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Is Cerner Edging Up On Epic?

Posted on January 7, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

At Verona, Wisc.-based Epic Systems, growth is a way of life. In fact, the EMR vendor now boasts a workforce of 9,400, which is estimated to be an increase of 1,400 staffers over the past year.

Not only that, Epic is confident enough to build cute. Its Campus 4, dubbed the “Wizards Academy Campus,” is designed to resemble the fictional Hogwarts school of Harry Potter fame — or if you’re academically-minded, England’s Oxford University. When completed this summer, Campus 4 will add 1,508 offices and 2,000 parking spaces to the Epic headquarters.

I could go on with details of the Disneyland Epic is making of its HQ, but you get the picture. Epic leaders are confident that they’re only going to expand their business, and they want to make sure the endless streams of young eggheads they recruit are impressed when they visit. My guess is that the Epic campus is being designed as a, well, campus speaks to the idea of seeing the company as a home. When I was 25, unique surroundings would have worked on me!

In any event, if I was running the place, I’d be pretty confident too. After all, if its own stats are correct, Epic software is either being used by or installed at 360 healthcare organizations in 10 countries. The EMR giant also reports that its platform manages records for 180 million Americans, or about 55 percent of the entire U.S. population. It also reported generating a not-so-shabby $1.8 billion in revenues for 2014.

But a little-noticed report issued by analyst firm KLAS last year raises questions as to whether the Epic steamroller can maintain its momentum. According to the report, which admittedly came out about a year ago, “the competition between Epic and Cerner is closer than it has been in years past as customers determine their future purchasing plans,” analysts wrote.

According to KLAS researchers, potential EMR buyers are largely legacy customers deciding how to upgrade. These potential customers are giving both Cerner and Epic a serous look, with the remainder split between Meditech and McKesson upgrades.

The KLAS summary doesn’t spell out exactly why researchers believe hospital leaders are beginning to take Cerner as seriously as Epic, but some common sense possibilities occur to me:

The price:  I’m not suggesting that Cerner comes cheap, but it’s become clear over the years that even very solvent institutions are struggling to pay for Epic technology. For example, when traditionally flush-with-cash Brigham and Women’s Hospital undershoots its expected surplus by $53 million due (at least in part) to its Epic install, it’s gotta mean something.

Budget overruns: More often than not, it seems that Epic rollouts end up costing a great deal more than expected. For example, when New York City-based Health and Hospital Corp. signed up to implement Epic in 2013, the deal weighed in at $302 million. Since then, the budget has climbed to $764 million, and overall costs could hit $1.4 billion. If I were still on the fence I’d find numbers like those more than a little concerning. And they’re far from unique.

Scarce specialists:  By the company’s own design, Epic specialists are hard to find. (Getting Epic certified seems to take an act of Congress.) It must be quite nerve-wracking to cut a deal with Epic knowing that Epic itself calls the shots on getting qualified help. No doubt this contributes to the high cost of Epic as well.

Despite its control of the U.S. market, Epic seems pretty sure that it has nowhere to go but up. But that’s what Microsoft thought before Google took hold. If that comparison bears any weight, the company that will lap up Epic’s business and reverse its hold on the U.S. market probably already exists. It may not be Cerner, but Epic will face meaningful competition sometime soon.

I Have Seen The Portal, And It Is Handy

Posted on July 14, 2015 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

After writing about EMRs/EHRs and portals for many years, I’ve finally begun using an enterprise-class portal to guide my own care. Here’s some of my impressions as an “inside” (EMR researcher) and “outside” (not employed as a provider) user of this tool. My conclusion is that it’s pretty handy, though it’s still rather difficult to leverage what I’ve learned despite being relatively sophisticated.

First, some background. I get most of my care from northern Virginia-based Inova Health System, including inpatient, primary care, imaging and specialist care. Inova has invested in a honking Epic installation which links the majority of these sites together (though I’ve been informed that its imaging facilities still aren’t hooked up to core medical record. D’oh!) After my last visit with an Inova doctor, I decided to register and use its Epic portal.

Epic’s MyChart has a robust, seemingly quite secure process for registering and accessing information, requiring the use of a long alphanumeric code along with unique personal data to establish an account. When I had trouble reading the code and couldn’t register, telephone-based tech support solved the problem quickly.  (Getting nearsighted as I move from middle- to old-aged!)

Using MyChart, I found it easy to access lab results, my drug list and an overview of health issues. In a plus for both me and the health system, it also includes access to a more organized record of charges and balances due than I’ve been able to put together in many years.

When I looked into extracting and sharing the records, I found myself connected to Lucy, an Epic PHR module. In case you’ve never heard of it (I hadn’t) here’s Epic’s description:

Lucy is a PHR that is not connected to any facility’s electronic medical record system. It stays with patients wherever they receive care and allows them to organize their medical information in one place that is readily accessible. Patients can enter health data directly into Lucy, pull in MyChart data or upload standards-compliant Continuity of Care Documents from other facilities.

As great as the possibility of integrating outside records sounds, that’s where I ran into my first snag. When I attempted to hook up with the portal for DC-based Sibley Memorial Hospital — a Johns Hopkins facility — and integrate the records from its Epic system into the Inova’s Lucy PHR, I was unable to do so since I hadn’t connected within 48 hours of a recent discharge. When I tried to remedy the situation, an employee from the hospital’s Health Information Management department gave me an unhelpful kiss-off, telling me that there was no way to issue a second security code. I was told she had to speak to her office manager; I told her access to my medical record was not up for a vote, and irritated, terminated the call.

Another snag came when I tried to respond to information I’d found in my chart summary. When I noted that one of my tests fell outside the standard range provided by the lab, I called the medical group to ask why I’d been told all tests were normal. After a long wait, I was put on the line with a physician who knew nothing about my case and promptly brushed off my concerns. I appreciate that the group found somebody to talk to me, but if I wasn’t a persistent lady, I’d be reluctant to speak up in the future given this level of disinterest.

All told, using the portal is a big step up from my previous experiences interacting with my providers, and I know it will be empowering for someone like myself. That being said, it seems clear that even in this day and age, even a sophisticated integrated health system isn’t geared to respond to the questions patients may have about their data.

For one thing, even if the Lucy portal delivers as promised, it’s clear that integrating data from varied institutions isn’t a task for the faint of heart. HIM departments still seem to house many staffers who are trained to be clerks, not supporters of digital health. That will have to change.

Also, hospitals and medical practices must train employees to enthusiastically, cheerfully support patients who want to leverage their health record data. They may also want to create a central call center, staffed by clinicians, to engage with patients who are raising questions related to their health data. Otherwise, it seems unlikely that they’ll bother to use it.

Allscripts (MDRX) At Important Moment In Its History

Posted on May 21, 2015 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Allscripts has announced plans to move more of its software development and operations to India, while cutting 250 jobs in the U.S., or about 3.5% of its 7,200-member workforce.  While this is significant enough as it is, it’s an even more important leading indicator of how Allscripts may perform going forward. Here’s how I think things will net out.

Making a “rebalancing”:  The company has called the changes a “rebalancing” of staff which will allow it to respond more effectively and efficiently to shifts in its software design and product dev plans.

But the decision didn’t happen in a vacuum, either. Allscripts recently reported taking a $10.1 million loss for the first quarter ending March 31. That’s down from a loss of $20.7 million for Q1 2014, but the company still appears to be struggling. Allscripts’ overall revenue dropped 2% to $334.6 million for the quarter ending March 31, compared with Q1 of 2014.

What’s next? What should providers draw from these numbers, and Allscripts’ plan to shift more development work offshore? Let’s consider some highlights from the vendor’s recent past:

* Despite some recent sales gains, the vendor occupies a difficult place in the EMR vendor market — neither powerful enough to take on enterprise leaders like Epic and Cerner directly, nor agile enough to compete in the flexibility-focused ambulatory space against relentless competitors like athenahealth.

* According to an analysis of Meaningful Use data by Modern Healthcare, Allscripts is second only to Epic when it comes to vendors of complete EMRs whose customers have qualified for incentives. This suggests that Allscripts is capable of being an effective provider business partner.

* On the other hand, some providers still distrust Allscripts since the company discontinued sales of and support for its MyWay EMR in 2012. What’s more, a current class action lawsuit is underway against Allscripts, alleging that MyWay was defective and that using it harmed providers’ business.

* Partnering with HP and Computer Sciences Corp., Allscripts is competing to be chosen as the new EMR for the U.S. Department of Defense’s Military Health System, and is still in the running for the $11 billion contract. But so are Epic and Cerner.

The bottom line: Taken together, these data points suggest that Allscripts is at a critical point in its history.

For one thing, cutting domestic staff and shifting dev operations to India is probably a make or break decision; if the change doesn’t work out, Allscripts probably won’t have time to pull back and successfully reorient its development team to current trends.

Allscripts is also at a key point when it comes to growing place in the brutal ambulatory EMR market. With players like athenahealth nipping at its heels from behind, and Epic and Cerner more or less controlling the enterprise market, Allscripts has to be very sure who it wants to be — and I’m not sure it is.

Then when I consider that Allscripts is still in the red after a year of effort, despite being at a peak level for sales, that tears it.  I’m forced to conclude that the awkwardly-positioned vendor will have to make more changes over the next year or two if it hopes to be agile enough to stay afloat. I believe Allscripts can do it, but it will take a lot of political will to make it happen. We’ll just have to see if it has that will.

Customizable EMRs Are Long Overdue

Posted on May 5, 2015 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

EMRs can be customized to some extent today, but not that much. Providers can create interfaces between their EMR and other platforms, such as PACS or laboratory information systems, but you can’t really take the guts of the thing apart. The reality is that the EMR vendor’s configuration shapes how providers do business, not the other way around.

This has been the state of affairs for so long that you don’t hear too much complaining about it, but health IT execs should really be raising a ruckus. While some hospitals might prefer to have all of their EMR’s major functions locked down before it gets integrated with other systems, others would surely prefer to build out their own EMR from widgetized components on a generic platform.

Actually, a friend recently introduced me to a company which is taking just this approach. Ocean Informatics, which has built an eHealth base on the openEHR platform, offers end users the chance to build not only an EMR application, but also use clinical modules including infection control, care support, decision support and advanced care management, and a mobile platform. It also offers compatible knowledge-based management modules, including clinical modeling tools and a clinical modeling manager.

It’s telling that the New South Wales, Australia-based open source vendor sells directly to governments, including Brazil, Norway and Slovenia. True, U.S. government is obviously responsible for VistA, the VA’s universally beloved open source EMR, but the Department of Defense is currently in the process of picking between Epic and Cerner to implement its $11B EMR update. Even VistA’s backers have thrown it under the bus, in other words.

Given the long-established propensity of commercial vendors to sell a hard-welded product, it seems unlikely that they’re going to switch to a modular design anytime soon.  Epic and Cerner largely sell completely-built cars with a few expensive options. Open source offers a chassis, doors, wheels, a custom interior you can style with alligator skin if you’d like, and plenty of free options, at a price you more or less choose. But it would apparently be too sensible to expect EMR vendors to provide the flexible, affordable option.

That being said, as health systems are increasingly forced to be all things to all people — managers of population health, risk-bearing ACOs, trackers of mobile health data, providers of virtual medicine and more — they’ll be forced to throw their weight behind a more flexible architecture. Buying an EMR “out of the box” simply won’t make sense.

When commercial vendors finally concede to the inevitable and turn out modular eHealth data tools, providers will finally be in a position to handle their new roles efficiently. It’s about time Epic and Cerner vendors got it done!

Epic Belatedly Accepts Reality And Drops Interoperability Fees

Posted on April 21, 2015 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Unbeknownst to me, and perhaps some of you as well, Epic has been charging customers data usage fees for quite some time.  The EMR giant has been quietly dunning users 20 cents for each clinical message sent to a health information exchange and $2.35 for inbound messages from non-Epic users, fees which could surely mount up into the millions if across a substantial health system.  (The messages were delivered through an EMR module known as Care Everywhere.)

And now, Epic chose #HIMSS15 to announce grandly that it was no longer charging users any fees to share clinical data with organizations that don’t use its technology, at least until 2020, according to CEO Judy Faulkner.  In doing so, it has glossed over the fact that these questionable charges existed in the first place, apparently with some success. For an organization which has historically ducked the press routinely, Epic seems to have its eye on the PR ball.

To me, this announcement is troubling in several ways, including the following:

  • Charging fees of this kind smacks of a shakedown.  If a hospital or health system buys Epic, they can’t exactly back out of their hundreds-of-millions-of-dollars investment to ensure they can share data with outside organizations.
  • Forcing providers to pay fees to share data with non-Epic customers penalizes the customers for interoperability problems for which Epic itself is responsible. It may be legal but it sure ain’t kosher.
  • In a world where even existing Epic customers can’t share freely with other Epic customers, the vendor ought to be reinvesting these interoperability fees in making that happen. I see no signs that this is happening.
  • If Epic consciously makes it costly for health systems to share data, it can impact patient care both within and outside, arguably raising costs and increasing the odds of care mistakes. Doing so consciously seems less than ethical. After all, Epic has a 15% to 20% market share in both the hospital and ambulatory enterprise EMR sector, and any move it makes affects millions of patients.

But Epic’s leadership is unrepentant. In fact, it seems that Epic feels it’s being tremendously generous in letting the fees go.  Here’s Eric Helsher, Epic’s vice president of client success, as told to Becker’s Hospital Review: “We felt the fee was small and, in our opinion, fair and one of the least expensive…but it was confusing to our customers.”

Mr. Helsher, I submit that your customers understood the fees just fine, but balked at paying them — and for good reason. At this point in the history of clinical data networking, pay-as-you-go models make no sense, as they impose a large fluctuating expense on organizations already struggling to manage development and implementation costs.

But those of us, like myself, who stand amazed at the degree to which Epic blithely powers through criticism, may see the giant challenged someday. Members of Congress are beginning to “get it” about interoperability, and Epic is in their sights.

Allscripts And Team Battle Epic and IBM for DoD Contract

Posted on June 27, 2014 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Earlier this month,we shared the news that Epic and IBM had gotten together to fight for the DoD’s massive Healthcare Management Systems  Modernization project. The project is to replace the current Military Health System, which should serve some 9.7 million beneficiaries.  The winning team should make about $11 billion to do the work.

So it’s little wonder that another group of health IT giants have stepped up to fight for such a juicy prize.  A group lead by Computer Sciences Corp., whose partners include Allscripts and HP, has announced that it intends to compete for the contract.

The HMSM project is extremely ambitious. It’s intended to connect varied healthcare systems across the globe, located at Army hospitals, on Naval vessels, in battlefield clinics and more, into a single open, interoperable platform serving not only active-duty members, but also reservists and civilian contractors.

Before you burst out laughing at the idea that any EMR vendor could pull this off, it’s worth considering that perhaps their partners can.  It’s hard to argue that CSC has a long track record in both government and private sector health IT work, and HP has 50 years with of experience in developing IT projects military health and VA projects.

That being said, one has to wonder whether Allscripts — which is boasting of bringing an open architecture to the project — can really put his money where its mouth is. (One could say the same of Epic, which frequently describes its platform as interoperable but has a reputation of being interoperable only from one Epic installation to the other.)

To be fair, both project groups have about as much integration firepower as anyone on earth. Maybe, if the winner manages to create an interoperable platform for the military, they’ll bring that to private industry and will see some real information sharing there.

That being said, I remain skeptical that the DoD is going to get what it’s paying for; as far as I know, there is no massively interoperable platform in existence that meets the specs this project has.  That’s not an absolute dealbreaker, but it should raise some eyebrows.

Bottom line, the DoD seems determined to give it a try, regardless of the shaky state of interoperability in the industry overall. And its goals seem to be the right ones. After all, who  wouldn’t want an open platform that lends itself to future change and development?  Sadly, however, I think it’s more likely that will be shaking our heads over the collapse of the project some years from now.

Epic Joins IBM To Pitch DoD Contract

Posted on June 19, 2014 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Hoping to be the lucky vendors that win a massive pending DoD deal, Epic Systems has team up with global technology giant IBM to compete for the DoD’s Healthcare’s Management Systems Modernization contract.

The new project comes after years of  struggles and changes of direction by the DoD, which has worked for years to integrate its system with the VA’s EMR. Back in 2009, the two giant federal agencies kicked off an effort to create an integrated medical record, the iEHR, which would offer every service member the ability to maintain a single EMR throughout their career and lifetime. But those efforts failed miserably, and the iEHR project was halted in February 2013.

Since then, the DoD has announced that it’s moving along with its iEHR plans once again, a sprawling project which the Interagency Program Office estimates the cost somewhere between $8 billion and $12 billion.

Meanwhile, the DoD Healthcare Management Systems Modernization is moving ahead, slated to replace the current Military Health System. The DHMSM should serve some 9.7 million beneficiaries.

The two partners certainly bring a strong bench to the table. Epic offers an interoperable platform which is one of the most adopted EMR systems in the country, and according to company officials,its open architecture supports more than 20 billion data transactions between systems every year.  Epic says that its customer community, which currently includes 100 million patients, exchanges more than 2.2 million records each month with of the EMR vendors, HISPs, HIEs, the VA, DoD and Social Security Administration.

IBM, meanwhile,is contributing its system integration, change management and expertise , ad experiments in delivering large-scale solutions in partnership with complementary software and services providers. IBM’s Federal Healthcare practice will lead the effort, backed by IBM global information technology,research and health care organizations which already collaborate with Epic in support of EMR solutions internationally.

Without a doubt, IBM is the grandfather of all big iron providers, so they don’t have a lot to prove.  And Epic is a clear leader in the enterprise EMR space, by some measures leading the pack by a considerable margin. It’s likely they’re a top contender for the job.

If the DoD does indeed choose the partnership of Epic and IBM to make its health IT transition, it seems likely that they’ll have recruited more than enough firepower to get the job done — though there’s always the question of whether Epic, which is used to bossing hospitals around, will function as well when the big bureaucracy of the DoD is calling the shots.

But what’s more worrisome is whether the DoD will work effectively with these two private sector companies, assuming t hey win the bid. As noted, the DoD’s track record with change management is nothing to write home about, to say the least, and bureaucratic waffling could conceivably undermine even the most expert efforts to bring DoD’s healthcare architecture into the future. As big and powerful as they are, IBM and Epic may be in for one heckuva ride. In fact, John’s even suggested that the best thing for Epic might be for them to not win the DoD EHR contract.

Epic Hit With Class-Action Suit Over Worker Pay

Posted on December 12, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A former employee has filed a class action suit against Epic Systems, arguing that the EMR vendor has been violating labor laws by denying some of its workers overtime pay.

The suit, which was filed by a former QA employee Evan Nordgren, contends that he and as many as 1,000 former and present QA workers should have been paid time-and-half for overtime hours. (Nordgren is now enrolled in the University of Wisconsin’s law school.) The suit concerns hours worked over a three-year period taking place prior to the filing of the lawsuit.

Epic, of course, disagrees with the suit’s assessment. It argues that state and federal law “make it clear that employees in computer-related jobs who primarily test software are appropriately classified as salaried professionals,” making them exempt from overtime pay.

Epic certainly has enough money to pay its employees whatever they’re due. The company had revenues of $1.5 billion in 2012, according to Forbes. Judy Faulkner, who founded Epic in 1979, has a net worth of about $2.3 billion and was ranked number 243 on Forbes 2013 list of the richest 400 Americans, according to the Wisconsin State Journal.

On other hand, if Epic is forced to cough up overtime pay to past and present QA employees, it seems likely — to me at least — that other suits of this type will follow, something no company wants to take on.  I guess we’ll have to wait and see on this one.

California Nurses Slam Sutter’s Epic System

Posted on July 17, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Nurses at two Sutter hospitals have flooded the management with complaints that the Epic EMR installed there is causing safety problems and eating up time best spent in patient care.

According to a statement from the California Nurses Association, more than 100 RNs at Alta Bates Summit Medical Center facilities in Oakland and Berkeley have filed reports citing problems with the new Epic system in place there.  The nurses submitted these complaints on union forms designed to document assignments the nurses believe to be unsafe.

Specific incidents documented by the nurses included the following. (Apologies for the length of the list, but it’s worth seeing.)

• A patient who had to be transferred to the intensive care unit due to delays in care caused by the computer.
• A nurse who was not able to obtain needed blood for an emergent medical emergency.
• Insulin orders set erroneously by the software.
• Missed orders for lab tests for newborn babies and an inability for RNs to spend time teaching new mothers how to properly breast feed babies before patient discharge.
• Lab tests not done in a timely manner.
• Frequent short staffing caused by time RNs have to spend with the computers.
• Orders incorrectly entered by physicians requiring the RNs to track down the physician before tests can be done or medication ordered.
• Discrepancies between the Epic computers and the computers that dispense medications causing errors with medication labels and delays in administering medications.
• Patient information, including vital signs, missing in the computer software.
• An inability to accurately chart specific patient needs or conditions because of pre-determined responses by the computer software.
• Multiple problems with RN fatigue because of time required by the computers and an inability to take rest breaks as a result.
• Inadequate RN training and orientation.

This is not the first time nurses have gone on the warpath over issues with their hospital’s EMR rollout. Just last month, RNs at Affinity Medical Center in Massillon, OH got national attention when they cited problems in training and safety with the Cerner rollout in progress there.

Taken on their own, I don’t think such protests are going to much to slow the progress of EMR rollouts nationwide, even if the nurses involved are spot on in their observations.  Once the EMR juggernaut starts rolling, it’s very, very hard to slow it down.

But with any luck, the complaints will draw the eyes of regulators and patients to EMR safety and training concerns, and that will lead to some form of change. The issues raised by the Sutter RNs and others shouldn’t (and can’t) be pushed aside indefinitely.

Epic Investment May Have Prompted CIO’s Departure

Posted on July 15, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

As Forbes notes, Epic Systems has a gold-plated reputation in the hospital C-suite. In fact, we’re at the point where it’s accepted wisdom that you can’t lose your job for picking Epic.

But this time, it may actually have happened.  Barry Blumenfeld, former chief information officer at Maine Medical Center in Portland, seems to  have ended up leaving in part because of the financial impact of the hospital’s $160 million Epic buy, Forbes reports.

It’s worth noting that Maine Medical Center had other financial problems in addition to the cost of the Epic implementation. It’s also important to bear in mind that the Epic install seems to have gone badly, slowing collections and thereby cutting revenue. But the fact remains that the big-ticket Epic purchase wasn’t a golden ticket for Blumenfeld.

According to Forbes, other stories of career-mangling Epic disasters are popping up as well. For example, it noted that the chief information officer of Wake Forest Baptist Health recently resigned in the middle of a troubled Epic launch.

Sheila Sanders, who was also VP of information technology, had been on board since 2009, hired to direct the facility’s IT overhaul, according to the Winston-Salem Journal. The Journal piece notes that Wake Forest, too, has seen expected revenue delayed due to problems with the Epic rollout. The hospital had spent about $13.3 milion on Epic, and now cites $8 million in Epic-related implementation expense and $26.6 million in lost margin due to volume disruptions related to go-live issues.

Of course, a CIO can lose their job if any EMR they’re implementing calamitously fails to live up to expectations, be it Epic or another platform. But these anecdotes suggest that the high expense associated with an Epic rollout — and perhaps just as importantly, high expectations — can do more to damage a CIO’s reputation than some might think.