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

Posted on August 21, 2011 I Written By

Katherine Rourke 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.

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?