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Startup Particle Health files antitrust lawsuit against Epic alleging it uses monopoly power to block competition


September 23, 2024

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"If left unfettered, Epic’s conduct will snuff out meaningful competition in the still- fledgling payer platform market, relegating yet another market to Epic’s monopoly control," Particle Health alleged in the lawsuit. (Fierce Healthcare)

Editor's note: This story has been updated with a statement from Epic


What began as a dispute between two health tech companies over healthcare data exchange practices has now led to a federal lawsuit alleging antitrust violations.


Venture-backed health tech company Particle Health filed an antitrust lawsuit against Epic in the Southern District of New York alleging that the electronic health records (EHR) giant is trying to muscle out competition.


The 81-page lawsuit (PDF), filed today, alleges Epic engaged in monopolistic, anti-competitive practices, using its "power over EHRs to expand its dominance into the fledgling market for payer platforms," according to the lawsuit, which was reviewed by Fierce Healthcare.


"Epic has used its position of dominance to worm its way to the core of the U.S. healthcare system and stamp out competition in a wide variety of interrelated markets, thereby generating billions of dollars for itself," Particle claimed in the complaint.


Particle Health argues in its federal complaint that Epic has not only engaged in anticompetitive behavior but has purposefully blocked the exchange of patient information.

In an emailed response to Fierce Healthcare, an Epic spokesperson said Particle’s claims are baseless.


"This lawsuit attempts to divert attention from the real issue: Particle’s unlawful actions on the Carequality health information exchange network violated HIPAA [Health Insurance Portability and Accountability Act] privacy regulations. Particle’s complaint mischaracterizes Carequality’s decision, which in fact proposes banning Particle customers that were accessing patient data for impermissible purposes," the Epic spokesperson said.


"Epic’s software is open and interoperable, allowing healthcare organizations to easily share data under HIPAA and all relevant regulations. Epic will continue to protect patient privacy and vigorously defend itself against Particle’s meritless claims," the spokesperson said.


The suit seeks an adjudication that Epic has violated the Sherman Act as well as monetary damages and injunctive relief compelling Epic to cease its anticompetitive conduct.


"Epic is using its monopoly power over electronic health records (EHRs) to bar Particle from the fledgling payer platform market —just one example of Epic plotting to 'snuff out' competition in new markets that leverage medical records," Particle Health executives said in a press release.


“Epic Systems controls the medical information of nearly every American—meaning one private company has unchecked power over our health care,” said Particle Health CEO Jason Prestinario in a statement. “Now, Epic is using that power to thwart an emerging industry intended to bring payers and providers into closer collaboration for better patient care.”


With a 36% market share of the hospital sector, Epic is a dominant force in the health IT industry. Particle Health claims that Epic controls the health information of up to 94% of Americans. Epic launched its payer platform in 2021.


Particle Health, founded in 2018, is a data platform that aggregates health information for digital health companies through APIs, providing access to more than 300 million patients’ medical records. Particle’s platform provides both a record retrieval service, which allows users to interface with EHR companies like Epic to smoothly request medical records at scale, and an analytics service, which allows users to efficiently store and monitor trends in the medical records they request. 


It’s one of many startups that act as data connectors between Epic and its provider customers, like hospitals and medical practices, and other healthcare stakeholders, like digital health companies. Much like Stripe makes using credit care networks easier, companies like Particle Health, Health Gorilla and Zus Health provide an easier connection to data networks so organizations can get access to the data they need.


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