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

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#201

Post by tomrod » Tue, Jan 21, 2020, 2:10 PM UTC

aguyfromnb wrote: post #191

tallgiraffe wrote: post #149

Earlier quoted context omitted.

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…

Generally barriers to entry preserving market power are what Warren Buffett looks at when BH buys companies. SV recognizes that tech typically lowers common barriers to entry like management silo expertise.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#202

Post by tomrod » Tue, Jan 21, 2020, 2:21 PM UTC

jsperx wrote: post #129

commandar wrote: post #35

Earlier quoted context omitted.

>They pick Azure because somewhere along the line the mid- and upper-level managers, including director-level IT people, have been made to believe that anything other than Windows is insecure and not suitable for HIPAA. I'd argue it's less because of a belief that a non-Windows environment is inherently insecure and more that Microsoft very aggressively promotes their products as being compliant with regulations like…

“Director-level IT” healthcare person here. We use AWS but are evaluating Azure because of the way Microsoft includes VDI in the form of Windows 10 Multi-Session licenses available only with Azure+Windows Virtual Desktop. Classic Microsoft bundle approach. Oh, and Slack is available with HIPAA compliance — https://slack.com/help/articles/360020685594-slack-and-hipaa Also, as someone who actively shops for SaaS offeri…

note: I would love to connect with you to discover other's director level experiences. I'm relatively new in the healthcare space after spending awhile in finance and utilities. If you'd like to connect, see my email in-profile.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#203

Post by shiftless » Tue, Jan 21, 2020, 2:23 PM UTC

fauigerzigerk wrote: post #166

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…

The problem is that Google has the most obvious conflict of interest of all cloud and AI providers when it comes to data use. Many people simply don't believe anything Google says, and even those who do believe them to some degree know that others won't. Google has become a reputational hazard in fields that deal with sensitive data such as healthcare. Some decisions made by current management don't help at all. Inst…

If you understood that Google is owned and operated by intelligence agencies, and has been from the very beginning, you would be a lot less baffled by their "mysterious" behavior. And the OP would be a lot less confused by the "unreasonably paranoid" people he references.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#204

Post by shiftless » Tue, Jan 21, 2020, 2:24 PM UTC

snarf21 wrote: post #196

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 grou…

> "The only way to solve healthcare in the US is to push regulations via CMS (Medicare)."

Not interested.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#205

Post by jamst174 » Tue, Jan 21, 2020, 2:27 PM UTC

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…

-> most EMR software is a billing system with record keeping attached

not really. Maybe that's how they started, but that's not what they have evolved into.

-> the software is always purchased by administrators, typically with little input from doctors.

again, maybe that's how it used to happen but anywhere that I've worked or consulted on has a myriad of doctors, nurses, etc that have input. The last hospital I worked for wouldn't even let us change a single field in the EMR without it being approved by a committee of nurses.

-> In most implementations, neither Cerner not Epic encourage structured data recording except for billing codes.

This is not true at all. In fact, it is the clinicians' preference to write or dictate notes that is the reason for this. Both Epic and Cerner provide digital forms that allow for selections from lists or checkboxes which are then stored as discrete data elements in their respective databases. I'm not going to say either are perfect and - surprise! - clinicians hate change so they always hate their EMR, but it's not for the reasons you state.

I'm curious which division of Google you work for and how much experience you have working for an EMR vendor or healthcare system.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#206

Post by lern_too_spel » Tue, Jan 21, 2020, 2:31 PM UTC

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

Apple?

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#207

Post by lern_too_spel » Tue, Jan 21, 2020, 2:32 PM UTC

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…

You seem to be under the impression that Google is building an EHR system. It is not. It is just losing hundreds of GCP contracts due to incompetence.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#208

Post by TheCoelacanth » Tue, Jan 21, 2020, 2:37 PM UTC

killjoywashere wrote: post #142

oarsinsync wrote: post #121

Earlier quoted context omitted.

You’ve just described Jira, or really any other heavily customisable tool that can fit multiple complex workflows.

Having used a dozen EMR systems and Jira, I'd say Jira is much better at its job than most EMRs are at theirs. In fact, now that you mention it: you could easily model each patient as an epic, assignments to various people on various teams (ICU, pharmacy, lab, etc), to-do/in-progress/done. Holy cricky, you may have just cracked the EMR nut.

Just make sure you don't move the epic to "Done" status.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#209

Post by metafizikal » Tue, Jan 21, 2020, 2:38 PM UTC

everyone has conspiracy theories about what is "really going on here", this is to stamp out a competitive threat in google, or whatever, but I do think this story probably is just that hospitals (and "traditional enterprises" broadly) are not using GCP for their cloud infrastructure and are instead going with AWS or Azure.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#210

Post by shadowgovt » Tue, Jan 21, 2020, 2:42 PM UTC

wizzwizz4 wrote: post #184

skj wrote: post #177

Earlier quoted context omitted.

The data flow is quite well-contained. I obviously can't offer you proof that you'd be likely to accept, but I do work on GCP and have experience with how data is partitioned.

I believe you. I do not, however, believe that Google has any incentive to keep it that way, once there's buy-in. What Google's doing here is great, but on the other hand it's Google that's doing it.

Let's assume Google pulls a "gotcha" five years down the road and meshes its medical data into its advertising data.

What incentive do doctors and patients have to keep vending the data to Google at that point? And what incentive would other Cloud customers have to trust their data wouldn't get aggregated?

The GCP business model is different from Google's other business models and they know it.