Epi Software Systems

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Epic Systems Corporation, or Epic, is a privately held healthcare software company. According to the company, hospitals that use its software held medical records of 64% of patients in the United States and 2.5% of patients worldwide in 2015. Epi Info is statistical software for epidemiology developed by Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia (US). Epi Info has been in existence for over 20 years and is currently available for Microsoft Windows, Android and iOS, along with a web and cloud version. The program allows for electronic survey creation, data entry, and analysis. Founded in a basement in 1979, Epic develops software to help people get well, help people stay well, and help future generations be healthier. Sign into the UserWeb, Epic's website for end-users.

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Epic Systems Corporation, or Epic, is a privately held healthcare software company. According to the company, hospitals that use its software held medical records of 64% of patients in the United States and 2.5% of patients worldwide in 2015.^[4]

• 3Concerns

History[edit]

Epic was founded in 1979 by Judith R. Faulkner^[5] with a $70,000 investment^[6] (equivalent to $240,000 in 2018). Originally headquartered in Madison, Wisconsin, Epic moved its headquarters to a large campus in the suburb of Verona, Wisconsin in 2005,^[7] where it employs 9,800 people as of 2019.^[8]

As of 2015, the company was in the fifth phase of campus expansion with five new buildings each planned to be around 100,000 square feet.^[4] The company also has offices in Bristol, UK; 's-Hertogenbosch, Netherlands; Dubai, United Arab Emirates; Helsinki, Finland; Melbourne, Australia; Singapore; and Søborg, Denmark.^[9]

Product and market[edit]

Epic primarily develops, manufactures, licenses, supports, and sells a proprietary electronic medical record software application, known in whole as 'Epic' or an Epic EMR. The company offers an integrated suite of healthcare software centered on its Chronicles database management system. Epic's applications support functions related to patient care, including registration and scheduling; clinical systems for doctors, nurses, emergency personnel, and other care providers; systems for lab technologists, pharmacists, and radiologists; and billing systems for insurers.

Epic also offers hosted solutions for customers that do not wish to maintain their own servers; and short-term optimization and implementation consultants through their wholly owned subsidiary Boost Services.

Epic Systems was voted top overall software suite in the 2018 Best in KLAS awards; the company has received this award 8 years in a row. Epic Systems also took the top spot for overall physician practice vendor in 2018, receiving Best in KLAS awards in 7 segments.^[10]

The company's competitors include Cerner, MEDITECH, Allscripts, athenahealth, and units of IBM, McKesson, Siemens and GE Healthcare.^[11] In 2003, Kaiser Permanente, the largest managed care organization in the United States,^[12] chose Epic for its electronic records system.^[11] Among many others, Epic provides electronic record systems for Cedars-Sinai Medical Center in Los Angeles, the Cleveland Clinic, Johns Hopkins Hospital, The Mount Sinai Hospital,^[11][13]UC Davis Medical Center in Sacramento, multiple campuses of the Mayo Clinic,^[14] and Yale–New Haven Hospital. Partners HealthCare began adopting Epic systems in 2015 in a project initially reported to cost $1.2 billion, which critics decried and which is greater than the cost of any of its buildings.^[15] By 2018, the total expenses for the project were $1.6 billion, with payments for the software itself amounting to less than $100 million and the majority of the costs caused by lost patient revenues, tech support and other implementation work.^[16]

Concerns[edit]

Data sharing[edit]

Care Everywhere is Epic's health information exchange software, which comes with its EHR system.^[17] A 2014 article in The New York Times interviews two doctors who say that their Epic systems won't allow them to share data with users of competitors' software in a way that will satisfy the Meaningful Use requirements of the HITECH Act. At first, Epic charged a fee to send data to some non-Epic systems.^[18] Epic says the yearly cost for an average-sized hospital is around $5,000 a year.^[17] However, after Congressional hearings, Epic and other major software vendors announced that they would suspend per-transaction sharing fees.^[19] Epic customers must still pay for one-time costs of linking Epic systems to each individual non-Epic system with which they wish to exchange data; in contrast, Epic's competitors have formed the CommonWell Health Alliance which set a common interoperability standard for electronic health records.^[19] A 2014 report by the RAND Corporation described Epic as a 'closed' platform that made it 'challenging and costly for hospitals' to interconnect with the clinical or billing software of other companies.^[20] The report also cited other research showing that Epic's implementation in the Kaiser Permanente system led to efficiency losses. Implementation in the Hennepin Health system did not change outcomes for critically ill patients; however, physicians complained of workflow interruptions and slower processes of care.^{[citation needed]}

In September 2017, Epic announced Share Everywhere, which allows patients to authorize any provider who has internet access to view their record in Epic and to send progress notes back.^[21]

UK experience[edit]

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An Epic electronic health record system costing £200 million was installed at Cambridge University Hospitals NHS Foundation Trust in October 2014, the first installation of an Epic system in the UK.^[22][23]

After 2.1 million records were transferred to it, it developed serious problems and the system became unstable.^[24] Ambulances were diverted to other hospitals for five hours and hospital consultants noted issues with blood transfusion and pathology services.^[25] Other problems included delays to emergency care and appointments, and problems with discharge letters, clinical letters and pathology test results.^[23] Chief information officer, Afzal Chaudhry, said 'well over 90% of implementation proceeded successfully'.^[22]

In July 2015, the BBC reported that the hospital's finances were being investigated.^[26] In September 2015, both the CEO and CFO of the hospital resigned.^[27] Problems with the clinical-records system, which were said to have compromised the 'ability to report, highlight and take action on data' and to prescribe medication properly, were held to be contributory factors in the organization's sudden failure.^[28] In February 2016, digitalhealth.net reported that Clare Marx, president of the Royal College of Surgeons of England and member of the NHS National Information Board, found that at the time of implementation, 'staff, patients and management rapidly and catastrophically lost confidence in the system. That took months and a huge amount of effort to rebuild.'^[29]

Danish experience[edit]

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Danish health authorities spent 2.8 billion DKK on the implementation of an Epic system for the two largest health regions in Denmark. An audit of the implementation that voiced concerns was published in June 2018.^[30] At the end of 2018, 62% of physicians expressed they were not satisfied with the system.^[31]

See also[edit]

References[edit]

1. ^Eisen, Mark (June 20, 2008). 'Epic Systems: Epic Tale'. Isthmus. Archived from the original on December 19, 2013. Retrieved December 18, 2013.
2. ^Conn, Joseph (March 10, 2015). 'As Epic Systems has soared, Madison has become a center for health information technology'. Modern Healthcare. Archived from the original on May 22, 2018. Retrieved December 8, 2017.
3. ^Jeff Glaze - Wisconsin State Journal. 'Epic Systems draws on literature greats for its next expansion'. madison.com. Archived from the original on January 9, 2015. Retrieved January 23, 2015.
4. ^ ^abGlaze, Jeff (January 6, 2015). 'Epic Systems draws on literature greats for its next expansion'. Wisconsin State Journal. Archived from the original on January 9, 2015. Retrieved January 23, 2015.
5. ^Eisen, Marc (June 20, 2008). 'Epic Systems Corporation: An Epic timeline'. Isthmus. Archived from the original on May 22, 2011. Retrieved February 20, 2009.
6. ^'Epic Systems soars with transition to electronic health records'. Archived from the original on November 16, 2016. Retrieved November 15, 2016.
7. ^Boulton, Guy (August 24, 2008). 'Epic Systems' $300 million expansion tangible sign of success'. Milwaukee Journal Sentinel. Archived from the original on February 4, 2016. Retrieved January 28, 2016.
8. ^Newman, Judy (April 8, 2019). 'Electronic health records giant Epic Systems turns 40'. Wisconsin State Journal. Retrieved June 5, 2019.
9. ^Glad, Jack. 'Epic EMR – EHR Review'. EHRSoftware.US. Archived from the original on August 2, 2016. Retrieved August 2, 2016.
10. ^'Epic Systems lands Best in KLAS award 8th year in a row'. Healthcare IT News. Archived from the original on June 29, 2018. Retrieved June 29, 2018.
11. ^ ^abcFreudenheim, Milt (January 14, 2012). 'Digitizing Health Records, Before It Was Cool'. The New York Times. Archived from the original on December 25, 2016. Retrieved September 26, 2014.
12. ^'Kaiser Permanente CEO on saving lives, money'. USA Today. October 23, 2012. Archived from the original on January 26, 2015. Retrieved December 21, 2014.
13. ^'Electronic Medical Records at The Mount Sinai Medical Center Shown to Greatly Improve Quality of Care'. Archived from the original on April 15, 2015. Retrieved April 9, 2015.
14. ^Reilly, Mark (July 14, 2017). 'Mayo Clinic begins shift to $1.5B digital records system from Epic Systems'. Milwaukee Business Journal. Retrieved November 26, 2018.
15. ^'Partners HealthCare's new computer system challenges some doctors, nurses - The Boston Globe'. BostonGlobe.com. May 16, 2016. Archived from the original on April 15, 2017. Retrieved May 17, 2017.
16. ^Gawande, Atul. 'Why Doctors Hate Their Computers'. The New Yorker. Retrieved November 7, 2018.
17. ^ ^abSullivan, Mark (December 8, 2014). 'Saying Epic is a Closed System is an Oversimplification'. Venture Beat. Archived from the original on January 25, 2015. Retrieved January 23, 2015.
18. ^Creswell, Julie (September 30, 2014). 'Doctors Find Barriers to Sharing Digital Medical Records'. The New York Times. Archived from the original on January 23, 2015. Retrieved January 23, 2015.
19. ^ ^abCaldwell, Patrick (October 2015). 'EPIC FAIL. Digitizing America's medical records was supposed to help patients and save money. Why hasn't that happened?'. Mother Jones. Archived from the original on September 7, 2017. Retrieved September 6, 2017.
20. ^Kobb, Enesha; Sauser, Kori (2014). Electronic Health Records(PDF). RAND. Archived(PDF) from the original on March 22, 2016. Retrieved March 7, 2016.
21. ^Boulton, Guy (November 10, 2017). 'Epic Systems lets patients share medical records with doctors around the world'. Milwaukee Journal Sentinel. Retrieved November 16, 2017.
22. ^ ^ab'Addenbrooke's Hospital paperless system's 'significant problems' reported'. BBC News. November 24, 2014. Archived from the original on November 27, 2014. Retrieved December 21, 2014.
23. ^ ^ab''Major incident' declared for flagship IT project'. Health Service Journal. November 25, 2014. Archived from the original on December 23, 2014. Retrieved December 23, 2014.
24. ^'The NHS's chaotic IT systems show no sign of recovery'. The Guardian. December 21, 2014. Archived from the original on December 21, 2014. Retrieved December 21, 2014.
25. ^'Addenbrooke's consultants reveal eHospital concerns in letter to management'. Cambridge News. December 11, 2014. Archived from the original on January 3, 2015. Retrieved December 21, 2014.
26. ^'Addenbrooke's Hospital's e-hospital finances investigated'. July 31, 2015. Archived from the original on December 3, 2016. Retrieved May 17, 2017 – via www.BBC.co.uk.
27. ^'Addenbrooke's Hospital chief executive Keith McNeil resigns'. September 14, 2015. Archived from the original on August 17, 2017. Retrieved May 17, 2017 – via www.BBC.co.uk.
28. ^'Addenbrooke's and Rosie hospitals' patients 'put at risk''. BBC News. September 22, 2015. Archived from the original on September 24, 2015. Retrieved October 3, 2015.
29. ^McBeth, Rebecca (February 25, 2016). 'EPR implementation led to 'catastrophic loss of confidence''. Digital Health Intelligence Limited. Archived from the original on February 28, 2016. Retrieved March 7, 2016.
30. ^'Har brukt 2,8 milliarder på ny plattform: – Ikke mulig å tro at profesjonelle aktører er i stand til å lage et så elendig produkt'. Digi.no (in Norwegian). Archived from the original on June 25, 2018. Retrieved June 25, 2018.
31. ^Christensen, Mikkel Fyhn; Sturlason, Astrid Sofie (January 23, 2019). 'Blå blok vil droppe Sundhedsplatformen: »Har gjort det værre for sundhedspersonale og patienter i stedet for at gøre det bedre«'. Berlingske.dk.

External links[edit]

• Epic, state's largest solar producer, to build own wind farm - Milwaukee Journal Sentinel article
• Epic Systems feeling heat over interoperability - Modern healthcare article
• Epic Systems, Leading Defense EHR Bidder, Slammed for Lack of Interoperability - Nextgov article
• Patient records giant Epic Systems will take a big step into the cloud in 2015 - VentureBeat article
• Cancer moonshot head recounts exchange with Epic’s Faulkner - Politico article

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