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Epic Tells Customers It Will Stop Google Cloud Integrations

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Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#191

Post by aguyfromnb »

tallgiraffe wrote: post #149
ksmsnxn wrote: post #141

Earlier quoted context omitted.

Is Google going to try to compete in the EHR space? I don’t think of them as an enterprise software company - at least not in the same way as an Oracle or MSFT. My impression of their strategy/focus is that they are trying to sell cloud compute and ML services?

I feel like Google is an everything company. Traditionally EHR has been done via enterprise and connections, but it doesn’t mean google can’t change it. In fact, they could open a network of Google hospitals, and run their own software on them, or buy a big chain. Much like Amazon got WholeFoods, Google can get into the game if they choose to, and at the end of the day, if they want to grow, they will have to find mo…

>In fact, they could open a network of Google hospitals, and run their own software on them, or buy a big chain. Much like Amazon got WholeFoods,

I'm a fan of Google, but what's with people thinking Silicon Valley companies can easily "get into" everything? What business is Google in that leads you to believe they could run hospitals? They couldn't even design a decent social network, which is their wheelhouse. At least Amazon was selling groceries before they bought Whole Foods.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#192

Post by franga2000 »

echelon wrote: post #144
stygiansonic wrote: post #134

Earlier quoted context omitted.

I talked to a doctor at Stanford and he mentioned to me one reason why the main Stanford Health and Stanford Children's Health have separate patient portals (not unified) that you have to create separate logins for is because of the huge amount Epic wanted to charge to merge them. (They both run separate Epic instances as far as I can tell)

How are leeches like this tolerated? The sooner they are driven out of business, the better.

From what I understand this is the norm in the US. For another example, see credit reporting agencies. Control of critical infrastructure is given to private companies under the assumption that competition will make them do good. In practice, most competition goes away immediately and the maximization of profit destroys any remaining incentives to not be horrible for everyone involved.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#193

Post by v7p1Qbt1im »

raxxorrax wrote: post #162
foota wrote: post #161

Earlier quoted context omitted.

GCP is not an ad company

The income of the owning company comes to 85% from advertising. It is pretty save to say that they are an ad company. It is also very likely that any data collected is used to reinforce and consolidate their main business.

Oh come on. There are contracts with GCP customers in place. There is a massive set of regulations around data misuse. Do you really think Google would risk the company-destroying liability of being caught using data improperly (something that‘s not in their T&c)? Who‘s to say there wouldn‘t be whistleblower tomorrow.

A company can do more than one thing. It probably would be a decent idea to make GCP a subsidiary, just so it‘s absolutely clear to everyone. Their capabilities in data analysis and ML make this an ideal project.

Like why is no one saying Amazon might be misusing data from AWS to benefit themselves. This just seems like the usual HN bias.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#194

Post by v7p1Qbt1im »

givinguflac wrote: post #187
sz4kerto wrote: post #164

Earlier quoted context omitted.

This is where things get mixed up. EPIC is suggesting that using Google Cloud is somehow equivalent with handing data over to Google so that Google works with that data. These are absolutely, extremely different. Assuming that Google will somehow break into your VMs or GKE clusters to get data out and monetize it is crazy, of course, but EPIC tries to suggest that.

| is crazy, of course Sure, and what company would drive around the entire planet and collect peoples private info and WiFi networks? That’s crazy obviously lmao

It isn‘t the same as going against T&C and getting sued by every customer they have.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#195

Post by marcinzm »

leoh wrote: post #140

Google is absolutely doing the right thing. Anything that can be done to enhance the efficacy of EMR software will help lead to better patient outcomes. As far as I can tell, Google is approaching the problem foremost from the perspective of "how can we make people healthier by making software more effective." Epic and Cerner are simply not doing that. Somewhere in the comments here someone mentioned that most EMR so…

>In most implementations, neither Cerner not Epic encourage structured data recording except for billing codes. This means that if a patient comes through the medical system frequently, doctors have to read pages and pages of unstructured text to get a sense of what's going on for the patient. The software is designed to be sold to administrators and, as currently designed is unquestionably leading to worse outcomes for patients.

So instead doctors need to spend hours typing up their notes using the just correct code or term so it's structured? As I understand it, doctors find having to type things into EMRs to be a giant time sink as it is that takes away from their ability to care for patients.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#196

Post by snarf21 »

leoh wrote: post #140

Google is absolutely doing the right thing. Anything that can be done to enhance the efficacy of EMR software will help lead to better patient outcomes. As far as I can tell, Google is approaching the problem foremost from the perspective of "how can we make people healthier by making software more effective." Epic and Cerner are simply not doing that. Somewhere in the comments here someone mentioned that most EMR so…

I agree with your comments about how EMRs are bought by executives not doctors. This is exactly the same as companies buying SAP and then everyone else is stuck implementing it for 2 years and then hates using it daily. I work in healthcare and have literally never met a single person who uses Epic not absolutely HATE it!

Healthcare can't be fixed with software or cloud providers. Healthcare is a problem of four groups with misaligned incentives. Any "solution" usually only considers one or two of these groups. The only way to solve healthcare in the US is to push regulations via CMS (Medicare). Medicare is such a huge piece of the pie that they drive the ship. Anything they mandate will move to commercial payors since they need to implement it everywhere anyway.

Healthcare is like homelessness. It is a political problem not a technical problem without solutions. We know what will fix it, we just don't have the will to do so.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#197

Post by transect »

stygiansonic wrote: post #134
semerda wrote: post #115

Epic is a cash cow private company. Sutter Health in the Bay Area paid $1B for its EHR. Epic stays quiet to protect its walled gardens; deeply integrated into hospital infrastructure. No doubt Google is a threat to them. Here’s an old article I found that references this juicy revenue opportunity (the rest have been cleared by Epic, so the story goes): https://www.healthcareitnews.com/news/setback-sutter-after-1...

I talked to a doctor at Stanford and he mentioned to me one reason why the main Stanford Health and Stanford Children's Health have separate patient portals (not unified) that you have to create separate logins for is because of the huge amount Epic wanted to charge to merge them. (They both run separate Epic instances as far as I can tell)

I used to go to NYU medical, which uses Epic. As janky as their interface is, it was nice enough to use and see all my charts, etc, as well as communicate with doctors over email. So when I moved to another city I specifically chose a medical system that used Epic. Once I got my login I then logged into my NYU Epic to initiate a data transfer and wouldn't you know it... it was impossible. After digging around to no avail I contacted my new provider and they told me the best thing to do is print out a PDF of my medical history in NYU's Epic and they would scan it back into their Epic... with a complete loss in structured historical data (bloodwork, vitals etc). Insane.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#198

Post by tomrod »

echelon wrote: post #144
stygiansonic wrote: post #134

Earlier quoted context omitted.

I talked to a doctor at Stanford and he mentioned to me one reason why the main Stanford Health and Stanford Children's Health have separate patient portals (not unified) that you have to create separate logins for is because of the huge amount Epic wanted to charge to merge them. (They both run separate Epic instances as far as I can tell)

How are leeches like this tolerated? The sooner they are driven out of business, the better.

I suppose because when tech, like Google, comes along Epic gaslight, obstructs, and projects their way in the media to becoming the good guy.

Healthcare IT is full of deeply committed professionals who deeply dislike Epic.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#199

Post by tomrod »

parasubvert wrote: post #174
warent wrote: post #159

Earlier quoted context omitted.

They're not entirely tolerated fortunately. The US government has been taking action to tear down EHR walled gardens via the Cures Act[1] which is manifesting in public access APIs called FHIR. [1] https://en.wikipedia.org/wiki/21st_Century_Cures_Act

FHIR is nice but doesn’t completely reduce the complexity of integrating the underlying data itself considering the mess that is HL7 and mess that occurred with v3. The situation is sort of like moving from SOAP+XML Schemas to REST/JSON. Easier to develop, but the underlying data structures are still extremely complicated and tricky to get right. This is especially true when dealing with ancient systems written in ni…

Do you feel OMOP helps to resolve this?

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#200

Post by tomp »

v7p1Qbt1im wrote: post #193
raxxorrax wrote: post #162

Earlier quoted context omitted.

The income of the owning company comes to 85% from advertising. It is pretty save to say that they are an ad company. It is also very likely that any data collected is used to reinforce and consolidate their main business.

Oh come on. There are contracts with GCP customers in place. There is a massive set of regulations around data misuse. Do you really think Google would risk the company-destroying liability of being caught using data improperly (something that‘s not in their T&c)? Who‘s to say there wouldn‘t be whistleblower tomorrow. A company can do more than one thing. It probably would be a decent idea to make GCP a subsidiary, j…

Has any company ever been punished for data misuse (i.e. severely, enough to make other companies think twice before doing the same thing)?

Apple listens to Siri conversations, whatever. Experian leaks private data, no biggie. Experian gets hacked, oops. Grindr sells your sexual orientation data, business as usual.

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