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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

#221

Post by voicedYoda »

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…

I'm in healthcare software, worked for epic, and now am trying to solve part of the problem. If love to learn more about what you think are the 4 corners thar need to be solved.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#222

Post by kotaKat »

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...

As a former hospital IT employee, as it was told to me by my IT management, you don't get to pick Epic as your EMR; Epic somehow "decides" you're worthy enough to buy it.

Then once you do, you're told who to hire, what to buy, what to train on, what to overall do, and if you don't do that they hold your support costs hostage under the guise of a "quality installation score". Not to mention the no-competes they slap on hospital staff so they can't bail as soon as Epic goes live.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#224

Post by logfromblammo »

ShirtlessRod wrote: post #61
neuro_image3 wrote: post #46

Earlier quoted context omitted.

Absolutely. | Also EPIC is spectacularly unfit for purpose. Total garbage software that essentially functions as a billing tool.

How is it "garbage software"?

In 2005, when I started working there, the Epic codebase was MUMPS and Visual Basic 6, which left mainstream support before I was even allowed to touch it. There was no migration plan for expiration of extended support in 2008.

As for the MUMPS code, there was a node size limitation for the code. Which included variable names and comments. So each code segment (identified by inscrutable five-letter (or less) names like "^ZHMRG") was jam-packed as tightly as possible with one-letter variable names and zero comments. Basically unmaintainable, but I bet they're still using it.

Garbage software. I left in 2007.

They like to hire straight out of universities. It was the second job for me, so I didn't really know to jump ship earlier.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#225

Post by fauigerzigerk »

loceng wrote: post #218
fauigerzigerk wrote: post #166

Earlier quoted context omitted.

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…

It's data ownership laws and adequate monitoring (including whistle blower laws with adequate rewards) and enforcement that is necessary. Replace "Google" with any unknown or known bad actor that can be taken over by a bad actor, and we return to the same problem.

At the end of the day you're right, but look at it from the perspective of a healthcare decision maker.

What if something questionable happens, even if it's legal, and you're found to have handed over patient data to Google, the largest ad targeting firm on the planet?

Pointing at legalities will not save your reputation or your job in the face of glaring misalignment of interests.

It's like letting your dog guard your employer's sausages after giving it state of the art training in self control.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#226

Post by Herodotus38 »

JshWright wrote: post #213
Herodotus38 wrote: post #120

Earlier quoted context omitted.

I'll be the first, then. I've used two versions of Cerner (the first was heavily modified by the University where I did residency and the second is a more recent version), Soarian, Epic, CPRS, and had brushings with half a dozen outpatient EMRs. Epic is bad, but it's unfortunately still miles better than anything else I have ever used so far.

I think you and I have different definitions of "like"...

I think you’re right. I would like/love it if my hospital dropped Cerner for Epic, as I could get my job done at least 20% faster, which would allow more time with family.

My main point I wanted to make was 1) that I also hated Epic the first time I used it in residency (we switched from Cerner to Epic for outpatient only). 2) I have so far never met someone who prefers another EMR over Epic, which really says something since Epic is also bad.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#227

Post by bagacrap »

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…

I thought they designed a perfectly serviceable social network. As a product I thought it worked better than Facebook. It wasn't enough better to beat the network effect of the latter, however, and medical records keeping would likely be an even tougher nut to crack. How are you going to convince a hospital that just spent $10M on an epic install to switch to your version, even if it is 15% better?

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#228

Post by v7p1Qbt1im »

ocdtrekkie wrote: post #215
v7p1Qbt1im wrote: post #193

Earlier quoted context omitted.

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…

Actually a lot of people point out that Amazon abuses it's storefront data as market research for it's own first party products on a scale nobody else can match. (And then, in turn, gives its first party products better placement in the store, to then crush the competition.) The difference is, Amazon hasn't demonstrated a massive desire to collect and use health data, and fundamentally, isn't an ad company. The other…

Amazon using it‘s marketplace data for their own purposes, while obviously also problematic, is not the same thing as going behind their AWS clients back and using their data. The data literally belongs to the client.

I‘m pretty sure they are only accessing their data as allowed by the contracts for maintenance for example. Likewise for GCP and Azure.

Regarding your second argument. Doubleclick is on the consumer side. That‘s why GCP has it‘s own CEO, it‘s own buildings and org in general. They are seperate from the consumer side.

Put yourself in Google‘s shoes. They can make tons of money by revolutionizing the health care sector, improving patient care at the same time. Why would they fuck it up by feeding data to the ad side illegally. The risk is too high. No one would ever trust them again and they‘d probably be sued out of existence.

Is it not feasible that they are simply trying everything they can to become less reliant on ads. They have stated several times that the cloud side will be the dominant revenue source in the future. Is that possible? No idea. But strategically it makes sense to push cloud with all possible force.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#229

Post by bagacrap »

ShirtlessRod wrote: post #61
neuro_image3 wrote: post #46

Earlier quoted context omitted.

Absolutely. | Also EPIC is spectacularly unfit for purpose. Total garbage software that essentially functions as a billing tool.

How is it "garbage software"?

It's garbage because the interface sucks. It looks like it was designed in 1998, and is full of clunky non sequiturs like, "You cannot proceed. Proceed anyway?" There are untold hours and dollars spent on training users because of it.

It's garbage on the backend because the update process is ridiculously manual. Every minor change sends out a ticket with incredibly detailed instructions, e.g. to update a single element somewhere. The role of the analyst is essentially to execute a script, by hand. Not only is this more costly and slower, it's more error prone. But it creates an ecosystem of these Epic-trained and -approved technicians which helps lock in customers and ensures another steady stream of income to epic.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#230

Post by v7p1Qbt1im »

tomp wrote: post #200
v7p1Qbt1im wrote: post #193

Earlier quoted context omitted.

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.

Different scenario. Voice assistant customers are regular users. The opposing side is a government agency who collects fines.

In a cloud data misuse case the civil liabilities are actually terrible, because you’re going up against other cash-rich corporations. Insert saying: stealing from the poor vs stealing from the wealthy.

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