has been the primary obstacle to interoperability. Ken Glueck, an executive vice president at Oracle, went so far as to call Faulkner "the single biggest obstacle to EHR interoperability" in a May 2024 blog post. The argument: Epic benefits from data lock-in. If patient data flows freely between systems, the switching costs that keep hospitals on Epic would diminish. Therefore, Epic has an incentive to make data exchange difficult — and, the critics allege, it has acted on that incentive through proprietary interfaces, restrictive data-sharing agreements, and foot-dragging on open standards.
Epic's defenders — and the company itself — counter that Epic has been an early adopter of interoperability standards, including FHIR (Fast Healthcare Interoperability Resources) and, more recently, TEFCA (Trusted Exchange Framework and Common Agreement), the federal government's framework for nationwide health data exchange. Epic's MyChart patient portal allows patients to access their records across institutions, and the company's Care Everywhere network facilitates data exchange between Epic sites and, increasingly, non-Epic sites.
The truth, as is often the case with Epic, sits in a productive ambiguity. The company has genuine incentives both to enable interoperability (customers demand it, regulators require it, and the Cosmos data platform benefits from broader data flows) and to constrain it (data lock-in is a real competitive advantage, and every third-party integration creates a potential attack surface). Faulkner has navigated this tension with characteristic pragmatism — moving far enough on interoperability to satisfy regulators and customers, while maintaining enough control over data flows to preserve Epic's strategic position.
[Judy Faulkner is] the single biggest obstacle to EHR interoperability.
The AI Frontier
Every major technology platform is, in 2025, making its AI bet. Epic is no exception — but its bet looks different from most.
The company has invested in AI across multiple dimensions: ambient clinical documentation (using AI to listen to doctor-patient conversations and automatically generate clinical notes), clinical decision support (surfacing evidence-based recommendations in real time), predictive analytics (identifying patients at risk of deterioration or readmission), and operational tools (optimizing scheduling, staffing, and revenue cycle management). At its 2024 Users Group Meeting, AI was a central theme, with Epic showcasing integrations with large language models and announcing partnerships with companies like Abridge, a startup specializing in AI-powered clinical documentation.
But the relationship between Epic and the AI startup ecosystem is, as Business Insider characterized it, "the messiest relationship in healthcare AI." Epic's platform control means it can bless or block AI startups that want to integrate with the EHR. Companies like Abridge have built businesses on Epic integration, only to find that Epic can develop competing functionality and route it through its own interface. The dynamic is familiar — it's the same platform leverage that Microsoft exercised in the 1990s, that Apple exercises through the App Store, that Amazon exercises in marketplace commerce. But in healthcare, the stakes are literally life and death, and the regulatory environment adds layers of complexity that don't exist in consumer technology.
Epic's data advantage through Cosmos positions it as potentially the most important AI company in healthcare — not because it builds the best models (it doesn't, and likely won't), but because it controls the data on which those models must be trained and the workflow into which they must be embedded. In AI, distribution and data are more valuable than model architecture. Epic has both.
The Weight of the System
The paradox of Epic's dominance is that the company that was supposed to modernize healthcare may now be the thing that healthcare needs to modernize around. Clinicians complain about click fatigue — the sheer volume of clicks required to document a patient encounter in Epic, a problem so widely documented that it has been linked to physician burnout. Startups complain about platform control — the difficulty of integrating novel tools into a system that was designed to be self-contained. Policy-makers worry about concentration — a single private company holding the health records of 90% of Americans, with no public shareholders, no SEC filings, and limited transparency into its operations.
Hospital consolidation has amplified Epic's position. When health systems merge — as they have at an accelerating rate over the past two decades — the combined entity typically standardizes on a single EHR platform. Because Epic is already the dominant player among large academic medical centers, it is almost always the platform that survives the merger. Each consolidation event further concentrates the market, creating a dynamic where Epic's share increases not just through new sales but through the structural reorganization of the American healthcare system.
And yet. Hospitals that use Epic consistently rate it higher than alternatives. The software, for all its flaws, works — in a domain where "working" means that medication orders don't get lost, that lab results reach the right physician, that billing codes match clinical documentation, that a patient's allergy information is visible to every caregiver they encounter. In a field littered with catastrophic implementations, where competing systems have caused medication errors, missed diagnoses, and — in at least one controversial study — higher death rates, Epic's reliability is not a marketing claim. It is a competitive moat.
The company doesn't follow a preordained budget. It has no board of directors in any conventional sense. Faulkner makes the major decisions. The Ten Commandments hang in the breakrooms. And the flywheel keeps spinning: better software attracts more hospitals, which generates more revenue, which funds more development, which produces better software, which attracts more hospitals.
A Swan in Verona
In August 2024, thousands of healthcare executives gathered on Epic's campus for the annual Users Group Meeting. Judy Faulkner, 81 years old, walked onto the stage of an arena-sized underground auditorium dressed in a swan costume. She told the assembled hospital CEOs, CIOs, and CMOs that the campus buildings account for 8% of Epic's total expenses. She reminded them that it's cheaper to build in Verona than in any tech hub in America. She talked about AI and interoperability and the future of clinical documentation. And then she went back to running the company she started in a basement 45 years earlier.
Somewhere in the audience was Sumit Rana, the newly named president, the man most likely to eventually succeed her. Somewhere in Oracle's headquarters in Austin, Texas, Larry Ellison was preparing his next pitch about the future of healthcare AI. Somewhere in a congressional office, a staffer was drafting language about health data interoperability. And somewhere in a hospital in Houston, or Cleveland, or Boston, a doctor was clicking through a patient's chart on a screen that was unmistakably, recognizably Epic.
Forty-two percent of the nation's hospital beds. Three hundred and twenty-five million patient records. $5.7 billion in revenue. Zero acquisitions. Zero investors. One founder, one campus, one codebase, one set of commandments printed in every bathroom.
The Data General Eclipse minicomputer is long gone. The basement on University Avenue is someone else's problem now. But the code Judy Faulkner started writing on that refrigerator-sized machine — rewritten, extended, rebuilt a thousand times over, running on modern infrastructure across thousands of hospitals — is, in a meaningful sense, still running. It holds the medical history of nearly every American who has ever seen a doctor. And it belongs, still, to one woman in a small town in Wisconsin who once dressed as a swan.
