Willy Wonka and the Medical Software Factory
For a take on Epic-the-software (as opposed to Epic-the-company), Atul Gawande had a great piece in the New Yorker recently: <a href="https:&#x2F;&#x2F;www.newyorker.com&#x2F;magazine&#x2F;2018&#x2F;11&#x2F;12&#x2F;why-doctors-hate-their-computers" rel="nofollow">https:&#x2F;&#x2F;www.newyorker.com&#x2F;magazine&#x2F;2018&#x2F;11&#x2F;12&#x2F;why-doctors-ha...</a><p>It gets into some (though hardly all) of the issues of why EHR software is the way it is, and why (some) doctors hate it. (Among my friends who are doctors, some hate Epic, and some absolutely love it - depends on specialty, age, institution, how it&#x27;s configured, etc.)<p>Among some interesting issues:<p>- As others in this thread have noted, the buyer (administrator concerned with maximizing billing) is not the user. That&#x27;s the easy one that&#x27;s common to a lot of enterprises.<p>- Epic makes it easier for medical directors to track population health and impose standard protocols of care. Individual practitioners don&#x27;t always like that! I am not expert enough in those fields to say who&#x27;s right, and I suspect there&#x27;s not always an obviously correct answer.<p>- A lot of doctors dislike the underlying mechanic - being forced to actually write down everything they&#x27;re doing and why - on top of sub-par UIs. The goals of the system conflict with the goals of the practitioner.<p>- Interoperability sucks, but it&#x27;s true that standards aren&#x27;t really there, and it&#x27;s hard to get consensus... plus everything you put in prod needs to be back-compatible approximately forever. A lot of institutions got burned by maintaining internal software built over decades that you can&#x27;t turn off because lives depend on it, and Epic&#x2F;etc. are part of trying to avoid repeating that mistake.<p>There&#x27;s more. I only have a toehold in that world now, but love to chat about it. Email in profile.