I've heard interminable complaints about Epic...
For heaven's sake, their patient portal is written in ASP .NET!
Howdy. I'm a CS major this 2015 application cycle with 2+ years of industry experience as a web programmer.
Some thoughts:
Epic. Oh Epic. It's basically a sweatshop for programmers. I have many friends that were lured into working there after college. Nearly all of them quit within a year and the rest are planning their exit. I interviewed there, but fortunately read the countless Glassdoor reviews about their terrible retention rate.
As for their software, it's mostly legacy code heavily written on top of an outdated database that they pay Microsoft to maintain because it would go defunct otherwise. No programmer this day and age wants to be programming in .NET.
It seems EHR is way behind the curve, design-wise. Epic is not a satisfactory system. You'd think with the billions of dollars they're raking in, they could at least invest in some serious UI/UX training.
There is SOOOO much room for innovation in EHR. Problem is, there are patents on top of patents to be waded through, then meaningful use requirements to be filled. Cost of investment is very high. That being said, there are many tech investors looking at the medical sector, wanting to get a cut of that market.
Yes. You can combine computer science with just about any discipline. It might just be on your own time, but a you'll eventually hit a problem in your day to day activities and think, "I could write a program to do this for me."
I really believe that there need to be more clinician-doctors developing software because they have the best understanding of what clinicians and patients need. The greater the degree of separation from the end user, the harder it is to develop software. As DHH says, "Scratch your own itch." Some of the best software is the stuff you write for yourself as opposed to other people because you have an intimate understanding of the user.
+1
Agree with this!
I used the Epic system of one of the aforementioned health systems and let me tell you, it sucked. Sunrise was actually much better, but lacked the integration necessary for future operations. The way Epic is set up, it's damn near impossible to find any useful information from anyone that doesn't have their system built exactly as yours is. Need some nursing data that isn't in your abridged physician chart? Good luck finding it, as it's buried so deep in the system that unless you're a nurse, you either will have trouble finding it or don't have access to it altogether. Want to look at the respiratory weaning flowsheet for the morning? Wouldn't we all! But only respiratory has access to the full respiratory flowchart, because someone thought that in the name of convenience and brevity only certain respiratory data should be passed on to the physician flowsheets, and the weaning data wasn't a part of it.
Valid. Just because they're popular doesn't mean they're the best gig in town, but I think there are examples out there of what it can do right. There's a different between the capabilities vs. execution of an EHR. There are several large health systems that have been recognized for their integrated EHR systems, and several of them are Epic: http://www.himss.org/resourcelibrary/TopicList.aspx?MetaDataID=2803.
A lot of that recognition is based less on the hospital's actual implementation of the system and more on their ability to sell their implementation of said system, just as EHR systems are not selected so much based on their capabilities as they are on how good their sales departments are.
That's the thing though- in theory, they could have said our Epic system met meaningful use criteria. It could bill, it could share between facilities flawlessly, it had cross-provider data integration, all the bells and whistles. From the outside, it looks great. But when you're using it day-to-day, it just isn't as great as they sell it, because it records too much information to be useful. There comes a point when you've got so much data that sorting the chaff from the wheat becomes impossible, if you can even find the grains to begin with because they're stored in the wrong warehouse and you don't have the key.
Agreed, there is a lot of information out there and it's not most conducive to patient care. It's the problem when you have non-clinical programmers building a system for clinicians, but I feel like most vendors end up doing that. Sure most vendors have in-house doctors, but they haven't practiced for years most likely, and they do more of that selling that you're referring to. I mean when are we going to have physician programmers? I think the data piece is going to be the next big thing!
+1. I have heard all the same things.
We had a very good implementation of Sunrise that put Epic to shame.
Like I said, I think a lot rests on the hospital to be the translator between the system and the clinicians. If you let all the bells and whistles go that are not really relevant to patient care, then you are stuck with a poor product.
