Particle v. Epic: Healthcare's Latest David & Goliath Story

In the electronic health records (“EHR") space, there is one player who undeniably sits ahead of the rest: Epic.^[1] Epic was founded in 1979 in Wisconsin and is the EHR vendor for over 40% of hospitals, beating its closest competitor’s market share two-fold.^[2] Epic is a $5 billion company employing 14,000 people.^[3] Those familiar to the Philadelphia region have likely interacted with the healthcare information giant through the MyChart app, Epic’s patient-facing interface, used by local healthcare systems Main Line Health, Penn Medicine, and CHOP.^[4] Clearly, Epic is ubiquitous.^[5] 

So, when Particle Health (“Particle”), a comparatively tiny competitor, challenged Epic in court in 2024 for antitrust violations, the industry took notice.^[6]

Particle was founded in 2018 in New York City.^[7] It employs fewer than 50 people and is focused on analytical connectivity to unify patient records across data sources.^[8] This is a growing area of focus in healthcare because success in population health initiatives requires historic and real-time data on the patient population being managed to identify high-risk patients, utilization trends, and actionable data opportunities.^[9] Notably, there is a broader industry shift from fee-for-service contracting toward population health and risk-based contracting for the dual purposes of 1) shifting industry focus from sick-care to proactive health-care and 2) creating more financial opportunity for providers as fee-for-service margins compress.^[10]

Epic and Particle’s legal battle in Particle Health Inc. v. Epic Systems Corp. (“Particle v. Epic”)[11] originated out of a dispute Epic filed with Carequality, a nationwide healthcare information exchange (“HIE”).[12] Both Epic and Particle began offering payer platform products a few years prior to the dispute, so participating in the Carequality HIE allowed them to access more patient records for their payer platform clients.[13] In March 2024, Epic blocked data from being accessible to certain Particle customers on Carequality, alleging those customers were misusing Epic’s data by using it for non-clinical treatment purposes.^[14] Particle responded to Epic’s complaint to Carequality in May 2024, stating that Epic’s allegations were unfounded and caused Particle’s business to suffer significantly (i.e., Epic would allow Particle customers to access its data “if and only if” they left Particle’s platform).

^[15] The dispute resolution process continued through summer of 2024, during which time Particle approached Epic several times to discuss implementing resolution measures, but Epic declined to participate in discussions.[16] In August 2024, the Dispute Panel provided written recommendations for Particle to implement in a six-month corrective action plan.[17] The Carequality dispute stunted Particle’s business growth after years of upward trajectory.[18]

In September 2024, Particle filed suit against Epic in federal court in the Southern District of New York.[19] Particle brought nine claims for violations of the Sherman Antitrust Act, including two claims of tortious interference, one claim for violation of New York business law, one claim of defamation, and one claim of libel.[20] Epic filed a 12(b)(6) motion to dismiss in December 2024,[21] arguing that the claims were “baseless” and that Epic was “within its rights to protect patient data.”[22]

In September 2025, the court ruled on the motion.[23] Judge Buchwald dismissed five of the claims and allowed four to survive: monopolization, attempted monopolization, monopoly leveraging claims in violation of the Sherman Act, and tortious interference.[24]

This is a big win for Particle.[25] Particle stood up to a healthcare giant, showing that it won’t be intimidated and it has what it takes to proceed in the adversarial system.[26] Particle’s CEO celebrated that this is the first time an antitrust lawsuit against Epic has progressed this far.[27]

However, the reality facing Particle as it moves through the litigation process is anything but easy.[28] For its monopolization claim, for instance, Particle has done enough to survive a motion to dismiss by “rais[ing] a non-speculative inference that Epic’s actions were uneconomic and inconsistent with the rational behavior of a legitimate competitor.”[29] As Judge Buchwald wrote, whether or not Particle can establish “willful acquisition of market power” in trial “remains to be seen.”[30] Though the action has moved into discovery, Judge Buchwald has limited the discovery scope to three narrow questions regarding the payer platform market.[31] Particle has pushed for a much broader scope, but neither Epic nor Judge Buchwald have supported this interpretation.^[32] As one data interoperability writer put, “[t]he judge let this claim survive only because Particle’s alleged 'payer platform' market is plausible at the pleading stage. If Particle can’t prove payer platforms are distinct from broader EHR products, the case could collapse.”[33]

Though the litigation between Epic and Particle is still in process, it has brought several considerations to light to entrepreneurs and lawyers alike. First, given that clinical data is held by so many disparate entities, what does it look like to play nice in the sandbox?[34] Healthcare data and informatics is a complicated space, with many companies claiming to have the intellectual bench to provide the next greatest clinical solution.[35] We are seeing new companies spring up, as well as industry giants horizontally expand into new services.[36] The[RM1]  lack of interconnectivity continues to drive poor outcomes, wasteful spending, and frustrating patient experiences.[37]

Second, Particle v. Epic shines a light on the emerging challenge of data governance in a world of interoperability and data sharing.[38] This case originated out of an alleged violation of proper data usage for payer and provider clients to access patient medical records.[39] There are regulations in place to protect patient data; there are frameworks in place to regulate how data is used within HIEs; and yet this litigation is surviving in federal court.[40] Who polices the use of medical data? How will lawsuits like this impact who is accessing data and how they can use it?  How can entrepreneurial organizations protect themselves in the normal course of business?

This dispute does not appear poised to resolve anytime soon, and in fact, the situation is getting messier: in January 2026, Epic sued Health Gorilla for illegally accessing patient records.^[41] Health Gorilla has denied the accusations.^[42] The litigation over clinical data access and use will continue to inform our understanding of data privacy and company cooperation (or lack thereof) in our current competitive landscape.[43]

^[1] See Maggy Bobek, Most Common Hospital EHR Systems by Market Share, Definitive Healthcare (May 7, 2025), https://www.definitivehc.com/blog/most-common-inpatient-ehr-systems; Top 10 Ambulatory EHR Vendors, Definitive Healthcare (Oct. 15, 2025),  https://www.definitivehc.com/blog/top-ambulatory-ehr-systems.

^[2] See Epic Systems, Forbes (last updated Dec. 17, 2025), https://www.forbes.com/companies/epic-systems/; Bobek, supra note 1; Top 10 Ambulatory EHR Vendors, supra note 1.

^[3] See Epic Systems, supra note 2.

^[4] See Naomi Diaz, Health Systems Begin Activating Epic’s New Features, Becker’s Health IT (Nov. 21, 2025), https://www.beckershospitalreview.com/healthcare-information-technology/ehrs/health-systems-begin-activating-epics-new-features/; Naomi Diaz, Penn Medicine, Epic Reimagine Clinic Design Together, Becker’s Health IT (Jan. 14, 2026), https://www.beckershospitalreview.com/healthcare-information-technology/ehrs/penn-medicine-epic-reimagine-clinic-design-together/; Joseph Goedert, Main Line Health Goes Live on Epic With Device Integration, Health Data Mgmt. (May 4, 2018), https://www.healthdatamanagement.com/articles/main-line-health-goes-live-on-epic-with-device-integration.

^[5] See Giles Bruce, Epic’s Dominance in 12 Numbers, Becker’s Health IT (July 18, 2024), https://www.beckershospitalreview.com/healthcare-information-technology/ehrs/epics-dominance-in-12-numbers/.

^[6] See Maya Goldman, Health Records Giant Epic Hit With Antitrust Suit, Axios (Sep. 24, 2024), https://www.axios.com/2024/09/24/antitrust-lawsuit-filed-ehr-giant-epic.

^[7] See Particle Health - Company Profile, Tracxn (last updated Feb. 2, 2026), https://tracxn.com/d/companies/particle-health/__-rhmOY9Q_QtqAsC0WCA-UZi_m0r9uivaNvTjmHD4s0o.

^[8] See id.; Particle Health, LinkedIn, https://www.linkedin.com/company/particle-health/ (last visited April 1, 2026).

^[9] See generally Contract and Risk Management, Healthcare Fin. Mgmt. Assn. (2023), https://www.hfma.org/wp-content/uploads/2023/07/Contract-and-risk-management.pdf.

^[10] See How Shifting to Value-Based Care Benefits Physicians and Patients, ChenMed (Mar. 18, 2025), https://www.chenmed.com/blog/how-shifting-value-based-care-benefits-physicians-and-patients. 

[11] No. 24 Civ. 7174 (NRB), 2025 WL 2581579 (S.D.N.Y. Sep. 5, 2025).

[12] See id. at *2.

[13] See Heather Landi, Particle Health's Antitrust Lawsuit Against Epic Moves Forward After Judge Denies Full Dismissal, Fierce Healthcare (Sep. 8, 2025), https://www.fiercehealthcare.com/health-tech/particle-healths-antitrust-lawsuit-against-epic-moves-forward-after-judge-dismisses.

^[14] See Naomi Diaz, Epic and Particle Health’s Dispute: A Timeline, Becker’s Health IT (Jan. 17, 2025), https://www.beckershospitalreview.com/healthcare-information-technology/ehrs/epic-and-particle-healths-dispute-a-timeline/; Particle Health Inc., supra note 11, at *4-5.

^[15] Particle Health Inc. v. Epic Sys. Corp., 2025 WL 2581579 at  2, 5-6. 

[16] See id. at *5.

[17] See id. 

[18] See id. at *6. 

[19] See id. 

[20] See id.

[21] See id.

[22] Diaz, supra note 14.

[23] See Andrea Fox, Judge Denies Full Dismissal of Particle's Antitrust Case Against Epic, Healthcare IT News (Sep. 9, 2025), https://www.healthcareitnews.com/news/judge-denies-full-dismissal-particles-antitrust-case-against-epic.

[24] Particle Health Inc. v. Epic Sys. Corp., 2025 WL 2581579 at  *23.

[25] See Landi, supra note 13 (“Particle Health . . . claimed victory”).

[26] See id.

[27] See id.

[28] See id.

[29] Particle Health Inc. v. Epic Sys. Corp., 2025 WL 2581579 at  *16.

[30] Id.

[31] Id. at  *11.

^[32] See Particle Health Inc. v. Epic Sys. Corp., 1:24-cv-07174, (S.D.N.Y. Sep. 15, 2025) ECF No. 47, https://www.courtlistener.com/docket/69184842/47/particle-health-inc-v-epic-systems-corporation/; Particle Health Inc. v. Epic Sys. Corp., 1:24-cv-07174, (S.D.N.Y. Oct. 03, 2025) ECF No. 43 https://www.courtlistener.com/docket/69184842/43/particle-health-inc-v-epic-systems-corporation/.

[33] Landi, supra note 13 (quoting Brandon Keeler).

[34] See Deven McGraw & Carolyn Petersen, From Commercialization to Accountability: Responsible Health Data Collection, Use, and Disclosure for the 21st Century, Applied Clinical Informatics (May 20, 2020), https://pmc.ncbi.nlm.nih.gov/articles/PMC7239667/.

[35] See Maia Anderson, Healthcare Interoperability is Ripe for Startup Disruption, Experts Say, Healthcare Brew (June 24, 2023), https://www.healthcare-brew.com/stories/2023/06/24/healthcare-interoperability-is-ripe-for-startup-disruption-experts-say.

[36] See id.; Naomi Diaz, Epic’s Biggest Moves so Far in 2025, Becker’s Health IT (July 21, 2025), https://www.beckershospitalreview.com/healthcare-information-technology/ehrs/epics-biggest-moves-so-far-in-2025/; Heather Landi., Digital Health Startups Raise $3B in Q1 as Market Faces Near-Term Uncertainty, Fierce Healthcare (Apr. 7, 2025), https://www.fiercehealthcare.com/digital-health/digital-health-startups-raise-3b-q1-market-faces-uncertainty-rock-health.

[37] See Peter Pronovost, et al., Procuring Interoperability p. 5–13 (Nat’l Academy of Medicine 2018), https://www.ncbi.nlm.nih.gov/books/NBK594851/pdf/Bookshelf_NBK594851.pdf; Judith Graham, In Days Of Data Galore, Patients Have Trouble Getting Own Medical Records, KFF (Oct. 25, 2018), https://kffhealthnews.org/news/in-days-of-data-galore-patients-have-trouble-getting-own-medical-records/; Harlan Krumholz, Opinion: It's Your Right To See Your Medical Records. It Shouldn't Be This Hard To Do, NPR (Aug. 28, 2019), https://www.npr.org/sections/health-shots/2019/08/28/754725843/opinion-its-your-right-to-see-your-medical-records-it-shouldn-t-be-this-hard-to-.

[38] See Heather Landi, Epic's Lawsuit against Health Gorilla Raises Broader Issues About the Future of Data Sharing, Industry Executives Say, Fierce Healthcare (Jan. 16, 2026), https://www.fiercehealthcare.com/health-tech/epics-lawsuit-against-health-gorilla-raises-broader-issues-about-future-data-sharing.

[39] See id.

[40] See id.

^[41] See Andrea Fox, Epic and Health Systems Sue Health Gorilla and Data Companies, Healthcare IT News (Jan. 13, 2026),

https://www.healthcareitnews.com/news/epic-and-health-systems-sue-health-gorilla-and-data-companies.

^[42] See id.

[43] See Steve Alder, Epic Sues Health Information Exchange Network Alleging Improper Record Access, HIPAA J. (Jan. 16, 2026), https://www.hipaajournal.com/epic-sues-health-information-exchange-network-improper-record-access/.

 [RM1]Added this sentence -- just wanted to confirm the citations are OK.