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Kaiser Permanente seems to be in big trouble because they chose EPIC as their EMR. EPIC seems to be ducking comment and blaming Citrix. Here are a number of items related to this.
Kaiser has asked its IT staffing vendors to reduce their rates by up to 40 percent, according to a confidential memo obtained by the Business Times. This was in July - the sign of trouble coming.
Kaiser CIO Cliff Dodd resigned amidst a thicket of finger pointing about Kaiser Permanente's 7 billion dollar financial implosion. Happened last week after the loss announcement.
A 722-page report compiled by Kaiser’s IT department details hundreds of technical problems with the system, based on technology from Epic Systems Corp — some affecting patient care.
It appears the software was written in MUMPS (Massachusetts General Hospital Utility Multi-Programming System) -- a health care programming language originally developed in the 1960s. Is the EPIC system just a rework of the VA's Vista EMR ?? Using a programming language written in the 60s and no longer actively being developed should have sent a lot of red flags!!!
Kaiser employee Justen Deal stated in an email, “Epic simply cannot scale to meet the needs of Kaiser Permanente. We’re wasting billions of dollars trying to make it. The big issues for me are the financial repercussions of trying to launch such an ineffective and inefficient and unreliable system across the organization.”
Deal also said that the Citrix scalability issue is significant. Deal argued that “using Citrix is something that defies common sense. It would be like trying to use a dial-up modem for thousands of users. It’s just not going to work. I don’t think that Citrix really appreciates what we’re trying to do with their software.”
Bottom line, EPIC may have been a big company (this may make them a small company again) but the whole premise, the underlying system architecture premise is wrong. It is based on old legacy technology ( and in this case really old) which can not possibly support a decent EMR. Some on this forum board think I am arrogant, but only because I believe the "the user is NEVER wrong, if the user has trouble - it is not more user training, or more support, or more system "tweaks", or more whatever - other than more care in understanding the user and using appropriate technology for the user.
Most EMRs (not all) are guaranteed to be a pain because they have the wrong premise - forget ASP, point and click and all the fancy certifications because they mean nothing if in the real world the user is treated like a young school boy who needs to be patted on the head and told they don't understand!
Yes I understand some have an EMR they are happy with, but we are not going to get to a national system or widespread adoption if we continue to use old technology and design. Kaiser is only 400 hospitals and just over 50,000 doctors(??) If this doesn't work how are we going to make 6,000 hospitals and 800,000 work together?? The answer is new innovation in design and technology – its the only answer.
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