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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

#241

Post by ta999999171 »

wizzwizz4 wrote: post #189
leoh wrote: post #137

Earlier quoted context omitted.

You haven't spoken to many doctors then. I don't mean to be a jerk or snarky. It really is an awful piece of software. Among its worst flaws is that 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 goi…

This comment is mostly copied and pasted from another of your comments.

This does not change the truthfulness... I'd be more concerned if he didn't.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#242

Post by snarf21 »

voicedYoda wrote: post #221
snarf21 wrote: post #196

Earlier quoted context omitted.

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.

The four groups are the payors, the health systems/providers, the employers and the patients(employees). It is almost impossible to balance four competing goals.

The solution is to make it fewer competing concerns. We need to make employer provided healthcare illegal (go back to pre WWII) and force competition on the open market. We can still have you buy your own with HSA pre-tax dollars. We need to move to reference based pricing. Payors can't charge more than 1.3 * Medicare. This also solves the "out of network" bullshit, it is all the same so just pay. We also need to separate wellness/preventative from "health insurance". The one you know you will and should perform annually and the other is against catastrophe. Unfortunately, today we treat them as the same thing. I don't think a Medicare for all works but I do think it might work if it was for primary care only. Specialty care and Urgent/Emergency care could be handle by private payors.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#243

Post by shadowgovt »

jblwps wrote: post #234
shadowgovt wrote: post #210

Earlier quoted context omitted.

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.

That argument seems insufficient, or inertia would prevent people from moving onto the platform in the first place.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#244

Post by fauigerzigerk »

loceng wrote: post #238
fauigerzigerk wrote: post #225

Earlier quoted context omitted.

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 VA…

I don't think ads should be obliterated. People will always try to influence other people and ads are just one way of doing that. In my opinion, there are far more nefarious, manipulative and intransparent ways of pursuing the same goal.

Also, ads are currently indispensible for privacy as weird as that may sound. There is currently no widespread, privacy preserving form of electronic payment, and I very much doubt that there will ever be one.

What we should do is regulate/restrict ad targeting and make sure that advertising is as transparent as possible.

But none of that has anything to do with Google's reputation issues and conflict of interest. Google should split off its ad business from all other activities. Otherwise they will always remain an advertising company and distrust in everything else they do will only grow.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#245

Post by cosmodisk »

ta999999171 wrote: post #240
cosmodisk wrote: post #139

Earlier quoted context omitted.

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

I try them at least once or twice a year and always get to the point where I'm like: "Ok, where's my Excel". It's not the ribbon, it's the whole experience that is lacking. Also MS office products do integrate well with each other.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#246

Post by organsnyder »

killjoywashere wrote: post #59
karpodiem wrote: post #45

Earlier quoted context omitted.

Right. And while Epic does the heavy lifting of crafting software to support healthcare provider workflows, integrating dissimilar systems (PACS, etc.), and storing all that data, the companies you mentioned feel they can create value by attempting to automate diagnosis and potentially offer some integration point for genetic counseling.

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.

Keep in mind your priorities are very different from your employer's. Healthcare systems have been on a big kick to reign in physician independence, and EMRs are effective tools in this goal.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#247

Post by warent »

warent wrote: post #159
echelon wrote: post #144

Earlier quoted context omitted.

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

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

Just a small correction my original post (better late than never). It's also (perhaps to a larger extent) due to the HITECH Act: https://en.wikipedia.org/wiki/Health_Information_Technology_...

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#248

Post by loceng »

fauigerzigerk wrote: post #244
loceng wrote: post #238

Earlier quoted context omitted.

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 VA…

I don't think ads should be obliterated. People will always try to influence other people and ads are just one way of doing that. In my opinion, there are far more nefarious, manipulative and intransparent ways of pursuing the same goal. Also, ads are currently indispensible for privacy as weird as that may sound. There is currently no widespread, privacy preserving form of electronic payment, and I very much doubt t…

How about an "ad system" that people actively engage with when they're wanting to discover vs. being bombarded everywhere - perhaps not understanding the implications of manipulation of ads have on them? At minimum it changes the user experience greatly.

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#249

Post by dang »

givinguflac wrote: post #186
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.

You may not think you’re lying, but the company you work for is and does. Alphabet exists. If they actually cared about solving it and not collecting data. Why not use one of their other alphabet companies or create another? It’s blatantly obvious... you are blind to it apparently

That crosses into personal attack. We ban accounts that do that, so please don't.

https://news.ycombinator.com/newsguidelines.html

Re: Epic Tells Customers It Will Stop Google Cloud Integrations

#250

Post by dang »

powowow wrote: post #125
killjoywashere wrote: post #53

This is a head-in-the-sand move by US companies (not just Cerner and Epic, but the hospital system CIOs). If they really think Google is going after healthcare data, they should keep in mind Google is already working with NHS and has a little thing called the Billion Users project focused on India. The British and Indian populations have the same health problems Americans do. Proportions might change, but the content…

Your AWS conspiracy theory is bizarre.

Would you please stop breaking the site guidelines? You've been doing it a lot, unfortunately, and we're hoping for more thoughtful conversation here.

https://news.ycombinator.com/newsguidelines.html

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