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# Epic’s EU Opportunity, Doctolib’s Threat
- URL: https://marginsofcare.com/epics-eu-opportunity-doctolibs-threat/
- Published: 2026-09-03T20:01:56.000Z
- Updated: 2026-09-04T06:50:36.000Z
- Author: Eva Worst

Yesterday I wrote how ChatGPTs integration with Epic is nothing new for Epic itself - there wasn’t even a press release from their side about it! -, even as it is table stakes for OpenAI in their effort to become the new home for healthcare. The big question in my eyes is what’s in it for Epic? 

At the same time, many of those announcement and capabilities are understandably focused on the US market, seemingly avoiding the EU. Indeed, Epic holds around 43% of the US market share and is reportedly used “only” in around 100 organisations in Europe, but they surely are setting up camp and [quietly preparing](https://www.kma-online.de/aktuelles/it-digital-health/detail/us-anbieter-epic-gewinnt-kis-ausschreibung-54974?ref=marginsofcare.com) their first rollout in Germany.

Charite CMIO Felix Balzer shared in March with respect to the [planned Epic integration](https://www.bibliomedmanager.de/fw/artikel/55025-warum-die-entscheidung-auf-epic-fiel-und-wie-der-go-live-gelingt?ref=marginsofcare.com) (translated):

> MyChart (patient portal) will complement the solution funded by the Hospital Future Act (currently Doctolib) and integrate them into a transitional architecture. In the future, MyChart will take over key functions: appointment booking, communication, and results feedback. Our goal is a shared architecture in which patients can actively participate and securely access information on their devices.

When asked about the expected challenges around the implementation, he replied (translated, emphasis mine):

> First, we need to get the green light for funding. Then we'll move on to building additional teams, harmonizing clinical processes, **and reducing interfaces**. Much of this is more process-related than software-related. That's why we're investing the nine months of lead time in governance, analysis, and preparation.

Germany is needless to say a very attractive market for any company, and Epic specifically, so winning one of the biggest hospitals in the country as a pilot customer is no small feat, that will likely convey enough credibility for other hospitals to follow suit.

This is bad news for smaller and more specialised players such as Doctolib, who has so far made good progress in filling the gaps left by current HIS providers. But those gaps are closing on one hand by companies like Epic which provide the functionality natively, reducing the amount of interfaces and with that the cognitive load and workflow time as well. And on the other hand by companies like [Avelios](https://marginsofcare.com/avelios-helios-and-the-his-opportunity/) which by the nature of being a cloud-native can easily commoditise individual tools, making them to a large extend interchangeable.

In the [Ways of the Workflow](https://marginsofcare.com/the-ways-of-the-workflow/) I wrote: 

> The first idea is that specialised AI tools - for example for [diagnosis, documentation or billing](https://marginsofcare.com/clinician-economics-part-2/) \- will need to be managed and orchestrated into a single smooth workflow. The opportunity is in owning and orchestrating the workflow for individual clinical domains and in that commoditising those AI tools, which now become just another API call.

> The second idea is that there is no point trying to repair the existing system, and that instead the whole thing should to be remade. Don’t digitise the workflow; redesign it.

> The third idea is that whoever owns the data, owns the workflow and thus has decision power. If you become the system of record, you become the place where actions take place. This is what Big MedTech is best positioned to do. Companies like Siemens Healthineers and GE Healthcare are already well established within clinics and already enable the generation of [proprietary data](https://marginsofcare.com/pharma-ai-acquisitions-data-origins/). For them to expand their moats, they’d need to integrate vertically, and that’s exactly what they [have been doing](https://www.siemens-healthineers.com/press/releases/cmd2025?ref=marginsofcare.com).

Those three models can co-exist and attach to the specific realities of different hospitals. It would be interesting to see how that plays out and how will newcomers like OpenAI approach the EU market with all of its unique rules.