6 ms·

Also, I've never heard a good thing about Epic...

conanbatt 7y ago
It's made in Visual Basic, and it literally cannot interact with its own versions. Hospitals have different versions of the same system in the same building and cant exchange information. All EMR's suck though. (note: I made one)
- Ididntdothis 7y ago
  ”It's made in Visual Basic” We shouldn’t feed the illusion that old stacks are inherently bad and that new stacks will magically solve all problems.
  - slumdev 7y ago
    Nobody makes this complaint about C++ (which is older) or Java (which is almost as old.)
    - Ididntdothis 7y ago
      Sure people do.
      - slumdev 7y ago
        I think it's a matter of having the right tool for the job. If someone wanted to write a modern website in C++, I'd probably gripe about that. But Java, with either J2EE or Spring? No complaints here. VB just isn't appropriate anywhere anymore.
        Ididntdothis 7y ago
        Every app has to start somewhere and will after a while be outdated. Whatever problems EPIC has are most likely not because of VB but because of bad management. I work in medical and I see almost every day management decisions that will lead to future software problems but nobody in leadership understands or wants to understand. Have a problem? Just throw the cheapest offshore team you can find at it. Repeat that a few times and you have a completely incoherent architecture. You will get this result with any stack. I certain wouldn’t advocate using VB for new code. All I am saying is that the real problem is not the stack.
        conanbatt 7y ago
        This 'app' charges in the range of 6 digits yearly per provider.
- stevula 7y ago
  I’ve always heard it was programmed in MUMPS
  - shigawire 7y ago
    MUMPS in the back. Front is c# and typescript replacing the much maligned VB.
- noelsusman 7y ago
  It's written in MUMPS.
- dekhn 7y ago
  This is only my individual anecdote, but when I switched between two EPIC-using care providers (Kaiser->Anthem/Sutter), once I provided consent they pulled all my records over and 5 minutes later I was talking to a new doctor who had all the info from my previous doctor. All EMRs suck though.
  - conanbatt 7y ago
    Yes, but that only works epic-to-epic. If you go to a non-epic place, epic will send you a 100 page PDF.
- tbyehl 7y ago
  Some of a competing EMR is PowerBuilder. Hopefully not the one you made ;-)
- braindeath 7y ago
  The front-end is in Visual Basic. The backend is most certainly not in anything close to Visual Basic.. (MUMPS - using Intersystems Cache as the object store implementation)
logfromblammo 7y ago
Worked for Epic after the dot-com crash, as they were finishing up their Verona headquarters. I will tell you one good thing about it: underground parking. That matters in Wisconsin. All of the good things I could tell you that I remember about Epic have zero relationship with the software they sell. And none of them could stop me from leaving, because the software was the job. It was all essentially gold spray paint on a turd.
skwb 7y ago
It's very du joure to talk bad about Epic (and certainly not without reason re: HHS healthcare interoperability proposed rules) but they have been a huge success from a business perspective. The reason why they provide EHR support for the majority of large healthcare system hospitals is that they provide a lot of flexibility to implimentation. If you want the ability to support some very unique functionality, they will find a way to help support it. In a business that is almost nothing but edge cases (almost all of healthcare is complex, which is why you need 8+ years of training), you need lots of custom software behavior to fit these needs. The UCSF switch from GE healthcare to Epic about a decade ago is the prime example of what value Epic. [1, 2]. [1]. https://www.wired.com/2015/03/how-technology-led-a-hospital-to-give-a-patient-38-times-his-dosage/ https://www.wired.com/2015/03/how-technology-led-a-hospital-... [2]. https://www.forbes.com/sites/zinamoukheiber/2012/04/18/epic-systems-tough-billionaire/#5887a58558d9 https://www.forbes.com/sites/zinamoukheiber/2012/04/18/epic-...
- JshWright 7y ago
  They're in a very different market from Practice Fusion though. There aren't many small/independent practices rolling out Epic deployments...
  - skwb 7y ago
    Now you're right in that traditionally Epic has served larger healthcare systems and tertiary hospitals, (hell they have even been known to turn down customers), but I think there's potentially a bit of role reversal on the horizon. Some Epic deployments have been creeping into community groups through licensing agreements [1, 2]. Probably makes more sense if you want your clinic pop to have greater access to tertiary services. It's something I would keep my eye on within the EHR business space. Also, my previous comment was in response to no one liking Epic though, so certainly on topic. [1]. https://health.ucsd.edu/news/releases/Pages/2015-05-06-uc-san-deigo-health-system-enters-agreement-with-ECRMC.aspx https://health.ucsd.edu/news/releases/Pages/2015-05-06-uc-sa... [2]. https://ucsdhn.org/providers/physician-network/advantages/technology/Pages/default.aspx https://ucsdhn.org/providers/physician-network/advantages/te...
  - 7y ago
stevula 7y ago
That’s because their customer is the institution, not the provider. The experience of the end user is probably not even in their top 3 priorities (similar to other enterprise software like Atlassian).

It's made in Visual Basic, and it literally cannot interact with its own versions. Hospitals have different versions of the same system in the same building and cant exchange information. All EMR's suck though. (note: I made one)

Ididntdothis 7y ago
”It's made in Visual Basic” We shouldn’t feed the illusion that old stacks are inherently bad and that new stacks will magically solve all problems.
- slumdev 7y ago
  Nobody makes this complaint about C++ (which is older) or Java (which is almost as old.)
  - Ididntdothis 7y ago
    Sure people do.
    - slumdev 7y ago
      I think it's a matter of having the right tool for the job. If someone wanted to write a modern website in C++, I'd probably gripe about that. But Java, with either J2EE or Spring? No complaints here. VB just isn't appropriate anywhere anymore.
      - Ididntdothis 7y ago
        Every app has to start somewhere and will after a while be outdated. Whatever problems EPIC has are most likely not because of VB but because of bad management. I work in medical and I see almost every day management decisions that will lead to future software problems but nobody in leadership understands or wants to understand. Have a problem? Just throw the cheapest offshore team you can find at it. Repeat that a few times and you have a completely incoherent architecture. You will get this result with any stack. I certain wouldn’t advocate using VB for new code. All I am saying is that the real problem is not the stack.
        conanbatt 7y ago
        This 'app' charges in the range of 6 digits yearly per provider.
stevula 7y ago
I’ve always heard it was programmed in MUMPS
- shigawire 7y ago
  MUMPS in the back. Front is c# and typescript replacing the much maligned VB.
noelsusman 7y ago
It's written in MUMPS.
dekhn 7y ago
This is only my individual anecdote, but when I switched between two EPIC-using care providers (Kaiser->Anthem/Sutter), once I provided consent they pulled all my records over and 5 minutes later I was talking to a new doctor who had all the info from my previous doctor. All EMRs suck though.
- conanbatt 7y ago
  Yes, but that only works epic-to-epic. If you go to a non-epic place, epic will send you a 100 page PDF.
tbyehl 7y ago
Some of a competing EMR is PowerBuilder. Hopefully not the one you made ;-)
braindeath 7y ago
The front-end is in Visual Basic. The backend is most certainly not in anything close to Visual Basic.. (MUMPS - using Intersystems Cache as the object store implementation)

logfromblammo 7y ago

Worked for Epic after the dot-com crash, as they were finishing up their Verona headquarters. I will tell you one good thing about it: underground parking. That matters in Wisconsin. All of the good things I could tell you that I remember about Epic have zero relationship with the software they sell. And none of them could stop me from leaving, because the software was the job. It was all essentially gold spray paint on a turd.

skwb 7y ago

It's very du joure to talk bad about Epic (and certainly not without reason re: HHS healthcare interoperability proposed rules) but they have been a huge success from a business perspective. The reason why they provide EHR support for the majority of large healthcare system hospitals is that they provide a lot of flexibility to implimentation. If you want the ability to support some very unique functionality, they will find a way to help support it. In a business that is almost nothing but edge cases (almost all of healthcare is complex, which is why you need 8+ years of training), you need lots of custom software behavior to fit these needs. The UCSF switch from GE healthcare to Epic about a decade ago is the prime example of what value Epic. [1, 2]. [1]. https://www.wired.com/2015/03/how-technology-led-a-hospital-to-give-a-patient-38-times-his-dosage/ https://www.wired.com/2015/03/how-technology-led-a-hospital-... [2]. https://www.forbes.com/sites/zinamoukheiber/2012/04/18/epic-systems-tough-billionaire/#5887a58558d9 https://www.forbes.com/sites/zinamoukheiber/2012/04/18/epic-...

JshWright 7y ago
They're in a very different market from Practice Fusion though. There aren't many small/independent practices rolling out Epic deployments...
- skwb 7y ago
  Now you're right in that traditionally Epic has served larger healthcare systems and tertiary hospitals, (hell they have even been known to turn down customers), but I think there's potentially a bit of role reversal on the horizon. Some Epic deployments have been creeping into community groups through licensing agreements [1, 2]. Probably makes more sense if you want your clinic pop to have greater access to tertiary services. It's something I would keep my eye on within the EHR business space. Also, my previous comment was in response to no one liking Epic though, so certainly on topic. [1]. https://health.ucsd.edu/news/releases/Pages/2015-05-06-uc-san-deigo-health-system-enters-agreement-with-ECRMC.aspx https://health.ucsd.edu/news/releases/Pages/2015-05-06-uc-sa... [2]. https://ucsdhn.org/providers/physician-network/advantages/technology/Pages/default.aspx https://ucsdhn.org/providers/physician-network/advantages/te...
- 7y ago

stevula 7y ago

That’s because their customer is the institution, not the provider. The experience of the end user is probably not even in their top 3 priorities (similar to other enterprise software like Atlassian).