Who’s Responsible? Epic or EHR Configuration

There’s a classic software problem that many who use an EHR don’t understand.  This was highlighted in a recent tweet by Dr. Graham Walker:

What’s Dr. Walker talking about? At the core of what he’s saying is that many people complain about Epic (or insert any EHR here) when in fact, the problem they’re complaining about is something that could be configured differently and would then not be a problem. Dr. Walker shared an example:

Obviously, there’s a lot going on in this tweet if the person feels like Epic “judging” them, but we’ll set that aside for this article. Are these push notifications an Epic problem or is Cadie’s organization who made the decision to leave these notifications on the problem? What’s Epic supposed to do? Go and force the hospital to turn off notifications they think are valuable?

Dr. Genie offered more insight and perspective on this:

A great example of this is would we get mad at Word for their spell checker changing EHR to HER? Ok. People do get mad over this, but do they hold Microsoft responsible? And of course, if you just add EHR to your dictionary in Word, then it won’t happen anymore. Is it Microsoft’s responsibility to let you know that there’s a feature that would prevent this pain?

The real problem is many healthcare organizations and EHR users who don’t know all the features in their EHR. Joanne Cournoyer told a classic story:

Of course, that’s not to say that EHR vendors are perfect and they don’t lack responsibility. In fact, Dr. Gabe Wilson asks this great question about why a poor configuration is even possible:

Dr. Walker’s response highlights the challenge that EHR vendors face and most users don’t appreciate. I’ve heard it over and over again from people. One doctor will describe a feature as the worst implementation ever and another doctor will describe that same feature as their favorite part of the EHR.

GruntDoc also got in on the action and shared how he often found it was the local configuration that was causing the problem.

Matt Van Cuyk highlighted the solution that I see in most healthcare organizations. It’s the often underappreciated informatics team:

Going back to where we started, Clay Forsberg offers this perspective:

He’s right that it’s still an Epic problem. Each of these “configuration” or “optimization” issues will take a toll on Epic’s EHR users and Epic will have to account for it. I recently heard Judy from Epic say that she understood at least part of this problem. To help address it, she created a grade for each of their customers for how much of their software they were actually using, were they updated to the latest version, etc. She didn’t share many details, but at least she understood that there was a problem of many healthcare organizations not being on the latest software where issues were resolved and of many organizations not using features that could make for a better user experience. No doubt, the problem above is also why the various EHR user conferences are so valuable. Meeting with users from another organization will often help an organization discover features they didn’t know about or better ways to optimize their configuration.

No doubt this is an age old enterprise software problem that’s not unique to EHR software. Whenever you have a software this complex that’s serving so many different organizations you’re going to have the challenge of whether it’s a configuration issue or a software issue.  The reality with enterprise software, it’s usually both.

About the author

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

   

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