Earlier quoted context omitted.
Yes; Epic participates in the CareEverywhere network which has a gateway to the CareQuality network, thus supporting decent interoperability with other hospitals and clinics using a variety of EHRs. Now, how much they share is potentially open to debate.
Is there any public documentation on Epic and how one can interact with it?
The Billionaire Who Controls Your Medical Records (2021)
11–20 of 58 posts
Re: The Billionaire Who Controls Your Medical Records (2021)
#12This software is the epitome of a roach motel, or Hotel California - data enters, but can never leave. Epic software is so proprietary and customized for each customers that two hospitals using it can't even exchange records, or have the same interaction methodology (source: I have family that worked at two large hospitals, both with Epic). People had a fit over Windows in the 90's and 2000's being proprietary lock i…
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FHIR is about as far from what I'd call a standard as you can get. Each individual country/region/hospital/department/lab can define "profiles" that configure the data to their specific use case and no-one else's. Not exactly the aim of a standard in the usual computing sense.
Re: The Billionaire Who Controls Your Medical Records (2021)
#13And Larry Ellison’s Oracle now owns Cerner.
Oracle might actually be an improvement over Cerner.
Re: The Billionaire Who Controls Your Medical Records (2021)
#14Earlier quoted context omitted.
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Does it actually work in practice? I often see 'theoretical' support, you can export data but if you re-import it, it's all fucked. Like Zigbee, in theory like every company supports it but in practice moat imlementations is not compatiable with each-other
Yes, it works in practice. The trouble is more with the customers than the vendor. Some customers are still using obsolete versions that are missing the latest standards-based open interoperability features. Or they just haven't enabled those features.
Re: The Billionaire Who Controls Your Medical Records (2021)
#15I always wondered why so many hospitals adopted EPIC, it's got the worst UI I've ever seen. This article provides insight to complete the picture: network effects, and lock-in.
It's likely resulted in many deaths. When my friend worked ER, any time Epic went down, they simply switched back to paper forms, the ER waiting room would empty within a few hours. EPIC is, in my opinion, a large fraction of why ER waiting rooms are always full these days.
Between Epic and HIPPA privacy rule[1], the effectiveness of emergency care in the US can only spiral downward. You're forced to slow down(because of EPIC) and fill out a bunch of online forms before you can let a patient go, filling the ER.
Then you're not allowed to follow up on patients and complete the feedback loop of care, because they're no longer an ER patient, and you're not allowed to inquire any more.
[1] https://en.wikipedia.org/wiki/Health_Insurance_Portability_a...
Re: The Billionaire Who Controls Your Medical Records (2021)
#16Re: The Billionaire Who Controls Your Medical Records (2021)
#17I always wondered why so many hospitals adopted EPIC, it's got the worst UI I've ever seen. This article provides insight to complete the picture: network effects, and lock-in. It's likely resulted in many deaths. When my friend worked ER, any time Epic went down, they simply switched back to paper forms, the ER waiting room would empty within a few hours. EPIC is, in my opinion, a large fraction of why ER waiting ro…
You’re going to have to explain how HIPPA privacy slows things down because, frankly, it’s one of the most important privacy laws for citizens I can can think of.
Re: The Billionaire Who Controls Your Medical Records (2021)
#18I always wondered why so many hospitals adopted EPIC, it's got the worst UI I've ever seen. This article provides insight to complete the picture: network effects, and lock-in. It's likely resulted in many deaths. When my friend worked ER, any time Epic went down, they simply switched back to paper forms, the ER waiting room would empty within a few hours. EPIC is, in my opinion, a large fraction of why ER waiting ro…
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Re: The Billionaire Who Controls Your Medical Records (2021)
#19You can't just blame to tools for annoying hospital policy, but similarly to https://chrisgagne.com/1255/mary-poppendiecks-the-tyranny-of... there's a nasty feedback loop that the provisioning of software for administration and tracking (vs direct use as tools) unlocks and enhance.
The perceived ability to have more detailed documents means all the effort goes into the detail of the documents and, with finite effort (or at least finite amount the higher-ups are willing to spend on individual contributors to give them more time to do things), more effort is spent on record-keeping than on the actual job.
Now that you have more record-keeping you can dig into "stats" and "trends" etc that may not have any statistical significance at the level you're inspecting them, but are suddenly much more visible, and pushes you towards tinkering with the process instead of the what of the work.
And then that slows down the doing, which makes you more interested in tracking and improving the process, repeat repeat repeat.
Re: The Billionaire Who Controls Your Medical Records (2021)
#20The key to making money: find something with extreme regulatory capture.
There is actually not much regulatory capture in the EHR market. The FDA doesn't classify most of those products as regulated medical devices. Provider organizations are required to implement certain open interoperability standards so that authorized parties can securely access patient charts so they are unlikely to buy an EHR without those features. But the required APIs are fairly easy for any competent engineering team to build, and there are open source libraries like HAPI FHIR which already get you halfway there.
https://www.healthit.gov/topic/oncs-cures-act-final-rule
The real barrier to entry is relationships. Epic has made huge investments in direct sales and consulting services to give the decision makers in large provider organizations exactly what they want.