Checklist: Critical Components of an Epic EHR Implementation TCO

A total cost of ownership (TCO) for an Epic electronic health record (EHR) implementation accounts for the direct and indirect costs (typically broken down by capital expenses and operating expenses) related to launching an Epic EHR system. Most often, TCOs are based on a 10-year time period for hospitals, health systems, and other large healthcare organizations. They help these organizations and their partners, like Medix Technology, set the budget and stay on track throughout the project.

A TCO includes a number of critical components which must be accounted for during a healthcare organization’s implementation planning process. Missing a single component can result in exceeding budget, so it’s vital to be organized and thorough from the start. Below is a checklist of the critical components, along with some related details.


Epic EHR Implementation TCO Checklist

  • Software One-Time Costs – Relatively large costs paid up front or over a certain period of time
    • Licenses – Necessary to use the products you have purchased, may be perpetual or termed in nature
  • Software Recurring Costs – Regularly recurring costs in various capacities
    • Subscription Fees – Ongoing usage fees
    • Recurring Maintenance Costs – Mostly consist of annual support fees
  • Professional Services and Labor Fees – Can make up to 75% of total cost over 10 years
    • Implementation Services – Epic and third-party fees related to implementation time and materials
    • Internal Labor Costs – Support team costs, high up-front compared to long-term
    • Training and Post-Live Training – Includes initial post-live training and ongoing training for new users
    • Go-Live Support – Usually a fixed cost during the go-live event
    • Third-Parties and Interface Reconfiguration – For various support technologies which must be reconfigured and connected to work alongside Epic
    • Hosting – Hosting of actual software, recurring cost
    • Travel Expenses – For vendors, advisory partners like Medix Technology, etc.
  • Physicals
    • Rooms and Working Space – Place for Epic IT team to work and collaborate, rooms for end-user training, etc.
    • Hardware – May need to upgrade devices and hardware to support software
  • Contingency – Buffers for when things go off track on overall TCO or for specific line items
  • Legacy System Savings – Sunsetting systems which are no longer needed


While this checklist can be used as a starting point when developing your organization’s TCO, know that TCOs are complex and layered. There are countless other details to discuss for each line item. During your Epic implementation’s planning phase, we recommend seeking outside advisory or consulting to help create your TCO—and to help with your governance model, timelines, and other important elements. Here at Medix Technology, we offer EHR advisory services so that you can create an accurate TCO, kicking off an implementation project that is on budget and on time, with the highest levels of user satisfaction.

For more details on an Epic implementation TCO, watch our on-demand webinar, “Calculating Total Cost of Ownership for Your Epic Implementation and Staying on Track,” which is a part of our Digital Healthcare Technology Summit.

Are you planning for an upcoming implementation? Do you need additional optimization and support staff? Wherever you are in your Epic journey, Medix Technology can help you make the most of it. Get in touch, and tell us about your needs.

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