3 ms·
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 succes
by 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 agoThey're in a very different market from Practice Fusion though. There aren't many small/independent practices rolling out Epic deployments...
- skwb 7y agoNow 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...
- nradov 7y agoSmall independent practices are a dying market anyway. Provider organizations are all consolidating in order to achieve economies of scale (especially for EHRs), provide comprehensive services to patients under one roof, and achieve greater pricing power when negotiating with payers. Plus most physicians prefer being employees; they just want to practice medicine without the additional administrative hassle of running a small business.
- conanbatt 7y agoIts true that running independently is getting more difficult, but that's not "on the market" but on the insidious regulations around insurance, malpractice law, etc. A doctor can't open up an office and tend to patients with pen and paper anymore, and they have to pay thousands of dollars a month to systems that are truly terrible to be compliant.
- skwb 7y ago*If they want to accept Medicare dollars (and usually private insurance just follows Medicare). I remembered some South Western (I want to say Arizona) specialty clinic that basically didn't accept insurance and had pen and paper charts still.
- nradov 7y agoMedicine is also a team sport now. Caring for patients with complex conditions requires coordination with multiple other practitioners. Exchanging paper records with them just isn't practical or safe. Plus if the doctor has to write a prescription, doing it on paper is so error prone as to border on malpractice.
- conanbatt 7y agoI will be willing to say the opposite as well. Exchanging records is terrible. If you get records from say, Epic, you might get 300 pages. Which doctor is going to read 300 pages of documentation for one if his 16 30-minute appointments a day?
- conanbatt 7y agoWhen small practices get bought or acquired by hospitals they typically switch to epic.
- rscho 7y agoEpic is far, far away from what us MDs imagine when someone mentions the benefits of EHRs. For starters, if one could make an EHR that just only attempts to also help practitioners in the trenches instead of just the billing dept. that would be stellar! So 'the value EPIC brings' is huge... for anyone but care providers, thank you very much.
- Scoundreller 7y agoSounds like you have a billing department problem. I think one big issue is that the US subsidized EHRs for a while. So non-US non-billing-focussed EHRs never really developed. Now those US EHRs are getting dumped on the rest of world, with all of that carefully developed billing tech disabled out-of-the-box.
- rscho 7y agoSounds like I have a problem with anything making my job more painful. The actual problem has nothing to do with nation-focused issues. With healthcare liberalization came competition, and therefore search for the cheapest solution. Problem is, in healthcare we have slaves (called residents) and what's cheaper than an educated slave? So actually, even european EHRs follow the 'for-billing' model because it's far easier to just dump the work on the residents. EHRs are the whip with which we 'encourage' human healthcare providers.
- conanbatt 7y agoBilling department pays everyone's salary. The billing system in the US is so complex that it eats up a huge part of administering care.
- conanbatt 7y agoThey've been a huge success for the wrong reasons. Its very much a rent-seeking driven business: vendor lock-in, big contracts with government money, etc. What they do would be considered anti-trust if it weren't that government paid them to do it. You can build an ehr with google docs if it were legal. But it isn't.