User:A.Hausker/Epic Systems

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Epic Systems Corporation
Company typePrivate
IndustryInformation Technology
Health Informatics
FoundedMadison, Wisconsin, United States (1979)[1]
FounderJudith Faulkner
Headquarters
Verona, Wisconsin
,
United States
Key people
Judith Faulkner, Founder & CEO
Carl Dvorak, President
Tim Toepel, CFO
Rick Dame, COO
Revenue$2.9 billion (2018)[2]
Number of employees
Approximately 10,000 (2019)[3]
Websiteepic.com

Epic Systems Corporation, or Epic, is a privately held healthcare software company. According to the company, hospitals that use its software held medical records of 54% of patients in the United States and 2.5% of patients worldwide in 2015.[4] In addition, as of 2018, Epic Systems is the Electronic Health Record (EHR) provider for each of the top 20 hospitals per the U.S. News & World Report Best Hospital rankings for 2018-2019.[5] Globally, more than 250 million patients have a current record stored electronically by Epic.[6]

History[edit]

Epic headquarters in Verona, Wisconsin.

Epic was founded in 1979 by Judith R. Faulkner[7] with a $70,000 investment[8] (equivalent to $290,000 in 2023). Originally headquartered in Madison, Wisconsin, Epic moved its headquarters to a large campus in the suburb of Verona, Wisconsin in 2005,[9] where it employs approximately 10,000 people as of 2019.[10]

As of 2015, the company was in the fifth phase of campus expansion with five new buildings each planned to be around 100,000 square feet.[4] The company also has customers and offices in Bristol, UK; 's-Hertogenbosch, Netherlands; Dubai, United Arab Emirates; Dhahran, Saudi Arabia; Helsinki, Finland; Melbourne, Australia; Singapore; and Søborg, Denmark.[11]

Product and Market[edit]

Epic primarily develops, manufactures, licenses, supports, and sells a proprietary electronic health record software application, known in whole as 'Epic' or an Epic EHR. The company offers an integrated suite of healthcare software centered on its Chronicles database management system. Epic's applications support functions related to patient care, including registration and scheduling; clinical systems for doctors, nurses, emergency personnel, and other care providers; systems for lab technologists, pharmacists, and radiologists; and billing systems for insurers.[12]

In September 2017, Epic announced Share Everywhere, which allows patients to authorize any provider who has internet access to view their record in Epic and to send progress notes back.[13] Share Everywhere was named Healthcare Dive's "Health IT Development of the Year" in 2017.[14]

Epic also offers hosted solutions for customers that do not wish to maintain their own servers; and short-term optimization and implementation consultants through their wholly owned subsidiary Boost Services.[15]

The company's competitors include Cerner, MEDITECH, Allscripts, athenahealth, Homecare Homebase, and units of IBM, McKesson, Siemens and GE Healthcare.[16] Epic and Cerner account for a combined 85% market share of the 500-bed category hospitals in the United States (Epic with a 58% share and Cerner with a 27% share).[17]

The majority of U.S. News and World Report's top-ranked centers for specialties, hospitals, and medical schools use Epic.[18] In 2003, Kaiser Permanente, the largest managed care organization in the United States,[19] chose Epic for its electronic records system.[20] Among many others, Epic provides electronic record systems for Cedars-Sinai Medical Center in Los Angeles, the Cleveland Clinic, The Mount Sinai Hospital,[20][21] UC Davis Medical Center in Sacramento, multiple campuses of the Mayo Clinic,[22] and Yale–New Haven Hospital.

Key Partnerships[edit]

Johns Hopkins Hospital announced in 2011 their plan to partner with Epic and use the EHR package across all of Johns Hopkins Medicine. Epic's software was first applied to only Johns Hopkins Outpatient Center in 2013 with a focus on ambulatory care.[23] Today, Epic is the sole medical record system for nearly the entire enterprise, the only exception being Johns Hopkins All Children's Hospital. According to the Johns Hopkins Medicine website, the goal of the Epic integration was to streamline the transfer of a patient's chart across multiple areas of care including emergency departments, ambulatory clinics and surgery areas, and 5 Johns Hopkins area hospitals.[24]

On February 1, 2020, New York Presbyterian Hospital (NYP), the teaching hospital of Columbia and Cornell, completed its multi-year, ~$1 billion conversion of its EHR from Allscripts to Epic. Partners HealthCare began adopting Epic in 2015 in a project initially reported to cost $1.2 billion, which critics decried and which is greater than the cost of any of its buildings.[25] By 2018, the total expenses for the project were $1.6 billion, with payments for the software itself amounting to less than $100 million and the majority of the costs caused by lost patient revenues, tech support and other implementation work.[26]

Alameda Health Systems (AHS) launched its Epic EHR in October of 2019 after a three-year implementation. With this specific customer win, Epic will begin servicing AHS's five hospitals that include nine facilities and employ roughly 1,100 physicians.[27]

In November of 2019, CHI Memorial Hospitals in Tennessee, a hospital with over 700 affiliated physicians, transitioned to Epic Systems after a $67 million implementation that took roughly one and a half years. The move was initiated to increase interoperability as roughly 40% of CHI hospitals will be using Epic Systems.[28]

AdventHealth Headquarters in Altamonte Springs, FL.

On February 11 of 2020 Epic became the official EHR provider for AdventHealth, a faith-based network of healthcare system with facilities in nine states across the United States.[29] After initially signing a deal with Epic's market competitors Cerner, Athenahealth and Homecare Homebase in 2002, AdventHealth is now making the transition to Epic Systems which will take up to five years and will span 1,200 acute-care, physician-practice, ambulatory, urgent care, home health, and hospice sites.[30]

Awards and Recognition[edit]

In 2020, Epic Systems was named by KLAS Research as the top overall software suite for the tenth year in a row. In the same annual awards, Epic won eight additional categories, including best in post-acute and ambulatory care hospitals and practice management. Some have praised Epic for its business culture, loyalty, and relationships[31].

The Healthcare Information and Management Systems Society, or HIMSS, developed a model using a 0-7 scale to score hospitals worldwide based on their EHR capabilities, 7 being the highest rank. Of the 47 health organizations awarded Stage 7 by HIMSS, 79% use EpicCare software. Furthermore, 90% of Stage 7 physicians also use Epic.[32]

Reaction Data, a customer and market research firm, listed Epic among the top-ranked EHR systems by physicians and c-suite executives.[33]

Epic is also involved with the nation's leading research organizations. The top 16 NIH grant recipients, including Johns Hopkins University, University of Michigan, and University of Pittsburgh, all employ Epic Systems software.[32]

Criticisms and Controversies[edit]

Data sharing[edit]

Care Everywhere is Epic's health information exchange software, which comes with its EHR system.[34] A 2014 article in The New York Times interviews two doctors who say that their Epic systems won't allow them to share data with users of competitors' software in a way that will satisfy the Meaningful Use requirements of the HITECH Act. At first, Epic charged a fee to send data to some non-Epic systems.[35] Epic says the yearly cost for an average-sized hospital is around $5,000 a year.[34] However, after Congressional hearings, Epic and other major software vendors announced that they would suspend per-transaction sharing fees.[36] Epic customers must still pay for one-time costs of linking Epic to each individual non-Epic system with which they wish to exchange data; in contrast, Epic's competitors have formed the CommonWell Health Alliance which set a common Interoperability Software standard for electronic health records.[36] A 2014 report by the RAND Corporation described Epic as a "closed" platform that made it "challenging and costly for hospitals" to interconnect with the clinical or billing software of other companies.[37] The report also cited other research showing that Epic's implementation in the Kaiser Permanente system led to efficiency losses.

Some have voiced concerns about data privacy with Epic software and its trade secrets among third party companies that install their software. Specifically, the largest trade-secret lawsuit ever filed in US courts was filed by and granted to Epic against Tata Consultancy.  Tata Consultancy is a third party systems integrator for Epic software implementations.  On April 16, 2016 Epic was awarded a grand total of $940 million for Tata Consultancy illegally downloading a portion of Epic’s software, stealing confidential information and trade secrets, and then sharing it with Med Mantra, Epic’s competing healthcare software provider in India.[38]

UK experience[edit]

An Epic electronic health record system costing £200 million was installed at Cambridge University Hospitals NHS Foundation Trust in October 2014, the first installation of an Epic system in the UK.[39][40]

After 2.1 million records were transferred to it, it developed serious problems and the system became unstable.[41] Ambulances were diverted to other hospitals for five hours and hospital consultants noted issues with blood transfusion and pathology services.[42] Other problems included delays to emergency care and appointments, and problems with discharge letters, clinical letters and pathology test results.[40] Chief information officer, Afzal Chaudhry, said "well over 90% of implementation proceeded successfully".[39]

In July 2015, the BBC reported that the hospital's finances were being investigated.[43] In September 2015, both the CEO and CFO of the hospital resigned.[44] Problems with the clinical-records system, which were said to have compromised the "ability to report, highlight and take action on data" and to prescribe medication properly, were held to be contributory factors in the organization's sudden failure.[45] In February 2016, it was reported that Clare Marx, president of the Royal College of Surgeons of England and member of the NHS National Information Board, found that at the time of implementation, "staff, patients and management rapidly and catastrophically lost confidence in the system. That took months and a huge amount of effort to rebuild."[46]

Danish experience[edit]

In 2016, Danish health authorities spent 2.8 billion DKK on the implementation of Epic in 18 hospitals in a region with 2.8 million residents.[47][48] On May 20th, Epic went live in the first hospital. Doctors and nurses reported chaos in the hospital and complained of severe under preparation and training, Epic and its Danish partners insisted that normal testing and training were carried out.

Almost immediately, a major issue was identified: Epic's system was not designed to be translated between languages. Physicians resorted to Google Translate, as specific medical terms either do not exist in Denmark, or hold much different meanings in Danish as compared to English. For example, when inputting information about a patient's condition, physicians were given the option to report between the left and the "correct" leg, not the left and right legs.[49] Another problem that surfaced involved integration with the national medical record system. This is meant to be accessed every time a patient is seen, but it took until 2019, three years after the initial installment, for the integration with the national system to be complete.

For many Danish physicians, these translational issues reflected a deeper issue. Epic Systems was designed specifically to fit the U.S. health care system and the many problems in Denmark showed that it may not be possible to apply Epic to such a dissimilar health care model. The vast differences in billing systems, specialties, inpatient and outpatient care, and more between the U.S. and Danish health care systems made the integration of the system difficult and problematic.[49]

An audit of the implementation that voiced concerns was published in June 2018. At the end of 2018, 62% of physicians expressed they were not satisfied with the system and 71 physicians signed a petition calling for the system to be removed.[49][50]

Outreach Initiatives[edit]

Under the company motto, "do good, have fun, make money," founder and CEO Judith Faulkner has said the mission of Epic Systems is to give people a reason to come to Wisconsin and give back to the greater community.[51] Personally, Faulkner has pledged to donate 99 percent of her accumulated wealth to The Giving Pledge, a campaign to entice wealthy people to contribute their wealth to philanthropic causes.[52] In 2013, Epic donated $30 million to the Dane Country Regional Airport to fund a project expanding available parking space.[53] In 2005, Epic Systems also donated $200,000 of building material to support the expansion of Stoner Prairie Elementary in nearby Fitchburg, Wisconsin.[54]

See also[edit]

References[edit]

  1. ^ Eisen, Mark (June 20, 2008). "Epic Systems: Epic Tale". Isthmus. Archived from the original on December 19, 2013. Retrieved December 18, 2013.
  2. ^ "#207 Judy Faulkner". Forbes. Retrieved October 28, 2019.{{cite news}}: CS1 maint: url-status (link)
  3. ^ Arthur Thomas. "Epic Systems gearing up for yet another expansion in Verona". Retrieved October 3, 2019.{{cite web}}: CS1 maint: url-status (link)
  4. ^ a b Glaze, Jeff (January 6, 2015). "Epic Systems draws on literature greats for its next expansion". Wisconsin State Journal. Archived from the original on January 9, 2015. Retrieved January 23, 2015.
  5. ^ "All of US News' top 20 hospitals use Epic". www.beckershospitalreview.com. Retrieved March 18, 2020.
  6. ^ "About Us | Epic". www.epic.com. Retrieved March 19, 2020.
  7. ^ Eisen, Marc (June 20, 2008). "Epic Systems Corporation: An Epic timeline". Isthmus. Archived from the original on May 22, 2011. Retrieved February 20, 2009.
  8. ^ "Epic Systems soars with transition to electronic health records". Archived from the original on November 16, 2016. Retrieved November 15, 2016.
  9. ^ Boulton, Guy (August 24, 2008). "Epic Systems' $300 million expansion tangible sign of success". Milwaukee Journal Sentinel. Archived from the original on February 4, 2016. Retrieved January 28, 2016.
  10. ^ Thomas, Arthur (October 3, 2019). "Epic Systems gearing up for yet another expansion in Verona". Milwaukee Biz Times. Retrieved October 3, 2019.
  11. ^ "Epic - Contact". Epic.com.{{cite web}}: CS1 maint: url-status (link)
  12. ^ EHRIntelligence (April 18, 2017). "Epic Modules Supporting Care across Healthcare Settings". EHRIntelligence. Retrieved April 26, 2020.
  13. ^ Boulton, Guy (November 10, 2017). "Epic Systems lets patients share medical records with doctors around the world". Milwaukee Journal Sentinel. Retrieved November 16, 2017.
  14. ^ Muchmore, Shannon (December 4, 2017). "Health IT Development of the Year: Epic's Share Everywhere". Healthcare Dive.{{cite web}}: CS1 maint: url-status (link)
  15. ^ Group, The HCI. "Epic in the Cloud". blog.thehcigroup.com. Retrieved April 26, 2020.
  16. ^ Freudenheim, Milt (January 14, 2012). "Digitizing Health Records, Before It Was Cool". The New York Times. Archived from the original on December 25, 2016. Retrieved September 26, 2014.
  17. ^ "In EMR Market Share Wars, Epic and Cerner Triumph Yet Again | HealthLeaders Media". www.healthleadersmedia.com. Retrieved March 19, 2020.
  18. ^ "Epic Community | Epic". www.epic.com. Retrieved March 19, 2020.
  19. ^ "Kaiser Permanente CEO on saving lives, money". USA Today. October 23, 2012. Archived from the original on January 26, 2015. Retrieved December 21, 2014.
  20. ^ a b Freudenheim, Milt (January 14, 2012). "Digitizing Health Records, Before It Was Cool". The New York Times. Archived from the original on December 25, 2016. Retrieved September 26, 2014.
  21. ^ "Electronic Medical Records at The Mount Sinai Medical Center Shown to Greatly Improve Quality of Care". Archived from the original on April 15, 2015. Retrieved April 9, 2015.
  22. ^ Reilly, Mark (July 14, 2017). "Mayo Clinic begins shift to $1.5B digital records system from Epic Systems". Milwaukee Business Journal. Retrieved November 26, 2018.
  23. ^ "The Epic Electronic Medical Record System for Johns Hopkins Medicine – The Pathology Blog". Retrieved March 19, 2020.
  24. ^ Day, Jo Ann. "Why Epic | Johns Hopkins Medicine". www.hopkinsmedicine.org. Retrieved March 19, 2020.
  25. ^ "Partners HealthCare's new computer system challenges some doctors, nurses - The Boston Globe". BostonGlobe.com. May 16, 2016. Archived from the original on April 15, 2017. Retrieved May 17, 2017.
  26. ^ Gawande, Atul. "Why Doctors Hate Their Computers". The New Yorker. Retrieved November 7, 2018.
  27. ^ EHRIntelligence (October 14, 2019). "California Health System Completes Epic Systems EHR Implementation". EHRIntelligence. Retrieved March 19, 2020.
  28. ^ "Patient records at CHI Memorial hospitals get $67 million upgrade, now easier to share with some outside hospitals". timesfreepress.com. Retrieved March 19, 2020.
  29. ^ www.bizjournals.com https://www.bizjournals.com/kansascity/news/2020/02/11/cerner-adventhealth-ehr-revenue-cycle-contract-end.html. Retrieved March 19, 2020. {{cite web}}: Missing or empty |title= (help)
  30. ^ "AdventHealth to drop Cerner, Athenahealth EHRs for Epic". Modern Healthcare. February 11, 2020. Retrieved March 22, 2020.
  31. ^ "Epic takes top award in KLAS survey for 10th year". Healthcare Dive. Retrieved March 19, 2020.
  32. ^ a b "Epic Community | Epic". www.epic.com. Retrieved March 19, 2020.
  33. ^ EHRIntelligence (November 19, 2015). "Epic EHR Use Not Widespread Internationally, Survey Shows". EHRIntelligence. Retrieved March 23, 2020.
  34. ^ a b Sullivan, Mark (December 8, 2014). "Saying Epic is a Closed System is an Oversimplification". Venture Beat. Archived from the original on January 25, 2015. Retrieved January 23, 2015.
  35. ^ Creswell, Julie (September 30, 2014). "Doctors Find Barriers to Sharing Digital Medical Records". The New York Times. Archived from the original on January 23, 2015. Retrieved January 23, 2015.
  36. ^ a b Caldwell, Patrick (October 2015). "EPIC FAIL. Digitizing America's medical records was supposed to help patients and save money. Why hasn't that happened?". Mother Jones. Archived from the original on September 7, 2017. Retrieved September 6, 2017.
  37. ^ Kobb, Enesha; Sauser, Kori (2014). Electronic Health Records (PDF). RAND. Archived (PDF) from the original on March 22, 2016. Retrieved March 7, 2016.
  38. ^ "Epic Systems wins $940 mln U.S. jury verdict in Tata trade secret case". Reuters. April 17, 2016. Retrieved March 18, 2020.
  39. ^ a b "Addenbrooke's Hospital paperless system's 'significant problems' reported". BBC News. November 24, 2014. Archived from the original on November 27, 2014. Retrieved December 21, 2014.
  40. ^ a b "'Major incident' declared for flagship IT project". Health Service Journal. November 25, 2014. Archived from the original on December 23, 2014. Retrieved December 23, 2014.
  41. ^ "The NHS's chaotic IT systems show no sign of recovery". The Guardian. December 21, 2014. Archived from the original on December 21, 2014. Retrieved December 21, 2014.
  42. ^ "Addenbrooke's consultants reveal eHospital concerns in letter to management". Cambridge News. December 11, 2014. Archived from the original on January 3, 2015. Retrieved December 21, 2014.
  43. ^ "Addenbrooke's Hospital's e-hospital finances investigated". BBC News. July 31, 2015. Archived from the original on December 3, 2016. Retrieved May 17, 2017 – via www.BBC.co.uk.
  44. ^ "Addenbrooke's Hospital chief executive Keith McNeil resigns". BBC News. September 14, 2015. Archived from the original on August 17, 2017. Retrieved May 17, 2017 – via www.BBC.co.uk.
  45. ^ "Addenbrooke's and Rosie hospitals' patients 'put at risk'". BBC News. September 22, 2015. Archived from the original on September 24, 2015. Retrieved October 3, 2015.
  46. ^ McBeth, Rebecca (February 25, 2016). "EPR implementation led to 'catastrophic loss of confidence'". Digital Health Intelligence Limited. Archived from the original on February 28, 2016. Retrieved March 7, 2016.
  47. ^ "Har brukt 2,8 milliarder på ny plattform: – Ikke mulig å tro at profesjonelle aktører er i stand til å lage et så elendig produkt". Digi.no (in Norwegian). Archived from the original on June 25, 2018. Retrieved June 25, 2018.
  48. ^ Allen, Arthur. "Lost in translation: Epic goes to Denmark". POLITICO. Retrieved March 22, 2020.
  49. ^ a b c Allen, Arthur. "Lost in translation: Epic goes to Denmark". POLITICO. Retrieved March 22, 2020.
  50. ^ Christensen, Mikkel Fyhn; Sturlason, Astrid Sofie (January 23, 2019). "Blå blok vil droppe Sundhedsplatformen: "Har gjort det værre for sundhedspersonale og patienter i stedet for at gøre det bedre"". Berlingske.dk.
  51. ^ "Epic decoded: An inside look at life and corporate culture at the center of the health IT world". www.beckershospitalreview.com. Retrieved March 22, 2020.
  52. ^ "Epic Systems CEO Judy Faulkner adds a billion to her fortune". Healthcare IT News. August 25, 2017. Retrieved March 22, 2020.
  53. ^ mivey@madison.com, MIKE IVEY | The Capital Times |. "Epic Systems driving $30 million parking expansion at airport". madison.com. Retrieved March 22, 2020.
  54. ^ Journal, Gena Kittner Wisconsin State. "CITY, SCHOOL GET A GIFT OF EPIC PROPORTIONS". madison.com. Retrieved March 22, 2020.

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