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The Billionaire Who Controls Your Medical Records (2021)

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Re: The Billionaire Who Controls Your Medical Records (2021)

#41

Post by Spooky23 »

zdw wrote: post #5

This 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…

My wife is dealing with cancer and associated complications at three distinct hospitals and a national cancer center.

The two hospitals on Epic are great - all of her records are immediately exchanged. The third hospital has a shitty cerner system and has problems sharing between departments. The cancer center has an excellent patient portal but doesn’t integrate.

Ultimately these problems are difficult as the creation of Medicare and Medicaid happened during the early days of computing. So we’re stuck with 75 years of legacy.

Re: The Billionaire Who Controls Your Medical Records (2021)

#42

Post by mikewarot »

FireBeyond wrote: post #36
mikewarot wrote: post #15

I 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…

> 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. This is factually incorrect. Healthcare providers are allowed to share information about the specifics of care provided to a patient, and, crucially, they are allowed to do so, within limitations, without the explicit consent of the patient (ma…

That may be what the law allows, but it wasn't what the hospital in question allowed.

Re: The Billionaire Who Controls Your Medical Records (2021)

#44

Post by FireBeyond »

mikewarot wrote: post #42
FireBeyond wrote: post #36

Earlier quoted context omitted.

> 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. This is factually incorrect. Healthcare providers are allowed to share information about the specifics of care provided to a patient, and, crucially, they are allowed to do so, within limitations, without the explicit consent of the patient (ma…

That may be what the law allows, but it wasn't what the hospital in question allowed.

Maybe, but you said "Between EPIC and the HIPAA privacy rule..."

Re: The Billionaire Who Controls Your Medical Records (2021)

#45

Post by seized »

mikewarot wrote: post #15

I 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…

That may be because when something like Epic or PACS (or other tier 1 systems, or the network/data center/power/etc) is down longer than X time the hospital will go into diversion, meaning as many ED patients as possible are diverted to a different nearby hospital.

And paper workflows can be fast in the moment but cause absolute chaos for cleaning up, reconciliation, and moving data between departments.

Source: Worked with many hospitals, including ones with Epic.

Re: The Billionaire Who Controls Your Medical Records (2021)

#46

Post by Herodotus38 »

zdw wrote: post #25
Herodotus38 wrote: post #9

Earlier quoted context omitted.

This is not universally true, but I don’t know where your family works or in what capacity. There are a lot of issues with epic but unfortunately it is the best out of all the garbage out there. Out of all the EMR’s I have used, Epic is the easiest to share information both within different hospitals using epic and sharing from epic to other emrs like Cerner. Source: Am physician who has worked in many different hosp…

FWIW, two separate deployments of Epic done in the last 15 years at two hospitals, from the perspective of folks working in the pharmacy.

In the last five years, it’s gotten a lot better. But I could see before then things are still pretty bad even with epic.

Re: The Billionaire Who Controls Your Medical Records (2021)

#47

Post by hanklazard »

FireBeyond wrote: post #34
zdw wrote: post #5

This 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…

It really is. And it's not good software. The UI looks decidedly amateur, and some of the modules are absolute garbage amateur hour (one I see a lot in my job is the ED track board, which captures information from the ED charge nurse about incoming ambulances, bed holds and cleaning needs, and gives a picture on what the ED might look like in the next hour or so). It looks like a VB app from the 90s. Text layout is p…

It’s total shit.

I’m rooting for something like this in the long term: https://github.com/openemr/openemr

Re: The Billionaire Who Controls Your Medical Records (2021)

#48

Post by hanklazard »

Spooky23 wrote: post #41
zdw wrote: post #5

This 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…

My wife is dealing with cancer and associated complications at three distinct hospitals and a national cancer center. The two hospitals on Epic are great - all of her records are immediately exchanged. The third hospital has a shitty cerner system and has problems sharing between departments. The cancer center has an excellent patient portal but doesn’t integrate. Ultimately these problems are difficult as the creati…

I’m sorry, that’s terrible. Best wishes to her and your whole family.

Re: The Billionaire Who Controls Your Medical Records (2021)

#49

Post by HaZeust »

zdw wrote: post #5

This 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…

"Open, simple, interoperable formats are the way out. We need more of these, especially in the health care sector."

We're getting there quickly with FHIR!

Re: The Billionaire Who Controls Your Medical Records (2021)

#50

Post by doubleg72 »

FireBeyond wrote: post #34
zdw wrote: post #5

This 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…

It really is. And it's not good software. The UI looks decidedly amateur, and some of the modules are absolute garbage amateur hour (one I see a lot in my job is the ED track board, which captures information from the ED charge nurse about incoming ambulances, bed holds and cleaning needs, and gives a picture on what the ED might look like in the next hour or so). It looks like a VB app from the 90s. Text layout is p…

No, it’s because they don’t pay for another HL7 interface. I am network admin for hospitals and see it daily. We use Meditech anyways, not even close to everyone uses Epic.
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