Later in October, a piece published in Mother Jones by Patrick Caldwell had few kind words to say about the country’s #2 EHR software vendor and self-proclaimed possessor of over 56 percent of the country’s patient records. “Instead of ushering in a new age of secure and easily accessible medical files, Epic has helped create a fragmented system that leaves doctors unable to trade information across practices or hospitals,” Caldwell writes.
While participating in such indictments and public thrashings of a software vendor that makes billions can be a droll activity, it is far from productive. Instead, we aim to provide some constructive criticism to Epic and other similar vendors who somehow dominate the market yet leave thousands of customers unsatisfied.
To point the market in a better, more results-oriented direction, here are five things companies like Epic can do to improve their offerings and the outcomes they bring:
1. Recognize the Need for Interoperability
When reading criticisms of Epic and other similar vendors “interoperability” is a word you will often hear brought up. Specifically, a lack thereof.
If a provider installs an Epic EHR system but does not want to use their proprietary billing or clinical modules, there will be heck to pay in the form of a confounding workflow and a general lack of easy methodology.
Epic will need to implement open-ended methods for clients who do not wish to use Epic software for all of their record-keeping and administrative needs rather than practically forcing each customer to go with the full suite.
2. Facilitate Easier Data Transfers to Other Providers with Competitor Systems
Epic’s software suite does an excellent job of communicating within installed hospital systems, some say. Different departments can quickly gain access to the files and information they need across the organization.
Transferring information to a different organization, however, is a different story. Sending and receiving updates to files or events like test results or prescriptions filled can be difficult. Worse, it can lead to errors like redundant entries, incorrect data and other mishaps that can directly detract from the quality of patient care.
“What [Epic] doesn't have — and ditto systems created by competitors Cerner and Meditech, the other bigwigs in EHR — is a framework to connect to other facilities using competing EHR systems,” Caldwell writes.
Standardization of file formats and a reliable, consistent way to export and import information could solve this problem. The issue as it stands now seems to be that companies like Epic have little incentive to operate simultaneously alongside systems installed by competitors.
In fact, Epic used to charge a per-patient fee until quite recently for such transfers. Defending the practice, Epic’s Eric Helsher stated: “We felt the fee was small and, in our opinion, fair and one of the least expensive, but it was confusing to our customers and others in understanding how it worked. There was logic to it, but it confused people, so we decided to end the fee until at least 2020 when we'll consider reevaluating.”
The tone of such statements belies the begrudging reaction Epic has when it is scolded and told to “play well with others.”
3. Improve the Quality of Individual Modules
When Epic was first released to the market, EHR systems were in their infancy relative to the development of other software. As such, Epic was one of the only solutions available that could offer a full suite of software modules as an end-to-end solution.
While as a whole the capabilities of the system can be satisfactory, each component when examined individually can be quite underwhelming. “What you hear is that, if you were to buy the best of breed — the best cardiology system, or the best chemotherapy system — no one would ever choose Epic,” University of Michigan researcher Julia Adler-Milstein told Caldwell.
To solve the problem, Epic must look to its smaller but recognized competitors. SOAPware, for instance, has received top marks for its functions that improve the quality of patient care. CureMD has similarly been praised for its E&M functions as well as its seamless integration with revenue cycle management modules. Making incremental improvements to each module could result in a more satisfactory product overall.
4. Open the Door to Outside Improvements
Most restaurants don’t let you bring your own condiments to the table, but software is different. Companies like Apple and Google released easy-to-use stable APIs so that third-party developers could create programs that added to the functionality of their mobile devices — thus, the App Store was born.
If EHR vendors like Epic would release similar APIs, innovation and competition would lead to huge improvements in functionality. Some companies are actively exploring this route, even collaborating with one another, but they will more than likely become competitors to Epic’s existing model rather than an impetus for it to adapt.
5. Be Wary of Nasty Rumors
At the risk of getting into more tabloid-style content, let us suffice it to say that many of the roles Epic has filled indicate a conflict of interest. According to Caldwell, many on Capitol Hill see Epic CEO Judy Faulkner’s appointment to the White House Health IT Policy Committee in 2009 and the company’s subsequent rise to prominence as hardly a coincidence.
Even if such hinted-at allegations were not true, the fact remains that large companies should be cautious when throwing their money around lest others get to talking. Maintaining an ethical image should be priority one for any company that wants to proclaim a customer-oriented focus rather than a focus on growth by any means necessary.
Get More from the Little Guy
CureMD aims to improve upon the criticisms leveled towards our industry at large by emphasizing interoperability and high-quality modules systems that can be purchased a la carte. We also maintain a steady staff of technical support to ensure that none of our customers get left high and dry should an issue arise.
Learn more about how our company tries to be different than the big guys by taking a look at our EHR and digital medical systems solutions.
Alex Tate is a health IT Consultant at CureMD who provides perceptive, engaging and informative content on industry wide topics including EHR, EMR, practice management and compliance.