Epic antimicrobial stewardship module vs third-party stewardship software, what an Epic hospital should build and what it should buy
If your hospital runs Epic, someone will ask why you would pay for a stewardship platform when Epic has a module. The published builds answer it better than any sales deck: the module works, and it takes years of analyst and pharmacist time to get there.
8 min read
The Epic antimicrobial stewardship module is the set of stewardship alerts, patient lists and reports that an Epic hospital builds inside its own EHR, usually alongside Bugsy, Epic's infection control application. It costs little in new license fees for a hospital that already has the pieces, and a great deal in analyst and pharmacist hours. Third-party platforms such as Sentri7, VigiLanz and TheraDoc arrive with a maintained rules library and charge an implementation fee plus an annual license. Neither route produces a CLSI M39 antibiogram without work, which is the piece Antimicrobe sells on its own for $249 a month.
This is written for the stewardship pharmacist, ID physician or pharmacy director at an Epic hospital who has to recommend build or buy. Epic does not publish its build documentation, so Epic is described here from published hospital experience, and the other vendors from their own product pages.
What the Epic stewardship module does in published builds
Stanford Health Care reported one of the early builds in Open Forum Infectious Diseases in 2016 (Mui and colleagues). Their module used rules for restricted antimicrobial orders, bug-drug mismatch, duplicate spectrum coverage, and Staphylococcus aureus or yeast in blood cultures, with a patient-level stewardship dashboard. After go-live the share of restricted antimicrobial orders that received audit and feedback rose from 64 to 92 percent, review time fell from 41 hours to 14, time to appropriate therapy for Enterococcus faecium bacteremia dropped from 18 hours to 9, and monthly interventions went from 58 to 80.
Johns Hopkins described its build in the American Journal of Health-System Pharmacy in 2021 (Dzintars and colleagues): customized alerts and a scoring system to triage patients, an intervention database, and Reporting Workbench reports for stewardship needs. Their conclusion is the one worth quoting to your CIO: customizing a stewardship module in the EHR takes significant time and expertise, and a team of stewardship physicians, pharmacists and Epic IT staff.
The University of Vermont Medical Center went the other way in 2019, leaving a third-party platform for Epic when it moved to the EHR. Its 2024 report in Antimicrobial Stewardship and Healthcare Epidemiology (Smith and colleagues) describes four years of optimization after the switch: an indication library for every antimicrobial, an on-demand 72-hour report of new starts, and a SlicerDicer dashboard of prescribing by indication, dose, clinician and department.
If the mismatch rule is the main thing you want, the vendors that sell it as part of a platform are compared in bug-drug mismatch software for hospitals, with the alert hit rates one hospital measured.
What third-party stewardship software adds
The enterprise platforms sell what a small team cannot build: a rules library that the vendor maintains, worklists that pull from the EHR, lab and pharmacy feeds, and NHSN AUR reporting that is already certified. Wolters Kluwer describes Sentri7 as NHSN validated and ONC certified with one-click AUR submission, and Sentri7 took both the 2026 Best in KLAS pharmacy surveillance and infection control segments. Inovalon sells VigiLanz in tiers, from a Starter tier for AUR collection at small hospitals up to Pro, which adds IV-to-PO, EHR-embedded alerts and antibiogram data. Premier describes TheraDoc as real-time alerts with automated NHSN reporting tools, for acute and post-acute care.
None of them publishes a price. VigiLanz discloses in its ONC certification materials that it charges a one-time implementation fee and an annual license, which is the usual model. The cost you will be quoted depends on bed count, modules and how the platform is bundled with other products.
If you are already talking to these vendors, the Sentri7 vs TheraDoc vs VigiLanz comparison covers their differences, and the Sentri7 alternatives and VigiLanz alternatives pages cover the rest of the field. Which AUR products NHSN has validated, Epic Bugsy included, is in antimicrobial use software for NHSN AUR reporting.
Epic module, third-party platform or antibiogram tool, side by side
| Option | Who builds and maintains the rules | NHSN AUR | Antibiogram | Price published |
|---|---|---|---|---|
| Epic stewardship module (with Bugsy) | Your pharmacists and Epic analysts | Bugsy is certified for AUR | Reporting Workbench or Clarity report you validate | No; cost is mostly build hours |
| Sentri7 (Wolters Kluwer) | Vendor library, configured with you | Yes, one-click per vendor | Yes, per vendor page | No |
| VigiLanz (Inovalon) | Vendor library, by tier | Yes, from Starter | Pro tier | No |
| TheraDoc (Premier) | Vendor rules, configured with you | Automated NHSN reporting tools | Not on current product page | No |
| Antimicrobe | Nothing to build; rules are CLSI M39 | No | Yes, it is the product | Yes, from $249 a month |
Is the Epic stewardship module enough for a community hospital?
Usually yes for alerts and worklists, if IT will give you the build time. A community hospital on Epic, including one on a Community Connect instance hosted by a larger system, already pays for the EHR, and the stewardship rules that matter most (restricted drugs, bug-drug mismatch, positive blood cultures, IV-to-oral) are well described in the published builds. The catch is the queue. At a hosted instance, changes go through the host's analysts, and a stewardship request competes with every other department.
The module is weaker where a vendor library saves real work: keeping hundreds of rules current as drugs and guidance change, and reporting across several hospitals on different EHRs. A system that runs Epic in some hospitals and something else in others is the classic buyer for a third-party platform.
The full shortlist by EHR, IT time and pharmacist hours is in best antimicrobial stewardship software for community hospitals.
How much does the Epic antimicrobial stewardship module cost?
Epic does not publish prices, and most of the cost is not a license line. It is analyst time to build and test rules and reports, pharmacist time to specify them, and the same again at every upgrade. The Johns Hopkins and Vermont reports both describe multi-year work by a combined clinical and IT team. If your hospital does not already license the infection control application, ask your Epic representative what adding it costs before you assume the module is free.
Compare that with a third-party platform's implementation fee plus annual license, and with the cost of the one report neither fixes cleanly, the cumulative antibiogram.
Where the antibiogram fits in either choice
Alerts and the antibiogram are different jobs. The module and the platforms act on individual patients today. The antibiogram summarizes a year of finalized susceptibility results so the committee can set empiric guidance, and it follows CLSI M39: first isolate per patient per organism, no percentage under 30 isolates, urine and non-urine split, breakpoint version stated.
In Epic that report comes from Beaker's Reporting Workbench or a custom Clarity query, and someone has to check its de-duplication logic against M39 every year. Many Epic hospitals keep the module for alerts and move only the antibiogram out: a quarterly export from Beaker or the micro instrument goes into a tool built for that report, and the Epic analysts stay on the alerts.
The Epic antibiogram routes and the five M39 checks are covered in antibiogram software for Epic hospitals. The report itself, with prices, is on hospital antibiogram software.
Questions to settle before you recommend build or buy
That last question decides the timeline more often than the clinical ones. Put the renewal date and notice period for your current surveillance vendor into your contract management software before the evaluation starts, so an auto-renewal does not make the decision for you.
- How many analyst hours will IT commit to stewardship this year and next, in writing
- Does the hospital already license Bugsy, and who owns AUR submission today
- Which of the published rule sets (restricted drugs, bug-drug mismatch, blood culture alerts, IV-to-oral) do you need at go-live, and which can wait
- Do all your hospitals run the same Epic instance, or will you need rules across different EHRs
- Who produces the annual antibiogram, and has anyone checked it against M39 since go-live
- If you already have a platform contract, when does it renew and what notice does it require
A simple way to decide
Build in Epic if you run one Epic instance, IT will commit the hours, and a stewardship pharmacist can own the rules for years. Buy a platform if you run several EHRs, need AUR certified this year without a build, or cannot get into the analyst queue. In both cases, decide the antibiogram separately. If the Workbench report passes the M39 checks, keep it. If it takes a week of cleanup each year, move it to a tool that exists for that report and keep your analysts on the alerts.
Antimicrobe's Lab plan builds the hospital antibiogram from a CSV export for $249 a month, bought by card with no implementation fee. The Stewardship plan at $749 adds unit and syndrome cuts, quarterly trends and MDRO alerts.
Related on this site: bug-drug mismatch software compared, antibiogram software for Epic hospitals, Sentri7 alternatives, TheraDoc alternatives, best antimicrobial stewardship software, Epic Bugsy alternatives.