Epic Tells Customers It Will Stop Google Cloud Integrations • Hacker News Board

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#91

Post by meddlepal » Tue, Jan 21, 2020, 4:03 AM UTC

daave wrote: post #84

deanCommie wrote: post #66

Earlier quoted context omitted.

The difference is Amazon won't use confidential AWS data to drive their other verticals. Google's very business model is selling their users to their customers.

Google states unequivocally in its Cloud privacy documentation: 3. Know that customer data is not used for advertising. You own your data. Google Cloud does not process your data for advertising purposes. https://cloud.google.com/security/privacy/

But they may process it for non-advertising purposes? That feels... flimsy

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#92

Post by paxswill » Tue, Jan 21, 2020, 4:04 AM UTC

asah wrote: post #63

killjoywashere wrote: post #59

Earlier quoted context omitted.

As a physician forced to use Epic, I'm not sure "crafted" is the word I'd use to describe their software. It's more like they addressed the spec from the C suite in a way that was equivalent to punching health care providers in the face. They take Dad's money, and use it to pay thugs to beat up his kids.

Serious q: are the other systems any better? Have you tried them? Have you compared notes with physicians using them? (I'm new to the field and genuinely curious... I haven't heard anybody saying anything nice about any of them...)

I’ve recently experienced two hospitals’ EMR systems (one using Epic, the other Cerner) from the patient’s perspective. Integrating/accessing my data from external systems (in my case Apple Health) is roughly equivalent–the important things are (mostly) there like test results, procedures, medications, etc; they just do some things differently that are annoying:

* The Cerner hospital will duplicate medications for a single visit. It also classifies a bunch of vital signs as lab test results, so things like blood pressure don’t get merged in with other sources of data.

* The Epic system seems to use more recent/complex FHIR structures, so occasionally there’ll be more info in the raw data (this is more a knock on Apple Health though).

The Epic system has a big advantage with MyChart though. It’s their app and website for accessing your records at various hospitals. Through the app you can get push notifications of test results and schedule procedures. The latter was nice as I’d get roughly 15-30 minutes of advance notice before having a procedure done. The discharge instructions being made available in the app is also very helpful. Finally, being able to browse the raw clinical notes through the website, and request a dump of all of my data is appreciated.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#93

Post by killjoywashere » Tue, Jan 21, 2020, 4:04 AM UTC

asah wrote: post #63

killjoywashere wrote: post #59

Earlier quoted context omitted.

As a physician forced to use Epic, I'm not sure "crafted" is the word I'd use to describe their software. It's more like they addressed the spec from the C suite in a way that was equivalent to punching health care providers in the face. They take Dad's money, and use it to pay thugs to beat up his kids.

Serious q: are the other systems any better? Have you tried them? Have you compared notes with physicians using them? (I'm new to the field and genuinely curious... I haven't heard anybody saying anything nice about any of them...)

My favorite so far, honestly, are the old military systems, CoPath and CHCS, with a terminal interface running on OpenVMS. They have are lightening fast to use for anyone who is actually in the business of getting things done (new users are sad for a couple weeks, but experienced hands are fast. Lots of keyboard shortcuts) and easy to pull data from when it comes to research.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#94

Post by synaesthesisx » Tue, Jan 21, 2020, 4:05 AM UTC

dontblink wrote: post #86

synaesthesisx wrote: post #76

I don't blame them - from my understanding there are certain Google Cloud services that have glaring security holes/are legitimately HIPAA violations.

It's amazing to me how social media is used to spread FUD against some companies. Please provide sources.

It's amazing to me how social media is used by employees to shill certain corporations.

https://www.managedcaremag.com/dailynews/20191113/hhs-invest...

https://healthitsecurity.com/news/google-uchicago-medicine-s...

I've heard there are a couple Google Ventures - backed healthcare startups that have questionable HIPAA-compliance as well, directly from clients that have worked with them. They're not necessarily holes in GCP itself but rather in integrations with certain services.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#95

Post by JshWright » Tue, Jan 21, 2020, 4:09 AM UTC

ShirtlessRod wrote: post #88

JshWright wrote: post #78

Earlier quoted context omitted.

My clinical experience with Epic is limited to emergency care, but I've yet to meet a clinical user that "likes" Epic.

I'm not really sure what to say to that, since you seem to be implying that no one likes it, which is pretty patently false. A lot of it does depend on the organization you're working with, as some are more dysfunctional than others when it comes to setting up best practices and build for their physicians. Others actually listen to their clinical users and tailor the system for them.

I'm not saying no one likes it, I'm saying none of the several dozen providers and nurses I know (between two different hospitals in the area using Epic) like it.

I also don't disagree with the fact that some of the issues arise from the implementation requirements. But at some point, it's still the system's fault if it allows its users to be burdened like that. It shouldn't take clicking across three different pages and who knows how many modals to triage one patient in an emergency room. It's silly that I've had to learn which order to provide my transfer of care report so the nurse doesn't have to keep clicking back and forth between different pages...

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#96

Post by JshWright » Tue, Jan 21, 2020, 4:12 AM UTC

wslack wrote: post #85

phren0logy wrote: post #70

Earlier quoted context omitted.

I have not used all of them, but every one of them I've touched is hot garbage. Like much enterprise software, the people who decide to buy it are not the people that use it. It would seem, from the outside looking in, that the majority of the effort goes into maximizing billing in the byzantine world of US insurance rather than the work of actually making people well. What concerns me most about the larger players i…

> Like much enterprise software, the people who decide to buy it are not the people that use it. Hard agree. There's also an incentive for hospital systems to "hold onto" patient data, which is not great.

In many cases those "incentives" are legal requirements.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#97

Post by drstewart » Tue, Jan 21, 2020, 4:13 AM UTC

JshWright wrote: post #78

ShirtlessRod wrote: post #75

Earlier quoted context omitted.

That's a pretty pessimistic and quite frankly not accurate assessment of the software. They have a ton of clinical functionality, and that's what the majority of the dev/design spends their time on at their users group meeting, among other places. You might not like it, but many do.

My clinical experience with Epic is limited to emergency care, but I've yet to meet a clinical user that "likes" Epic.

KLAS exists to attempt to objectively measure this.

You should check out who leads wins KLAS awards.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#98

Post by delfinom » Tue, Jan 21, 2020, 4:15 AM UTC

JshWright wrote: post #71

ShirtlessRod wrote: post #61

Earlier quoted context omitted.

How is it "garbage software"?

It's a billing system with clinical related functionality tacked on. It's pretty frustrating to use from the perspective of a "boots on the ground" user.

So it's a perfect fit for American healthcare...

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#99

Post by Spooky23 » Tue, Jan 21, 2020, 4:18 AM UTC

ehsankia wrote: post #38

organsnyder wrote: post #13

Epic being concerned about a giant gaining too much power? That's cute.

Also, if that was true, why would they only complain about the 3rd biggest cloud provider?

It’s like WalMart refusing to do business with Amazon.

Google does business in potentially adjacent areas on the ad side. At one point, the government was buying targeted ads to debunk extremist search topics when people at risk of extremist behavior pursued them.

There’s a lot of obvious health use cases that could use the same framework. Google knows more about you that anyone. Epic has medical claims data before the insurers do, and knows more about your healthcare spending that most anyone. They probably have or will have a business where they monetize that data for similar outcomes.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#100

Post by zerotolerance » Tue, Jan 21, 2020, 4:21 AM UTC

Before I read the article I was guessing that it had to do with the leaked memo regarding Google cloud growth targets and the popular conclusion that they'll be shutting it down or pivoting that LoB in 2023.

https://news.ycombinator.com/item?id=21815260