With that idea in the back of my mind, I called an editorial meeting in early February to discuss our June issue — the HCI 100.

The June issue is our largest of the year, containing a ranking of the top 100 HIT vendors by revenue, along with (in the past) different types of company profiles. These profiles came in three versions — ‘Headliners,’ ‘Up and Comers,’ and ‘Others to Watch.’ The definitions for these sections was difficult even for our staff to articulate, thus selecting the companies for them had become a confusing exercise.

Additionally, the ranking had become of questionable value, as it relied solely on vendor-submitted data — those opting out received no mention at all, leaving glaring holes in our listing. Also, perhaps due to a poorly constructed questionnaire, some companies were submitting — and being ranked according to — total revenues, rather than only HIT revenues. This wreaked havoc in the ranking, to the amusement of some readers and the embarrassment of our staff.

In fact, Daphne Lawrence, our senior associate editor, came to me after our last ranking with some critical blog fodder that laid into the 100. ‘It's not that good, but it's the best thing that's out there,’ was the sentiment of the posting (Lawrence recently blogged about this: http://www.healthcare-informatics.com/lawrence_100).

What to do? The safe (but losing) bet is always to keep doing what's been done. But my books and magazines on finding success (my wife tells friends I'm trying to take over the world) tell me that's just not good enough. If you know it's broken, fix it. So we set about doing just that. (Read the details in our intro to the 100 package, page 52)

Profiles in confusion

After developing an improved methodology for the ranking, we turned our attention to the various types of profiles and quickly came to the realization that we didn't have to do them if we didn't want to. Sure that sounds simple, but I bet you can name at least five projects or processes you're bound to just because, ‘Things have always been done that way.’ Well, I am lucky enough to be in a position where 99 percent of the time, I'm not bound to anything that doesn't work.

We did want to do some type of feature, however, that would complement the 100 ranking. So we decided upon one major, in-depth vendor profile where we'd let the readers decide the subject. Leveraging the strengths of the Internet and our interactive Web site, we posted a simple question: ‘The vendor I would most like to read an in-depth profile about is ….’ With eight choices, the field was open. The results were clear: Epic Systems Corporation received 39 percent of the vote, with Eclipsys coming in a distant second at 14 percent.

The result was certainly not a shock. Epic has always been considered interesting, if for nothing else than the fact that company executives don't ‘talk’ much. The only time one hears about the company is in blog chatter when it's inked another deal. The predominant knock on Epic it that its products and services are very expensive, but also very good. The most interesting rumor — you don't pick them, they pick you.

Ironically, exactly what made Epic interesting as a profile subject also meant it would be difficult to pull off — namely, the fact that its executives don't talk. Specifically, the company's intriguing founder, Judith Faulkner, very rarely gives interviews, though we are proud to say she did speak to HCI a number of years ago for a short profile piece in the 100 ranking. It seems that rather than touting initiatives or customer wins, Epic prefers to stay out of sight. This goes doubly true for Faulkner. In fact, Internet searches yielded no photos of her.

After first thinking, ‘Forget it, there's a good chance we won't be able pull the story off,’ my journalistic instincts thankfully kicked in. ‘I don't care if they're not going to talk,’ I rebounded. ‘We're going to do a top-notch profile, with our without their cooperation,’ I told HCI Contributing Editor Mark Hagland.

Right before HIMSS, Hagland began contacting Epic, pitching the story and trying to arrange interviews with executives. Of course, an interview with Faulkner was the main, albeit elusive, goal. With a tepid initial reception, we put the project on hiatus and packed our bags for HIMSS in Orlando.

Fate lends a hand

With the refined focus of HCI on acute care CIOs, this year I was invited to the CHIME CIO pre-conference symposium at HIMSS. The symposium was an all-day affair, featuring talks on leadership and change management — crucial skills for any CIO to be successful in today's complex environment.

Fast forward to the buffet line at the KLAS/William Blair reception on Monday night (Feb. 25). I was grabbing some food when that same hard-working reporter from the CHIME forum got on line behind me. She looked at my name badge and said, ‘Hi, Anthony. It's nice to meet you.’ I looked down to find her name (we all know that ‘I'm-trying-to-be-smooth-about-reading-your-name-badge’ moment), expecting to see some variation of, ‘Sally X, Advance for Healthcare IT Data Management Technology News Executives.’ Instead I saw, ‘Judy Faulkner, CEO, Epic Systems.’

I nearly dropped my mini-quiche.

‘I hear you want to do a story on us,’ she said.

‘Well, I guess I'd say we are doing a story on you, but we'd love for you to be a part of it,’ I responded.

Far from being distant and reclusive, as I might have presupposed, Faulkner was accessible and engaging, talking frankly about her plans for the company and the philosophical principles upon which it's been built. I, in turn, told her my vision and goals for our brand, and how I wanted to be every bit as valuable to my readers as she was to her customers. I think it's safe to say that we hit it off.

I had a few e-mail exchanges with Faulkner after that, as Hagland pursued interviews with senior Epic executives through other channels. Before agreeing to the interviews, Faulkner gave me a call. At issue were two requests: there would be no photos taken of her and she didn't want to ‘sit down’ for a formal interview. On both issues, we agreed. No photos of her would be taken, and walking and talking would do just fine. But Faulkner had one more concern before giving the green light — she was worried that doing an interview with HCI meant she'd have to do interviews with ‘everyone else.’ (See the aforementioned Advance for Healthcare IT Data Management Technology News Executives.)

‘Is Epic like everyone else?’ I shot back.

‘Certainly not,’ she replied.

‘Neither is HCI. That's why we're a perfect fit,’ I said.

Half-amused with my amateur lawyering, Faulkner agreed to do the interview. In fact, she invited me and Mark Hagland to the company's Verona, Wis., campus, generously blocking off about four hours of time with herself and other top Epic executives. The result of that day and countless other interviews is Mark Hagland's story — the most revealing and comprehensive profile on Epic ever written.

Give it a shot

I think a number of lessons can be taken from this little anecdote. First off, break free from the past by reexamining everything you and your organization do in a new light — the light of a clean slate. More specifically, look at both what you do and what you don't do. Critically evaluate all recurring projects and processes one at a time. Ask yourself and others, ‘Should we be doing this at all? Are we doing this the best way? Is this the best use of our time and resources or could they be better put to use elsewhere? Does this activity line up with our mission? Do we even have a mission?’

As you read our Epic profile, one of the dynamics that stands out is the company's commitment to its mission and values. Epic employees at all levels know what the company is about, and that allows them to make a million little decisions which further that mission. Going outside those bounds is eschewed as a waste of time (thus, the company turns away unsuitable business). But this yields a tremendous bounty. Think of compound interest — when you stay within your mission, you not only gain from the specific task, but the knowledge attained from its execution is plowed back into the company's intellectual capital pool.

Just as Epic has the discipline of turning away business that doesn't fall within the parameters it has established, HCI has the discipline not to follow stories that fall outside the scope of our core readership. As a CIO, have you established a mission statement for your department — one that lives comfortably under the overall organization's mission? Doing so will help you and your staff make a million little decisions without agonizing over each one. Doing so will also help you break away from past practices that don't fall in line with that mission.

But there's one other striking feature of Epic that I believe translates directly into the company's success — Faulkner is in the unique position of being at the head of a massive company where she is the final arbiter of all decisions. This yields tremendous consistency, as she must green-light any compromises (and Faulkner is tremendously disciplined). There is no public board, there is no private equity partial owner, there are no public shareholders. Epic is a mom and pop operation on steroids. Today, small businesses are usually the only kind of entity where ‘the boss’ is really the boss.

Epic has been successful because of a combination of two things — one person's vision has been executed without being diluted or mangled, and it's a good, sound vision. Though Faulkner would probably be horrified to think of it this way, a good analogy is how, every once in a while during the age of royalty, a good and benevolent king or queen would come along, making tremendous changes for the people. Faulkner might be thought of as a good queen, but what happens when the queen is gone? And who will be her replacement?

When embarking on this story, that was the number one concern of Epic customers. Her response in Hagland's piece will likely do little to dampen concerns that in fair Verona sits a queen, and what happens when she's gone may be the stuff of Shakespeare.