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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

#231

Post by cle »

sz4kerto wrote: post #164
cle wrote: post #148

Earlier quoted context omitted.

I try hard not to give my data to Google, for a lot of reasons. As a patient, having my healthcare provider hand my data over for them to monetize in God-knows-what ways is...undesirable.

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.

I was actually referring to Google teaming up with Ascension to “share data”, which is what the second half of the article is about (and thus presumably related to this decision?). I don’t think Google would be so brazen to do what you’re suggesting, their typical playbook is to hide behind euphemisms and reassurances about the security and anonymity of your data, while providing no evidence of either, and then quietly profiting from it.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#232

Post by fjp »

bagacrap wrote: post #227
aguyfromnb wrote: post #191

Earlier quoted context omitted.

> 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?

By undercutting the hell out of Epic (at least to start) is what I would expect.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#233

Post by jen20 »

phren0logy wrote: post #70
asah wrote: post #63

Earlier quoted context omitted.

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 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…

A few years ago I did a very thorough analysis of every dose-based electronic prescribing system suitable for secondary care available in the UK market (and several which were not officially). They fell into three categories:

- Home-grown systems which were fit for purpose but not operable or available outside the organisation for which they were designed. The Birmingham (UK) University Hospitals system [1] is a great example of these.

- "Enterprise" (pejorative) systems which generally came from the US and focused almost entirely on billing capture, and had almost no thought put into clinicians workflow. This encompassed Epic, Cerner Millenium and so forth.

- "New" systems which were UX first, but were often little more than front-end mockups. A good example was "Alert", a Portuguese system written in Flash which had almost nothing in the way of basic medicine management safeguards, and the team demonstrated zero aptitude for the ability to build them.

In the end the hospital in question used paper-based prescribing.

[1]: https://www.digitalhealth.net/2017/05/birmingham-childrens-g... is a reasonable story about this.

[2]: http://org-portal.alert-online.com/products-services

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#234

Post by jblwps »

shadowgovt wrote: post #210
wizzwizz4 wrote: post #184

Earlier quoted context omitted.

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.

> What incentive do doctors and patients have to keep vending the data to Google at that point?

Inertia, if nothing else. Moving platforms, especially in a highly-regulated industry, is no small thing.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#235

Post by l33tman »

killjoywashere wrote: post #145
guitarsteve wrote: post #51

Earlier quoted context omitted.

That’s so strange. Does anyone know why they’d want to chat using special hardware?

Because he's l33tman, man. l33t.

Haha exactly!

No, I'm sure they could have accepted any Hangouts call or being coerced into accepting a phonecall as well.

But truthfully what they wrote in the sendout was like I described - they outlined the procedure to go get the netbook and use it and at no point did they suggest a physical phone number to call or similar. I went along with it as far as I did just because I was kind of baffled by the suggested procedure :)

I assume it was part of some marketing scheme to try to market Hangouts and/or Chromebooks (or whatever it was) at the same time as GCP, but it just confused the sale and added unnecessary pain-points. The AWS guys just send an email and let me call them by a normal phone.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#236

Post by Silhouette »

skj wrote: post #177
raxxorrax wrote: post #169

Earlier quoted context omitted.

I doubt that the data flow will be contained within these "mini companies". Formally they are the same company and even with the inefficiency of large corps, I doubt that Google doesn't have the capabilities to efficiently exchange information. That aside, I do not want to rely on the inefficiency of internal processes for data protection.

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.

The problem here is that even if that is the case at the moment, the same organisation still has possession of the data and those partition walls can probably be moved later if the leadership of the organisation decide to do so.

Regardless of your personal good intentions and honesty, or anyone else's working there right now, a lot of people are never going to trust an organisation with the track record and potential conflicts of interest that Google has to process sensitive personal data responsibly. Its leaders and the investors backing them made their bed by helping to create the culture of pervasive involuntary surveillance that we all now suffer, and they will forever have to lie in that bed as a result.

It's unfortunate, because clearly there is considerable potential for improving patient outcomes through better use of big data and automation in medicine, and no doubt many of the people working on these kinds of projects have nothing but good intentions. However, until the culture of the technologists operates on the same kind of ethical and legal level as the culture of the clinicians, I don't see how the trust is ever going to be there now. The individuals doing the work need to be personally responsible for behaving ethically, even if they are directed to do otherwise by their superiors, like doctors and real engineers. Organisations that fail to meet the required standards need to face penalties that are an existential threat, so their investors stand to lose everything and their leaders can end their own careers if anyone breaks the rules deliberately or through gross negligence. Without those kinds of obvious, strong incentives, with the way so many players in the tech industry have exploited people's data in recent years, I think the barrier may simply be too high to clear.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#237

Post by avocado4 »

bryanrasmussen wrote: post #132
avocado4 wrote: post #104

Earlier quoted context omitted.

Google is now building an EHR as direct competition to Epic. It's definitely related to this move. Fwiw I welcome Google's entrance to this market because Epic's EHR and business practices are equally aweful.

Do you mean that Epic's EHR and business practices are equally awful to each other, or to Google's EHR and business practices (is Google's EHR in the state that its awfulness can be proclaimed?)

Epic's is significantly worse than Google's.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#238

Post by loceng »

fauigerzigerk wrote: post #225
loceng wrote: post #218

Earlier quoted context omitted.

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 yo…

I understand that monitoring and keeping people in check, and perhaps you're right that there should be a physical barrier between certain systems, however there's still nothing stopping bad actors from infiltrating in these systems. I personally think ads should be obliterated, as they're simply shallow and cheap methods of manipulating people; Presidential candidate Andrew Yang's plan is to tax ads higher in his VAT strategy than other things, progressively increase it over time, basically as a mechanism similar to a carbon tax countering pollution that's bad for us. Tesla spends no money on advertising, the word of mouth and media attention they get is all earned - meanwhile other vehicle manufacturers compete through emotional ads spend money which increases the cost of the vehicles, perpetuates the ad industrial complex, and to some degree limits people's depth of critical thinking for their buying decisions re: the emotional manipulation of ads bombarding them to build a good, relatable feeling, familiarizing them with specific products to make it feel like a safe, good choice.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#239

Post by throw_14JAS »

ta999999171 wrote: post #133
commandar wrote: post #49

Earlier quoted context omitted.

Exactly. From the perspective of high level decision makers, PaaS is heading toward being a commodity good, so differentiating your platform can be what makes a deal and making regulatory compliance "easy" in heavily regulated industries can be a pretty strong differentiator. If you have an existing business relationship with a company and already trust them to help you navigate regulatory hoops, there's going to be…

Like the new "Windows Terminal" project - EXCELLENT marketing strategies in recent years. I still don't trust them, but credit where credit is due.

I encourage you to consider how your statement, "I don't trust Microsoft," sounds to a higher level exec or department head. I don't mean this as a criticism -- I notice there's a tendency for ICs to state their opinions in such a way that hurts their perception.

Namely, if you were to state to a higher level manager that you "don't trust Microsoft", you will come across as a crank. Or a developer who doesn't see the bigger picture.

To improve perception, folks should try to reframe their personal preferences ("I don't trust MS") as risks to the business - "I worry that MS will lock us in to their platform and jack up prices". The former is reputation-harming; the latter is being a savvy 2nd order thinker, who looks beyond just what the MS salesman says.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#240

Post by ta999999171 »

cosmodisk wrote: post #139
plerpin wrote: post #26

Earlier quoted context omitted.

Windows and Office are Trojan horses for Azure. Microsoft does all sorts of SKU trickery at the time of Windows and Office license renewal to make it seem like you can't afford to NOT buy Azure from them.

The problem is, especially with Office, that it has no alternatives.Google Suite is a toy and any open source solution feels like someone chopped your hands off and sent you back to 90's..

How long has it been since you've used LibreOffice?

If lacking a ribbon interface makes you feel like someone chopped off your hands...take your hands off the mouse and put them on the keyboard, haha

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