Epic Systems Customizations or “Personalization?”

Healthcare Informatics published an article in its June 2008 issue, entitled “Behind the Curtain,” in which Carl Dvorak, executive vice president is asked about the reports that hospitals who adopt Epic are find themselves doing many customizations after the go-live. How true is this? In the article, Dvorak states that it’s not really customization, but personalization of templates’ look which the author of the article, Mark Hagland, has in mind. Dvorak reasons that nobody really customizes software these days. I don’t think that’s the case, however.

Software customization firms, including CodePartners, BeaconPartners, or larger consulting firms, such as IBM, for example, are in great range of both number and IT solutions, and they must be serving someone. There is certainly quite a bit of report customization (or “personalization”) for the hospitals, but the IT firms also help in go-live and workflow maximization after the go-live, which is also a sort of customization. I would also suggest other optimizations that people are looking for include enabling Epic modules to collect data from databases (such as a variety of children’s statistics) which are not default information in Epic. Others include viewing or suppressing certain information, or rearranging it according to what each practice is doing with the module.

Healthcare IT Adoption and Tech Standardization

In an opinion piece featured in the American Medical Association publication American Medical News published July 2008, the AMA expresses concern that pending legislation in Congress about healthcare IT standardization would leave physicians out of the decision-making process. In particular, the AMA names technical standards, privacy and financing as being the most frequent obstacles to IT adoption in the healthcare setting.

The lack of standards stands is noteworthy. If the US government is encouraging shared files similar to programs underway in Canada and in the UK, then this will be a larger problem as electronic health records and other forms of IT in healthcare expand in the US. Within the large-scale health systems area, there are several large enterprise groups, including McKesson, Epic Systems, Cerner, and Siemens. Each has its own unique data reporting and EHR system. But these larger groups make up less than half of the medical facilities in the US; about half of clinical care is conducted in practices with three physicians or less. The larger enterprise IT options are not scaled to suit the smaller practices, and between each practice, because of the lack of standards, there is the potential for automation without coordination.

The opinion piece states: “To boost confidence in an integrated network, the Health Insurance Portability and Accountability Act's privacy and security rules that apply to physicians, as well as other health care professionals and health plans, should be extended to any party that works with confidential health care records.” Is this the answer, however? Would standardization ensue to facilitate technical standards simply because of legislation? It seems at that point, there is less of the input for which the AMA advcates and a release of control of tech standards to the strongest IT solutions company in the marketplace.