If you are searching for an Epic App Orchard strategy, start with the program's current name. App Orchard became App Market, and Epic then replaced it with Connection Hub and Showroom. A good Epic strategy today is less about winning a listing and more about proving one clinical use case with one health system, then building a repeatable path to the next.
I advise healthcare SaaS founders, and investors who back them, on exactly this decision. The question I hear most is not "How do we get into the marketplace?" It is "Will an Epic integration actually produce revenue, and when?" This guide answers both.
TL;DR
- App Orchard no longer exists as a gate. Epic launched Showroom in January 2024 as the place to discover products that work with Epic, and a listing is optional once your app is live with an Epic customer.
- A listing is distribution, not adoption. Each health system decides whether to approve and switch on your app.
- Build in the sandbox, pick one narrow clinical workflow, and involve customer IT and operations early.
- Treat Epic as a sales channel tied to your outbound motion. Investors should evaluate pilot-ready workflow fit, not listing status.
Table of Contents
- What happened to Epic App Orchard
- How the current Epic pathway works
- Why a listing does not equal adoption
- When pursuing Epic makes strategic sense
- How to prepare before you approach an Epic customer
- How long does it take?
- What investors should evaluate
- Our perspective on Epic strategy
- Work with The StartUp MD
- FAQ
- Sources
What happened to Epic App Orchard
Epic launched App Orchard in January 2016 as its original third-party app store, designed to connect vendors with Epic customers. It later became App Market. By December 2022, Epic said the program had grown beyond 800 groups. Epic planned a smaller, more focused successor because that scale created market confusion and made focused support harder.
After the App Market closed in late 2022, Epic introduced Connection Hub and launched Showroom in January 2024. Showroom is a broader destination for finding products and services that work with Epic, not only apps.
This matters for strategy because many articles and forum threads still describe the old process: apply, wait for a review queue, pass a gate, appear in the store. That model is gone. If your plan is built around it, you are planning for a program that has been retired.
What a listing does and does not mean
Epic has been explicit that participation is not endorsement. An Epic executive told Fierce Healthcare that being in the App Market was not meant to signal co-development, an Epic seal of approval, or an Epic recommendation. The listing terms carry the same discipline: developers may use Epic's trademarks only under its guidelines and must not imply endorsement, certification, sponsorship, or affiliation.
So write your website and pitch deck accordingly. "Integrates with Epic" is accurate when it is true. "Epic certified" or "Epic approved" is not something you can claim.
How the current Epic pathway works
Epic's integration model is federated. Each Epic customer runs an independent instance and decides which apps can connect. Epic provides APIs, developer tools, and client IDs, but production implementation, configuration, testing, and go-live are coordinated directly with each customer.
That single fact reshapes the whole strategy. There is no central approval that unlocks every Epic hospital. There are many individual decisions, made by individual health systems, each with its own priorities and review process.
Technical pathways
Epic's own getting-started guidance lists SMART on FHIR, backend services, and bulk data as the main pathways. In practice:
- SMART on FHIR suits apps that launch inside the clinician's workflow and read or write patient-level data with user context.
- Backend services suit system-to-system integrations that run without a user in the loop, such as analytics or population-level processes.
- Bulk data suits large-scale export for analytics and quality reporting.
Match the pathway to the workflow, not to what your engineers find easiest. A clinician-facing decision support tool built as a backend job will never appear where the clinician works. If you are choosing between approaches, our guide on launching SMART on FHIR apps without weeks of vendor review covers the practical tradeoffs.
Connection Hub and Showroom
Epic's guidance is to request a Connection Hub listing for a live product with at least one Epic connection. The fee is $500 per product per year, non-refundable. That is a trivial cost next to the engineering and clinical effort behind the integration, which is the point: the listing is not where the money or the difficulty sits.
Also note the order of operations. Epic's developer resources say a Showroom listing is optional after an app goes live with an Epic customer. You can connect through a customer-specific implementation first. The listing follows the traction, it does not create it.
Why a listing does not equal adoption
This is the misunderstanding that costs startups the most time. A Showroom listing makes an app discoverable. It does not make it automatically available to clinicians, and each health system decides whether to approve it and turn it on.
The API subscription agreement is blunt about responsibility. Health systems are responsible for vetting API users and products, testing them, and authorizing them before enabling interaction with their Epic software. Epic also states that it does not test or oversee the products that interact with its software; the customer must vet them and make sure they meet its requirements.
Three practical consequences follow:
- Your real buyer is the health system. The CMIO, the clinical champion, IT security, and procurement decide your fate, not Epic.
- An individual physician cannot simply download your app. Adoption is an organizational decision, so your sales motion has to reach the people who can authorize it.
- Security review happens per customer. Showroom visibility does not replace a BAA, a SOC 2 report, or each hospital's own security review, as one vendor's explainer puts it.
If you have not yet mapped how hospitals take on new vendors, read our healthcare SaaS founder's guide to hospital vendor onboarding before you plan your first pilot.
When pursuing Epic makes strategic sense
Not every healthcare technology company should lead with Epic. It makes sense when three conditions hold.
Your target customers run Epic. Epic dominates large inpatient systems, but ambulatory groups, behavioral health, post-acute, and community settings use a wide mix of platforms. Check your actual pipeline before you commit engineering months.
Your product's value depends on being in the workflow. If clinicians must leave the chart to use you, adoption suffers. If your product sits comfortably outside the EHR, such as a patient-facing app or a standalone operational tool, a deep integration may be premature.
You have a clinical use case narrow enough to prove. Epic's own guidance for AI and advanced applications says the most successful developers start small: they solve specific clinical use cases to build trust and gather metrics, rather than attempting large integrations that are hard to validate and maintain.
That last point is the heart of an Epic strategy. The wrong plan is "integrate everything, then sell." The right plan is "integrate one workflow, prove one outcome, then expand."
Integration is a product decision, not an IT task
Founders often hand Epic integration to engineering and wait. The better approach starts with the workflow: who touches this task today, what data they need at that moment, and what they would do differently with your tool. Our piece on a workflow-first EHR integration strategy lays out how to cut integration time by designing the clinical flow before the interface. Teams that treat integration as a wider data and systems problem may also find this overview of CRM and systems integration strategy useful for thinking about how connected tools fit into one operating stack.
If you also sell into systems that run a different EHR, the same workflow-first logic applies, and our guide to Cerner integration provisioning and clinical fit shows how the steps differ.
How to prepare before you approach an Epic customer
Use this sequence as a working checklist.
- Define the clinical use case. One user, one workflow, one measurable outcome. Write the success criteria before anyone writes code. Epic's guidance points to specific workflows, clear success criteria, and tight iterative loops with pilot users.
- Build and test in the sandbox. Epic directs developers to develop and test in the open.epic sandbox and to involve customer operations and IT early. Do not wait until a contract to talk to the hospital's integration team.
- Limit your data scope. Common failure points in review include overly broad FHIR scopes and missing or incomplete security attestation. Request only the resources your workflow needs, and be able to explain why.
- Assemble your security package. Have your BAA language, security questionnaire answers, and independent audit reports ready. Hospitals will ask, and slow answers read as immaturity.
- Secure a design partner. A live connection at one Epic customer is what unlocks a Connection Hub listing, and it is also the proof every later prospect asks for.
- Then list. Once you have a live product with at least one Epic connection, request the listing and keep your claims within Epic's trademark and endorsement rules.
Listing terms are also worth a careful read. Submissions that are false, disparaging, or contain malicious code are prohibited, and Epic reserves the right to terminate listings at its discretion without prior notice. Treat your listing copy like regulated marketing: accurate, specific, and defensible.
How long does it take?
This is the question with the least reliable answer, and you should be skeptical of any single number. Older articles quote review windows of several weeks for App Orchard submissions, but that program is retired, and today the clock is set by several things at once:
- Your technical readiness: sandbox testing, scope design, and security documentation.
- Epic's listing steps, which only begin when you have a live product with an Epic connection.
- The customer's governance: clinical review committees, security assessments, contracting, and build scheduling for their Epic team.
- Competing priorities at the health system, which is often the largest variable. Epic upgrades, other vendor projects, and budget cycles all push a start date.
Because production implementation is coordinated directly with each customer, the honest planning approach is to build timelines per customer, not per marketplace. For fundraising models, I advise founders to show time-to-first-live-site from real pilots rather than a generic assumption. Check Epic's official developer resources for current listing steps before you commit dates to a board deck or investor update.
What investors should evaluate
If you back healthcare SaaS companies, an Epic integration claim deserves the same diligence as any revenue claim. Ask these questions.
| Question | What a strong answer looks like |
|---|---|
| Is the integration live at a customer? | A named or referenceable Epic site in production, not a sandbox demo |
| What is the clinical workflow? | One specific use case with a defined user and a measured outcome |
| Who authorized deployment? | A clinical sponsor and IT approval, not a one-off exception |
| How is the listing used in sales? | Wired into outbound selling, with reference customers, not treated as a lead source |
| What is the data scope? | Narrow, justified FHIR resources and completed security attestation |
| Can it repeat? | A documented implementation playbook for the second and third site |
That last point connects to sales. Industry commentary frames marketplace listings as distribution channels that de-risk sales rather than passive lead generators, and they work best when tied to an existing outbound strategy. A company that expects inbound demand from a listing alone is modeling revenue that will not arrive.
Pricing is the other half of the model. Integration cost, implementation effort, and what the customer will pay all interact, and our piece on what health systems will pay for healthtech helps frame that conversation.
Our perspective on Epic strategy
We see the same pattern in healthcare SaaS companies again and again. A team spends months on integration engineering, secures a listing, and then waits for demand that does not arrive. The listing was never the product. The workflow was.
What changes outcomes is clinical credibility at the point of decision. A health system evaluating your app is asking whether it will help a clinician in a real encounter, whether it adds clicks, and whether it creates risk. Those are medical leadership questions as much as technical ones, and they are answered by someone who has practiced, who understands how care teams actually work, and who can sit across from a CMIO or a physician champion and speak their language.
That is the gap a fractional Chief Medical Officer is built to close. We help healthcare SaaS leaders choose the first clinical use case, define success criteria a hospital will respect, shape the pilot, prepare the clinical and regulatory narrative, and support investor conversations about what an Epic integration will and will not deliver.
If your Epic plan feels misaligned with how your buyers decide, I would welcome a conversation.
Paul Bergeron MD, MBA
Work with The StartUp MD
The StartUp MD is a healthcare advisory firm for healthcare SaaS and digital health companies. We offer Fractional Chief Medical Officer leadership and advisory services covering clinical strategy, product evaluation, regulatory guidance, clinical operations, market readiness assessment, and investor support. If you are deciding whether, when, and how to pursue Epic, we can help you build the clinical case before you build the integration.
See how we work on the Fractional CMO and advisory services page, or start from The StartUp MD.
FAQ
Is Epic App Orchard still available?
No. Epic moved from App Orchard to App Market, closed the App Market in late 2022, and then introduced Connection Hub and launched Showroom in January 2024. Search results still surface App Orchard material, so check the date on any guide you rely on.
Can a physician download an app from Epic's marketplace?
Not on their own. A listing makes an app discoverable, but each health system decides whether to approve it and enable it. Adoption is an organizational decision that involves clinical leadership, IT, and security.
How much does an Epic listing cost?
Epic's listing terms set the Connection Hub fee at $500 per product per year, non-refundable. That figure covers the listing only. It does not include the cost of building, testing, securing, and implementing the integration with each customer.
Do we need a listing to connect to Epic customers?
No. Epic's developer resources say a listing is optional after an app is live with an Epic customer, and connectivity can happen through a customer-specific implementation. The customer still controls whether the app is authorized and deployed.
What is the most common reason integrations stall?
Usually it is scope and workflow rather than the technology. Overly broad FHIR scopes and incomplete security attestation are known failure points, and a use case that is too broad makes pilots hard to validate. Start with one narrow workflow and measure it.
Sources
- Epic launches new Showroom site for third-party apps, Fierce Healthcare
- Epic plans to overhaul its app market, Fierce Healthcare
- open.epic Developer Resources
- Epic Getting Started guide
- Developing and Deploying AI in Healthcare, Epic
- Connection Hub Listing Terms, Epic
- Epic API Subscription Agreement
- What is the Epic Showroom?