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Health Records Firm Epic and About 60 Client Hospitals Object to Data Sharing Rules Supported by Apple
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And what was supposed to be a $600 million system ended up costing $1.2 billion. Subsidized by a $35 billion government program.
My fiance and future MiL worked and still work in HC and have never had anything good to say about Epic. Anything that tears down a bloated, inefficient company/system like this is alright by me.
The health records industry has intentionally made a proprietary mess to insure customer lock in. What they've done goes directly contrary to the intention of electronic health records and the rules in the government funds they accepted to build these systems. Although Epic is better than some it's a huge house of cards right now and has real world impacts (such as issues with logic meant to protect against medication conflicts). Epic is just trying to protect the biggest roadblock they have to being disrupted into oblivion.
Exactly. Their fears are probably well-founded, too. Here’s Scott Kolesar, Americas health technology innovation and digital leader for Ernst & Young:
No end in sight: EHRs hit hospitals' bottom lines with uncertain benefits
Electronic health record software installations can take a financial toll on hospitals and health systems as they wrestle with temporarily lower patient volumes and disruptions to workflows, as well as higher IT costs.
www.modernhealthcare.com
medical records are very private
may be better for hospitals object
although if data security was secure may be good for users have more control of their own records
its a toss up for now
may be better for hospitals object
although if data security was secure may be good for users have more control of their own records
its a toss up for now
Epic is SKYNET. It made a few people in Madison billionaires, and created havoc, confusion and dismay among hospitals across the US.
I am a physician, and I still use paper charts. My colleagues envy me, and my patients love that I pay attention to them instead of a laptop.
If medical records are to be electronic, they need to be patient-centric; practitioners/providers/etc. should then be able to use a license to securely access the patient's database. Each entity having their own system that can't interact with each other is at best a disaster, a huge waste of time and money, and a major source of "physician burnout." I have seen electronic notes go on for 18 pages, crammed with utterly useless BS. My average office visit note is two pages, legible (using Dragon Dictate Medical for Mac- thanks for dropping support for that, Nuance!), and is quite comprehensive.
Hey Apple, I would love to consult with you....
I am a physician, and I still use paper charts. My colleagues envy me, and my patients love that I pay attention to them instead of a laptop.
If medical records are to be electronic, they need to be patient-centric; practitioners/providers/etc. should then be able to use a license to securely access the patient's database. Each entity having their own system that can't interact with each other is at best a disaster, a huge waste of time and money, and a major source of "physician burnout." I have seen electronic notes go on for 18 pages, crammed with utterly useless BS. My average office visit note is two pages, legible (using Dragon Dictate Medical for Mac- thanks for dropping support for that, Nuance!), and is quite comprehensive.
Hey Apple, I would love to consult with you....
It is handy having all my medical records from Kaiser Permanente sync to Health on my phone. The user experience is so much better than any other I’ve seen; regardless of how barebones the current feature set is.
I can’t wait to see what Apple Health will do in the future.
I can’t wait to see what Apple Health will do in the future.
It actually has everything to do with HIPAA. As the law stands now, I, as a patient, will be able to request access for Some Indy Developer's App. While my protected health data is required to be stored in a HIPAA complient manner, once I give that data to the 3rd party app, that app is not covered by HIPAA laws, can store my data in a non-secure manner, or even sell it to 3rd parties.
This is the commercialization of health data, and will absolutely be taken advantage of by enterprising companies.
Existing companies and tech companies like Google, Apple, Microsoft, etc are all vying for a piece of the health pie, with each wanting the largest they can get, because there is big money to be gained with the loads of very personal individual data.
Of course they object. They want to hold you hostage with your own data.
Ever tried getting multiple detailed records like scans and test results in a machine readable format? I have and they deliberately make it agonizing. If you can take your data with you, you’re less likely to be a repeat customer.
Ever tried getting multiple detailed records like scans and test results in a machine readable format? I have and they deliberately make it agonizing. If you can take your data with you, you’re less likely to be a repeat customer.
It also makes it very tough to near impossible to create a parallel system to compete with theirs. Healthcare does not need closed source products.
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I'd say that these larger hospitals know they are being extorted by Epic and others in order to comply with various laws.
Going to my doctor 3 times a year is not a problem since I don't have any changes to my personal info. However, anytime a person has to go to another doctor such as a specialist, information forms have to be completed at each office and every time that specialist is seen. It is past time to have medical records on a data base on a chip or in the cloud so that all these forms are not necessary. And the forms need to be standardized. We already can retrieve the results of our lab work / blood tests a couple days after a complete physical.
This is more a control issue than a technology issue. I have seen Epic systems, their implementation and the resultant care issues it creates first hand, both personally and as a technology professional. The area hospitals with Epic already offer patent portals that contain a significant portion of your medical data. I can get my blood work direct from the lab, ETC. What Apple wants is a unified format for this data and the complete data set to be accessible by an application. There is little additional risk to patents as far as data breaches since most of the information is already available online. The risk of a data breach is already there, the universal format doesn't impact that much.
As someone who has worked in the field of medical billing and finance in the past, this is just a reminder that Epic is horrible and no physician actually likes to use it. All Epic cares about is its profit. Its motive here is so obvious and self serving as it does not want inter-operability and easy sharing of medical records. It wants hospitals locked in for life to Epic. A good rule of thumb is that if Epic opposes something, the patient and physician should take the opposite stand.
Obviously you have the common experience of having to work for an Epic EHR installed system instead of having an Epic install work for you (and your department).
Sharing information, and TRANSPARENCY is not in the ’best interest” to their bottom line.
Keeping the system as convoluted, oblique and opaque as possible is the key to keep screwing customers.
Hopefully someday we will have modern systems in place for quick and easy sharing of our medical information across all health care providers.
We must demand complete control of what we can do with our medical records, the true costs, and efficacy of services to have some sort of accountability of our local medical institutions.
Imagine the cost savings and better care if healthcare providers had the information to treat us easily shared between them?
Imagine being able to search true costs and procedures and outcomes per health providers?
Imagine what researchers could do to improve this mess if they had the ability to sift through and start fixing this mess?
Ridiculous that these hospitals and healthcare providers can be allowed to be so oblique in everything they do, including our own personal records.
Keeping the system as convoluted, oblique and opaque as possible is the key to keep screwing customers.
Hopefully someday we will have modern systems in place for quick and easy sharing of our medical information across all health care providers.
We must demand complete control of what we can do with our medical records, the true costs, and efficacy of services to have some sort of accountability of our local medical institutions.
Imagine the cost savings and better care if healthcare providers had the information to treat us easily shared between them?
Imagine being able to search true costs and procedures and outcomes per health providers?
Imagine what researchers could do to improve this mess if they had the ability to sift through and start fixing this mess?
Ridiculous that these hospitals and healthcare providers can be allowed to be so oblique in everything they do, including our own personal records.
The Veterans' Affairs Health Care System (VAHCS) is already onboard with ensuring healthcare records for veterans is available to them via the Health app. The process that they have to go through to gain access to those records online is pretty intense, and is likely a barrier for the elderly who aren't as tech-savvy. However, once the veteran gains access, the process that Apple setup for the individual to grant access and link their account to the Health app is extremely straightforward. Added a couple of screenshots from the Health app to show what it looks like, and another screenshot showing the login process that links the VAHCS with the Health app.
I think the issue with any healthcare provider not willing to provide access for an individual to link their records is concerning. It's possible that their host system is not as secure as it should be. Instead of spending the money to modernize their digital infrastructure, their solution is to provide the patient records in a physical medium (i.e. paper or CD). This also means it's highly likely that their systems aren't talking directly to other systems, in order to reduce redundancy, latency, and errors. Those are all things that actually harm people's livelihood and health, and are quite costly to taxpayers by way of health insurance fraud.
What I find particularly troublesome is insurance companies, healthcare systems, and doctors who confuse ownership of the records instead of being good stewards of them for their patients.
I think the issue with any healthcare provider not willing to provide access for an individual to link their records is concerning. It's possible that their host system is not as secure as it should be. Instead of spending the money to modernize their digital infrastructure, their solution is to provide the patient records in a physical medium (i.e. paper or CD). This also means it's highly likely that their systems aren't talking directly to other systems, in order to reduce redundancy, latency, and errors. Those are all things that actually harm people's livelihood and health, and are quite costly to taxpayers by way of health insurance fraud.
What I find particularly troublesome is insurance companies, healthcare systems, and doctors who confuse ownership of the records instead of being good stewards of them for their patients.
It sure does, without a doubt. Have a read especially starting at Chapter 4:
Think of the scenario, someone gets medical records into a app and was able to modify the record to falsify a medical condition. Then said rogue patient goes to a different doctor to get a prescription for some opiod drugs. Having that vector where the medical record can be tampered with is a huge risk and mistake.
I would be certain that there would be controls for these kinds of apps in the first place, but even that is not a guarantee.
The bigger issue is that the red flag is the authenticity and integrity of the patient record can be considered flawed. Its not like they can simply throw in a MD5 checksum on a patient file and call it good.]
Have a read:
Granted health data should be available, but to date:
1. No standards across all products to easily convert easily.
2. No ability to authenticate integrity should a record be shared out from the iphone. (This one is huge, because there is no way to be able to ensure that say that you get your record from physician A and give to Physician B; where physician B would simply take the data at face valuet. I would be hopeful that common sense would be excersized here that Physician B call Physician A to confirm.
As someone who has dealt with Epic on several levels... they are only interested in their own profits. After all, they and Cerner pushed meaningful use 1 and 2 through the government which was basically a public subsidy of their platforms. And, yes, it will take >$1B to implement Epic on a large scale hospital system. Plus a great deal more after the sale as you are required to pay maintenance.
As another said, Epic is all about locking people into their system. They actively encourage facilities to throw out any Vendor that isn’t a secret partner.
Before others say that Cerner is behind FHIR and both do HL7... Those standards are really suggestions and no two facilities implement them the same way and there’s a great deal of confusion and disagreement on even where to put certain info.
As another said, Epic is all about locking people into their system. They actively encourage facilities to throw out any Vendor that isn’t a secret partner.
Before others say that Cerner is behind FHIR and both do HL7... Those standards are really suggestions and no two facilities implement them the same way and there’s a great deal of confusion and disagreement on even where to put certain info.
Epic makes money charging for point-to-point integrations, and has a terrible platform built upon MUMPS (now "Intersystems Caché"). They don't want standards that make data interchange easier, because that could reduce their lock-in.
Having seen many confidential records faxed to the wrong number, I don't feel faxes are the least bit secure. It's only marginally better than emailing information around unencrypted.