Athena and Epic are two different healthcare technology systems, and the choice between them depends on your organization’s size, specialty, and budget. Athena (often called athenahealth) is a cloud-based practice management and EHR platform known for its revenue cycle services, while Epic is a large, customizable EHR system typically used by large hospitals and health systems. This article explains the key differences, costs, and considerations to help you decide which fits your needs.
Background: What Are Athena and Epic?
Athenahealth was founded in 1997 and offers a suite of cloud-based services including electronic health records (EHR), practice management, and patient engagement tools. Its flagship product, athenaOne, combines these into a single platform designed for ambulatory practices, from small clinics to large medical groups. Athena is known for its revenue cycle management (RCM) services, where the company handles billing and collections on behalf of providers.
Epic Systems Corporation, founded in 1979, is a privately held company that develops one of the most widely used EHR systems in the United States. Epic’s software is installed on-premises or hosted in the cloud and is used by many of the nation’s largest hospitals, academic medical centers, and integrated delivery networks. Epic is known for its comprehensive functionality, interoperability (via its Care Everywhere network), and its ability to manage complex inpatient and outpatient workflows.
How They Work: Architecture and Deployment
The most fundamental difference is deployment. Athena is a true software-as-a-service (SaaS) product: you access it via a web browser, and athenahealth manages the servers, updates, and security. This reduces the need for an internal IT team to maintain hardware. Epic, on the other hand, traditionally requires a significant on-premises installation with dedicated servers and IT staff, though Epic now offers a hosted option (Epic Cloud) for some clients.
Athena’s cloud model means that all users share the same version of the software, and updates are rolled out automatically. Epic gives organizations more control over customization and upgrades, but this also means they must manage the upgrade process themselves, which can be resource-intensive. Both systems offer mobile apps and patient portals, but Epic’s patient portal (MyChart) is more widely recognized among patients.
Key Differences: Features and Functionality
Athena excels in practice management and revenue cycle. Its RCM services are a major selling point: athenahealth handles claim submission, payment posting, and denial management, often improving collections. The platform also includes appointment scheduling, patient communication, and a robust EHR with specialty-specific templates.
Epic is a more comprehensive EHR that covers both inpatient and outpatient care. It includes modules for surgery, radiology, laboratory, pharmacy, and population health. Epic’s interoperability is a strong point—its Care Everywhere network allows different healthcare organizations to share patient records securely. However, Epic’s sheer size means it may be overkill for a small practice.
How to Choose: Which One Fits Your Practice?
Choosing between Athena and Epic should be based on your organization’s size, workflow, and financial resources. Here are some practical considerations:
- Practice size: Athena is ideal for small to mid-sized ambulatory practices (1-100 providers). Epic is designed for large hospitals, health systems, and academic centers.
- Budget: Athena typically has lower upfront costs (subscription-based) and no hardware purchase. Epic requires a large initial investment for licensing, implementation, and hardware.
- Revenue cycle needs: If you need help with billing and collections, Athena’s RCM services are a major advantage. Epic’s RCM is more traditional and requires your staff to handle billing.
- Specialty: Athena offers strong templates for many ambulatory specialties. Epic has deep functionality for inpatient and complex care, but may require more customization for niche ambulatory workflows.
- IT resources: Athena requires minimal IT support. Epic demands a dedicated IT team for maintenance and upgrades.
Common Problems and Misconceptions
One common misconception is that Athena is only for small practices. While it started that way, athenahealth now serves large medical groups and some hospitals, but its core strength remains ambulatory care. Another misconception is that Epic is only for hospitals—Epic’s ambulatory module (Epic Ambulatory) is widely used, but it is often part of a larger health system deployment.
Common complaints about Athena include limited customization compared to Epic, and some users report that the software can be slow during peak hours. Epic’s common problems include high costs, long implementation times (often 1-3 years), and a steep learning curve. Both systems have had usability criticisms, but Epic’s complexity is often cited as a barrier to physician satisfaction.
Costs and Implementation
Cost is a major differentiator. Athena charges a subscription fee, typically a percentage of practice collections (often around 5-10%) or a per-provider monthly fee. This model includes software, support, and RCM services. There is no large upfront license fee, but you may have implementation and training costs.
Epic’s pricing is not publicly disclosed, but it is known to be among the most expensive EHR systems. The initial license can cost millions of dollars for a large health system, plus implementation fees that can be several times the license cost. Annual maintenance fees are also substantial. For a small practice, Epic is usually cost-prohibitive.
Alternatives to Consider
If neither Athena nor Epic seems right, there are other EHR options. For small practices, Kareo (now Tebra) and Practice Fusion offer low-cost, cloud-based EHRs. For mid-sized groups, eClinicalWorks and NextGen are popular. For large organizations, Cerner (now part of Oracle Health) is a direct competitor to Epic, and Meditech is another hospital-focused system. Each has its own strengths, so it’s wise to evaluate multiple vendors.
Frequently Asked Questions
Is Athena or Epic better for a small practice? Athena is generally better for a small practice because it is cloud-based, has lower upfront costs, and includes revenue cycle services. Epic’s cost and complexity are usually not justified for a small practice.
Can Athena be used in a hospital? Athena has some hospital solutions, but it is not designed for full inpatient care. Most hospitals use Epic or Cerner for inpatient EHR. Athena is best for outpatient and ambulatory settings.
Which system has better patient portal? Epic’s MyChart is widely regarded as one of the best patient portals, with features like appointment scheduling, test results, and messaging. Athena’s patient portal is functional but less polished.
How long does it take to implement Epic vs Athena? Athena can be implemented in a few weeks to a few months, depending on practice size. Epic implementation typically takes 1-3 years for a large health system, due to its complexity and customization.
Is Athena or Epic more user-friendly? Athena is generally considered more user-friendly because it is simpler and web-based. Epic is powerful but has a steep learning curve and many screens.
Does Epic work with other EHRs? Yes, Epic has a robust interoperability network called Care Everywhere, which allows secure sharing of patient records with other organizations using different EHRs. Athena also supports interoperability via standard protocols like HL7 and FHIR.
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