4 ms·

Maybe. I worked for a time with Epic Systems, which is an EMR company that saw record growth in the 2000's, and they're still privately traded today because th

by bduerst 10y ago

Maybe. I worked for a time with Epic Systems, which is an EMR company that saw record growth in the 2000's, and they're still privately traded today because they didn't want to focus on the bottom line. Anyone in the know could possibly argue that the CEO is also a control freak, but she's used that control to keep the company focused on a high-quality/safe user experience for patients, which isn't a bad thing IMO.

siculars 10y ago
...and monopolistic control over that EMR via no HL7 integration.
- bduerst 10y ago
  Epic Bridges sends/receives HL7 messages to just about any software with an interface. I'm not sure what you're talking about.
  - casparz 10y ago
    In addition to that, they are well underway to supporting HL7 FHIR (the new version of HL7).
    - siculars 10y ago
      When I can do bidirectional programmatic interface to Epic let me know. I won't hold my breath.
  - eonw 10y ago
    I wasn't on the team that implemented this at a large healthcare provider, but i remember that team bitched about it a lot. its also mentioned as a compliant on EPICs wikipedia article.
    - deleted 10y ago
      [deleted]
    - deleted 10y ago
      [deleted]
    - bduerst 10y ago
      That's because healthcare interfaces are terribly difficult to work with, because they're the worst of two worlds - mountains of bureaucracy mixed with different tech stacks from different eras.
      - siculars 10y ago
        You don't have to search too hard to read horror stories about interfacing with Epic. In practice EMR vendors are financially disincentivized from interfacing with anyone. To your point, why, specifically, is it so difficult to interface with these systems? Could it be by design?
        bduerst 10y ago
        Right, because you're searching for stories about interfacing with Epic and they have 50% of the patient marketshare. That's how appeals to popularity work. You still didn't elaborate on why you said Epic has no HL7 integration.
logfromblammo 10y ago
I also worked at Epic for a while; CEO was definitely a control freak at that time. I consider it very likely that she has not changed in that respect. I was promised employee stock at hiring. The company shortly thereafter reneged and substituted a "shadow stock" plan. The rationale I was given explicitly mentioned that having too many private stockholders would trigger mandatory financial reporting, and that the company would rather give me the finger than its balance sheet. It was just one of the many reasons why I left. The company was fueled entirely by the inherent brokenness of the US health care complex. It seemed to be metaphorically powered by shoveling fat stacks of $100 bills directly into the fireboxes of pre-Watt Newcomen steam engines. They didn't even bother with the seemingly simple expedient of converting the $100 bills into $1 bills to increase the available fuel supply. The end product that was visible to the customer was good, but it almost certainly cost several orders of magnitude more to produce it than was strictly necessary.
- stephencanon 10y ago
  > The end product that was visible to the customer was good This would be news to my wife (a surgeon), or any one of her coworkers. The software is universally viewed as terrible by everyone I've talked to. It actively results in worse records because (at least as configured) it's so cumbersome to use that many notes are frequently kept out of the system. A management plan that takes seconds to explain verbally requires minutes of data entry.
  - bduerst 10y ago
    The thing about Epic Hyperspace is that it's polarizing for those who work in the medical profession. You either love it or you hate it, and the physicians who hate it typically hate it because of what you said - they're suddenly having to type their own notes into a computer rather than dictate it to someone else. Personally I'm of the opinion that doctors doing their own data entry is better for liability and malpractice reasons, but I empathize with your wife and people who hate doing it.
    - stephencanon 10y ago

by bduerst 10y ago

siculars 10y ago

...and monopolistic control over that EMR via no HL7 integration.

bduerst 10y ago
Epic Bridges sends/receives HL7 messages to just about any software with an interface. I'm not sure what you're talking about.
- casparz 10y ago
  In addition to that, they are well underway to supporting HL7 FHIR (the new version of HL7).
  - siculars 10y ago
    When I can do bidirectional programmatic interface to Epic let me know. I won't hold my breath.
- eonw 10y ago
  I wasn't on the team that implemented this at a large healthcare provider, but i remember that team bitched about it a lot. its also mentioned as a compliant on EPICs wikipedia article.
  - deleted 10y ago
    [deleted]
  - deleted 10y ago
    [deleted]
  - bduerst 10y ago
    That's because healthcare interfaces are terribly difficult to work with, because they're the worst of two worlds - mountains of bureaucracy mixed with different tech stacks from different eras.
    - siculars 10y ago
      You don't have to search too hard to read horror stories about interfacing with Epic. In practice EMR vendors are financially disincentivized from interfacing with anyone. To your point, why, specifically, is it so difficult to interface with these systems? Could it be by design?
      - bduerst 10y ago
        Right, because you're searching for stories about interfacing with Epic and they have 50% of the patient marketshare. That's how appeals to popularity work. You still didn't elaborate on why you said Epic has no HL7 integration.

logfromblammo 10y ago

I also worked at Epic for a while; CEO was definitely a control freak at that time. I consider it very likely that she has not changed in that respect. I was promised employee stock at hiring. The company shortly thereafter reneged and substituted a "shadow stock" plan. The rationale I was given explicitly mentioned that having too many private stockholders would trigger mandatory financial reporting, and that the company would rather give me the finger than its balance sheet. It was just one of the many reasons why I left. The company was fueled entirely by the inherent brokenness of the US health care complex. It seemed to be metaphorically powered by shoveling fat stacks of $100 bills directly into the fireboxes of pre-Watt Newcomen steam engines. They didn't even bother with the seemingly simple expedient of converting the $100 bills into $1 bills to increase the available fuel supply. The end product that was visible to the customer was good, but it almost certainly cost several orders of magnitude more to produce it than was strictly necessary.

stephencanon 10y ago
> The end product that was visible to the customer was good This would be news to my wife (a surgeon), or any one of her coworkers. The software is universally viewed as terrible by everyone I've talked to. It actively results in worse records because (at least as configured) it's so cumbersome to use that many notes are frequently kept out of the system. A management plan that takes seconds to explain verbally requires minutes of data entry.
- bduerst 10y ago
  The thing about Epic Hyperspace is that it's polarizing for those who work in the medical profession. You either love it or you hate it, and the physicians who hate it typically hate it because of what you said - they're suddenly having to type their own notes into a computer rather than dictate it to someone else. Personally I'm of the opinion that doctors doing their own data entry is better for liability and malpractice reasons, but I empathize with your wife and people who hate doing it.
  - stephencanon 10y ago