News 11/22/06

Re: Sucking the energy out of Epic...

Kaiser is a pretty huge success - at least compared to any non governmental install on this planet(and aren't those inexpensive endeavors). Mr HIStalk - you could dig up a few facts that would easily establish that. And Epic along with some very hard working Kaiser people got them there. The Kaiser project was hard work, but it didn't suck the energy out of Epic.

> 5000 docs came live on an EMR, 4 million patients on EMR and more like 8million on practice management. Almost all patients now have access to their results and messaging via the patient Portal (kp.org). 30 hospitals have been rolled out with pharmacy and administrative/billing systems. 2 live CPOE sites.

None of that sucked the energy out of Epic. Though all this, they hit stride and continually improved and beat the competition.

What's sucks energy is very small group of goofy or disgruntled employees and unwitting bloggers and media people who benefit from the swirl and controversy more than they benefit from the truth.

You don't have to be a credentialed psychologist to recognize the hate posted on corphq.livejournal.com for what it is... a very small, very disgruntled and very unstable minority.

This isn't an Erin Brockovich story, but the media sure wishes it could be. Makes for better sales and readership.

Time to get on with life people. You need to do more than just wish bad things upon Kaiser because they are big. Instead - dazzle us with a few accomplishments of your own!

// namely that he is supervisor in the health education publications department and thus has no standing to speak//

First, only lawyers say "has no standing". Second, Justen is a project manager - the word "supervisor" is being used by Kaiser PR weenies who are trying to craft a message that demotes him. I call KaiserTurf!

Second, how did I miss your "who do you believe" poll? Put me down for Justen. And in some respects I can vouch/witness for him as well.

No offense, but can we move along? Hasn't Mr. Deal exhausted his 15 minutes?

"Large Group Looking" might want to take another look at that KLAS report. KLAS only has a 100+ provider category for one solution set - Ambulatory Billing and Scheduling. Epic is rated #1 in that category. AthenaHealth is #1 in the 1-5, 6-25, 26-100 physicians ambulatory billing and scheduling categories - a very impressive performance, but in segments of the market where Epic doesn't play.

Premature E-activation? Good grief - it is going to take me an hour to clean the coffee from the keyboard after reading that.

I cannot believe the amount of misinformation posted by some people. This one really struck me: " Oh, but wait, they cram most of us two to an office because we didn't build enough space initially..." When did this person last work for/visit Epic? At the Verona campus, almost every single person has their own office. I have walked the halls, and only saw a couple offices here and there with two name tags. Doubling up is VERY far from the norm out there.

"You don't have to be a credentialed psychologist to recognize...blah blah blah"

Easy to recognize your comment for what it is. Kaiser always tries to discredit anyone who complains as a "very small, very disgruntled minority." I've heard it so many times it no longer rings true, sort of like the ridiculous Thrive commercials (tell it to the kidney patients). Kaiser has done it to Justen, and everyone else who has had the cajones to complain knowing the kind of attacks on their character that will result. Fortunately a very stable majority believes Justen over Kaiser's lame PR.

The issue with Epic is that they only hire fresh people out of college to make decisions. At the hospital I worked at, they did not get that we had a different tax ID number and therefore billed differently than the hospital we were affiliated with. Their comment to this quandry, "This is how it is done and there is no changing it". Maybe they should figure out that hiring college students with no healthcare experience to implement and develop their systems does not give them the intelligence they need when it concerns workflow, industry knowledge, and most importantly, how healthcare works with regards to government in the real world. It amazes me that the industry in general is that naive to the whole Epic epidimic. I wish them the best in their endeavors, but why are hospitals so eager to pay them for products that are either in Beta or being developed?

//Hasn't Mr. Deal exhausted his 15 minutes?//

It's not about Justen's 15 minutes - it's about the fact that he's still on administrative leave, and Kaiser is just waiting for the media cycle to end to drop the hammer on him. If Kaiser gets away with that, then they confirm that they can get away with retaliation for mere criticism - which will server to intimidate the rest of their employees. This will set a horrific example for other large corporations as well.

This also goes way beyond the realm of HIT: it's about the quality of health care. Members of the general public who want the best health care system possible should care very much whether Kaiser and other HMOs permit employee criticism. The public needs to understand that when that criticism is conducted through the quiet venues that Kaiser prefers, the employee ends up being fired anyway, and then the problem just lingers on or gets worse.

to SCC - Epic doesn't beta. Things are released when they're released.

To people who are complaining about having "two to an office" or suchlike - when they started building the Verona campus, the company was half the size it is now and there WAS enough space at that time, first of all, and second of all, for those of us who are in Verona, most people are not sharing offices, and those who are usually have window offices, and we would all agree that even sharing an internal office with a door that shuts beats working in a cube farm.

Get over it and grow up. It's your job, not your life, and it certainly beats a lot of other places I've had the opportunity to work (coming, as I did, some time after having graduated from college).

// Kaiser is a pretty huge success - at least compared to any non governmental install on this planet //

Success by what measure? As far as I've read, their California region (their largest, by far) is years behind every other major HMO and hospital chain. They're program has been drug through the mud for the fact that it's billions over budget and down so often that it's jeopardizing patient care. And, given all that, most of their clinics have only put the Epic check-in piece into play, and they've only gotten two hospitals to get the inpatient piece live.

That isn't success, by any measure. It seems to me like it's heading fast down the road to failure, if it hasn't already arrived, at least.

All of the pieces for members.kp.org, except physician messaging, are actually from the legacy systems. Lab results, appointment times, prescriptions, are all from the legacy apps (or in the case of prescriptions and refills, from the third-party pharmacy app they chose to integrated into the Epic suite). Epic is doing some work on helping KP integrate some of those parts into a more seamless "EpicWeb experience," but I don't think Epic can yet take credit for the KP member portal features. Last I heard, that's sometime into 2008 right now for most of the regions (other than California, which might be 2009 at this point).

I agree with Fish N Chips concerning the scalability of the non-stop platform and Carecast. It would have done the job for large scale EMRs/EHRs such as Kaiser and Sutter with one caveat, Flowcast. If folks look towards Flowcast to handle the ADT and the billing piece, then the scalability of such an environment is just as good (or bad) as any other HIS offering. In fact, it might be a bit worse since the client would have to do the work and tie them together. Thus a client of such scale would have to use Carecast in it's entirety. Now there maybe implemenation issues to get Carecast in but it's not as bad as any other HIS offering, including Epic.

It seems to be in these circumstances that the hospital systems do not pay attention to their technical environment as much to the application workings. Thus, they suffer as a consequence due to downtimes, slowdowns, etc. Is there a lesson that was picked up? I doubt it. Incoming CEOs/CIOs will still have their biases as well as there are bandwagons to jump on.

Can someone really tell me there's that much of a difference between the systems? Even you Mr. HISTalk have stated that these systems are behind the times. If so, what difference does it make to select a given system other than those that do their due diligence and make a selection that fits their environment. I think that folks are picking Epic more because of the bandwagon effect versus anything spectacularly better than Cerner, GE, Misys, Meditech, etc.

I challenge someone to tell me different. One request, don't go into how clients have to tie together the disparate GE/IDX systems like Sharp, Stanford, etc. That's a very well known and glaring weakness. I'm talking about a stack up where a given HIS is the system of record and manges the CIS functionality.

Yes, Duuude, you are correct that most hospitals tend to over-emphasize user-functionality in their selection process. There is also some emphasis on reliability and support, however. That's why Meditech wins so often. Their system works and does exactly what they say!

It's great, Duuude, that you really love Comcast, but you need to know something. Comcast is history. It is as dead in the marketplace as that Russian spy that died in a Comcast hospital in London.