Why Do People Dislike Epic So Much? Let Me Count The Ways

Man oh man, Epic is burning up the track. As my colleague John Lynn noted in a recent post, there are tons of reasons why it’s developed a near monopoly in some sectors, especially with large hospitals.

Founded in 1979 with an initial investment of $70,000, the company now is conservatively estimated by Wall Street analysts to be worth $1.2 billion (as of 2008), Lynn notes.

And there’s tons of reasons Epic is doing so well (facts courtesy of @DanMunro) including:

* Kent Gale, president of KLAS Enterprises, a research firm known in healthcare specifically for its customer surveys said “…there’s a huge gap between Epic and the other vendors. That is probably the biggest differentiator. They are able to keep their commitments better.”
* Epic ranked No. 1 in seven out of 20 categories in one of KLAS’ most recent survey (and they don’t sell products for several of the categories).
* Epic’s software enabled Kaiser, the country’s largest health system (outside of VA?), to confirm that Vioxx increased the risk of blood clots, leading to the prescription painkiller being pulled from the market.
* The company rarely negotiates on price. There is one exception: It has been known to give breaks, such as waiving its annual maintenance fee, to struggling hospitals.

But is that all there is to the story? I don’t think such complaints are enough to generate the resentment, heck, hatred you pick up out there sometimes regarding the EMR giant.

It can’t help that many users dislike the Epic interface and generally find the product to be a PITA to use.  That doesn’t exactly generate good will.

The capper, really, may be the way Epic is handling its clout. CEO Judith Faulkner seems to be taking on an imperial attitude, doubtless because her company controls so many installations that it practically controls aspects of the entire US health reform process.

If you think that’s scary, consider the following. About six years ago, Geisinger Health System spent $35 million on an Epic Systems install. Not only after, during a pilot test of the software, the hospital’s psychiatric unit started to get wildly inconsistent and inappropriate medication orders. Apparently, the problem was an incompatibility between a commonly-used pharmacy database in place at Geisinger and the Epic system.

OK, just about any system can fail, and unfortunately, drug dosage problems are one of the many possible points of failure. That’s not what frightens me.

What had me reeling was a quote from a Business Week article written not long after the Geisinger debacle. When questioned, Faulkner didn’t apologize: she said, in essence, that it was Geisinger that was at fault for having the temerity to try and integrate Epic technology with existing systems. “It doesn’t work when you mix and match vendors,” Faulker told the magazine. “It has to be one system, or it can be dangerous for patients.”

Bear in mind that this was several years ago. I can only imagine that Faulker’s attitude has hardened since then, as her company’s market share and power has grown.  Will her position — that using best-of-breed, integrated health IT products is a bad idea — push the entire industry in that direction?  Perish the thought.

And that, my friends, is reason enough alone to reject Epic and all of its works, if you have the option.  At minimum, a healthy dislike seems very much in order. But maybe I’m being too harsh. What do you think?

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

11 Comments

  • I don’t think you’re being too harsh. Epic loves it’s closed wall garden. It will take a while to overcome that issue to the point that an open walled alternative is available. Until then, Epic will continue filling up its bank account.

  • Just went live with EPIC and not impressed with its claims for “improved integrated care”. Administrators just listened to their propaganda. They are not aware how many glitches there are at the bedside. Documentation will get easier, of course, but the communication between departments and clinics stinks.

  • Karean,

    This is a common problem with ALL EMR systems. Unfortunately, communication has been an issue in healthcare for generations and, though, EMRs can improve this, they will NOT do so overnight. With that said, you have the right to your own opinion. The value of an EMR system is in the eye of the end user, BUT Epic seems to be doing something right.

  • I am a Willow principle trainer and have a background in pharmacy automation (mckesson and pyxis) and I can agree that it is not Epics fault if the interface was not compliant. They design the software to be stand alone, but has the capability to interface with the pharmacy systems- IF the pharmacy leadership takes the initiative to create the flow. It is a very precise database manage and process with ensuring the medication ordered is the one dispensed when dealing with automation and barcoding. Epic provides the resources, but it is up to pharmacy to manage the databases. I work in a 14 hospital system with McKesson automation and Pyxis machines and it flows precisely as expected.

  • I’ve been at the bedside for 30 years, much of that time in the ICU. I have used 5 different clinical documentation systems and I can tell you EPIC is by far the easiest and fastest. EHR problems abound in a number of areas. I often wonder when I look at these programs who was responsible for the clinical input. Having said that EPIC, is a superior product relative to what is in the market.

  • EPIC will drive more physicians into retirement than any other factor. What used to take 5 minutes now takes 20. Not to mention the stress and frustration using it. The question is this; why are we being forced into a system that drives good experienced dr’s away? More and more surgeons will drop their inpatient surgeries and only do outpatient procedures at surgery centers that do not use a EHR.

  • I wholeheartedly agree with the last commenter. Our installation is a meaningful use compliant piece of junk. Judith is an completely unskilled computer scientist but a first class charlatan. EMR systems don’t have to be this bad. Hopefully others will catch on.

  • The reason why EHR systems are so bad is that they were not constructed with PROCESSES in mind. They have attempted to create a connection for DATA entry and DATA sharing. The data entry has not been appropriately designed for unique healthcare providers/services, have not organized the data to consolidate it for “meaningful use” and have not incorporated AUTOMATION of processes. They have not connected the industry PROCESSES just the sharing of data. DATA itself does not decrease cost or improve quality. PROCESSES do. In the future, EHR will be WEB-BASED (more affordable, built in connectivity) connecting all hospitals to each other and to insurers, IPAs, patients with real-time information/action exchanges, structure data entry in a way that is user-friendly, utilize automated processes that will decrease workforce effort and expert medical algorithms to consolidate, structure, analyze data… enabling the healthcare provider (nurse, physician, ancillary services, hospitals, insurers) the ability to spend the time PROVIDING quality care to patients. First the spine then the bone, muscle and skin. These current EHRs have no central nervous system (PROCESSES) and therefore have handicapped the true benefit of available technology.

  • A Geisinger patient noted in the current probems report attributed to EPIC, it stated: Atypical Psychosis (the patient had been drugged for removal of kidneys.) The patient suffered with delirium until the “medication” was ceased. It had a reverse influence. Once halted, his condition rapidly improved, and he was released from the hospital within two days.
    The patient complained that two years later the report from EPIC continued to list the psychosis on the current problem reports. The doctor attempted to change the term, but each time, the word delirium was automatically switch to psychosis.
    Regarding cancer, a patient was being treated with cancer for a period time until and a doctor ordered another PET/CT. There was no cancer (just blood). But more than one year later, the Epic report continued to state cancer as a current problem. The list goes on. The physican nurse commented that Epic would not permit the correction. Indeed, the patient never had a psychotic problem before the treatment nor afterwards. Can Epic really have such control?

  • Sorry,correction to typos: “each time the term delirium was typed the delirium was automatically changed to …
    “patient was being treated for cancer.” Not with can… Also, “physican and nurse commented”

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