Epic Systems

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Epic Systems Corporation
Private
Industry Health informatics
Founded Madison, Wisconsin, United States (1979)[1]
Founder Judith Faulkner
Headquarters Verona, Wisconsin, United States
Key people
Judith Faulkner, Founder & CEO
Carl Dvorak, President
Revenue $1.77 billion (2014)[2]
Number of employees
9,000+ (2015)[3]
Slogan Do good. Have fun. Make money.[4]
Website epic.com

Epic Systems Corporation is a privately held healthcare software company. According to the company, hospitals that use its software hold medical records of 54% of patients in the United States and 2.5% of patients worldwide.[5]

History[edit]

Epic Systems Campus in October 2010

Epic was founded in 1979 by Judith R. Faulkner.[6] Originally headquartered in Madison, Wisconsin, Epic moved its headquarters to a large campus in the suburb of Verona, Wisconsin in 2005,[7] where it employed more than 9,000 people as of 2015. In the same year, the company unveiled plans for the fifth phase of expansion with five new buildings each planned to be around 100,000 square feet.[5] The company also has offices in Hertogenbosch, Netherlands; Dubai, United Arab Emirates; Alexandra Road, Singapore; and Søborg, Denmark.[8]

Product and market[edit]

Epic's market focus is large healthcare organizations. The company offers an integrated suite of healthcare software centered on a Caché database provided by InterSystems.[9] 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.

The company's competitors include Cerner, MEDITECH, Allscripts, and units of I.B.M., McKesson, Siemens and GE Healthcare.[10] In 2003, Kaiser Permanente, the largest managed care organization in the United States,[11] chose Epic Systems for its electronic records system.[10] 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,[10][12] and Yale–New Haven Hospital. Partners HealthCare adopted Epic systems in 2016 for $1.2 billion, which critics decried and which is greater than the cost of any of its buildings.[13]

Epic Systems was voted top overall software suite in the 2015/2016 Best in KLAS awards, and took the top spot in 7 smaller segments as well.[14]

Concerns[edit]

Data sharing[edit]

Care Everywhere is Epic's health information exchange software, which comes with its EHR system.[15] A 2014 New York Times article 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 Meaningful Use requirements in a 2009 law. At first, Epic charged a fee to send data to some non-Epic systems.[16] Epic says the yearly cost for an average-sized hospital is around $5,000 a year.[15] However, after Congressional hearings, Epic and other major software vendors announced that it would suspend per-transaction sharing fees.[17] 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.[17] 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.[18] 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.

Research firm KLAS said Epic's scores for data sharing were "as good or better than most of the other vendors". Faulkner says Epic was among the first to create rules about sharing health data and a platform to do so, introducing Care Everywhere in 2005. The United States Office of the National Coordinator for Health Information Technology established a ten-year vision and agenda to achieve health care interoperability in 2014.[19][citation needed][needs update]

UK experience[edit]

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.[20][21]

After 2.1 million records were transferred to it, it developed serious problems and the system became unstable.[22] Ambulances were diverted to other hospitals for five hours and hospital consultants noted issues with blood transfusion and pathology services.[23] Other problems included delays to emergency care and appointments, and problems with discharge letters, clinical letters and pathology test results.[21] Chief information officer, Afzal Chaudhry, said "well over 90% of implementation proceeded successfully".[20]

In July 2015, the BBC reported that the hospital's finances were being investigated.[24] In September 2015, both the CEO and CFO of the hospital resigned,[25] and problems with the clinical records record 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 organisation's sudden failure.[26] 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."[27]

References[edit]

  1. ^ Eisen, Mark (June 20, 2008). "Epic Systems: Epic Tale". Isthmus. Retrieved December 18, 2013. 
  2. ^ Conn, Joseph (March 10, 2015). "Faulkner funds foundation to keep Epic private". Modern Healthcare. Retrieved February 6, 2016. 
  3. ^ Jeff Glaze - Wisconsin State Journal. "Epic Systems draws on literature greats for its next expansion". madison.com. 
  4. ^ Akanksha Jayanthi. "Epic decoded: An inside look at life and corporate culture at the center of the health IT world". beckershospitalreview.com. 
  5. ^ a b Glaze, Jeff (January 6, 2015). "Epic Systems draws on literature greats for its next expansion". Wisconsin State Journal. Retrieved January 23, 2015. 
  6. ^ Eisen, Marc (June 20, 2008). "Epic Systems Corporation: An Epic timeline". Isthmus. Retrieved February 20, 2009. 
  7. ^ Boulton, Guy (August 24, 2008). "Epic Systems' $300 million expansion tangible sign of success". Milwaukee Journal Sentinel. Retrieved January 28, 2016. 
  8. ^ Glad, Jack. "Epic EMR – EHR Review". EHRSoftware.US. Retrieved August 2, 2016. 
  9. ^ Moukheiber, Zina (March 4, 2013). "Behind Epic Systems, A Low-Key Health IT Company Called InterSystems". Forbes. Retrieved June 8, 2014. 
  10. ^ a b c Freudenheim, Milt (January 14, 2012). "Digitizing Health Records, Before It Was Cool". The New York Times. Retrieved September 26, 2014. 
  11. ^ "Kaiser Permanente CEO on saving lives, money", USA Today, October 23, 2012. Retrieved December 21, 2014.
  12. ^ "Electronic Medical Records at The Mount Sinai Medical Center Shown to Greatly Improve Quality of Care". Retrieved 9 April 2015. 
  13. ^ http://www.bostonglobe.com/business/2016/05/16/partners-healthcare-new-computer-challenges-some-doctors-nurses/1I4QsWGjCJ97xFmUbcDbaJ/story.html
  14. ^ "Epic tops Best in KLAS awards for 6th year; See the full list of 2015 winners". Healthcare IT News. Retrieved 2016-02-21. 
  15. ^ a b Sullivan, Mark (December 8, 2014). "Saying Epic is a Closed System is an Oversimplification". Venture Beat. Retrieved January 23, 2015. 
  16. ^ Creswell, Julie (September 30, 2014). "Doctors Find Barriers to Sharing Digital Medical Records". The New York Times. Retrieved January 23, 2015. 
  17. ^ a b Caldwell, 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. Retrieved October 2015.  Check date values in: |access-date= (help)
  18. ^ Kobb, Enesha; Sauser, Kori (2014). Electronic Health Records (PDF). RAND. 
  19. ^ "A 10-Year Vision to Achieve an Interoperable Health IT Infrastructure" (PDF). 
  20. ^ a b "Addenbrooke's Hospital paperless system's 'significant problems' reported". BBC News. November 24, 2014. Retrieved December 21, 2014. 
  21. ^ a b "'Major incident' declared for flagship IT project". Health Service Journal. 25 November 2014. Retrieved 23 December 2014. 
  22. ^ "The NHS's chaotic IT systems show no sign of recovery". The Guardian. December 21, 2014. Retrieved December 21, 2014. 
  23. ^ "Addenbrooke's consultants reveal eHospital concerns in letter to management". Cambridge News. 11 December 2014. Retrieved 21 December 2014. 
  24. ^ http://www.bbc.co.uk/news/uk-england-cambridgeshire-33735417
  25. ^ http://www.bbc.co.uk/news/uk-england-cambridgeshire-34249646
  26. ^ "Addenbrooke's and Rosie hospitals' patients 'put at risk'". BBC News. 22 September 2015. Retrieved 3 October 2015. 
  27. ^ McBeth, Rebecca (25 February 2016). "EPR implementation led to 'catastrophic loss of confidence'". Digital Health Intelligence Limited. Retrieved 7 March 2016. 

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