‘The soft­ware should be a joy to use’

Modern Healthcare - - Q & A -

Since its found­ing in 1979, Epic Sys­tems Corp. of Verona, Wis., has grown to be­come the na­tion’s No. 1 health­care soft­ware firm, with $2.5 bil­lion in an­nual sales and 9,700 em­ploy­ees. Founder Judith Faulkner, one of Mod­ern Health­care’s Top 25

Women in Health­care, still plays a ma­jor role in set­ting strat­egy at the firm. At last month’s Health­care In­for­ma­tion and Man­age­ment Sys­tems So­ci­ety’s an­nual con­fer­ence in Or­lando, Fla., Mod­ern Health­care Ed­i­tor Mer­rill Goozner sat down with Faulkner for an interview. The fol­low­ing is an edited tran­script.

Mod­ern Health­care: We’ve got a huge prob­lem in this coun­try with doc burnout. One of the causative fac­tors is poorly de­signed elec­tronic health records. How are you ad­dress­ing this prob­lem?

Judith Faulkner: I have fo­cused our whole staff on three things for the past four years. No. 1 is that the soft­ware should be a joy to use. For quite a while, we had to fo­cus on mak­ing sure it has all the fea­tures and func­tions that will save pa­tients’ lives and will meet all the gov­ern­ment re­quire­ments. But now we’re really fo­cused on mak­ing it a joy to use, in­tu­itive, as sim­ple as pos­si­ble, at­trac­tive. The sec­ond thing is value from data, and the third thing is col­lab­o­ra­tion.

MH: Yet given the ris­ing level of dis­sat­is­fac­tion with all ven­dors, do you have any new ini­tia­tives or thoughts on ways that we can really be­gin to ad­dress this?

Faulkner: I’m mar­ried to a doc­tor. My fam­ily has eight out of the 13 work­ing mem­bers who are doc­tors. I think physi­cian burnout be­gan maybe 20 years ago when it be­came, who’s go­ing to run ev­ery­thing? Is it go­ing to be the doc­tors or is it go­ing to be the gov­ern­ment and busi­ness? I thought the doc­tors would win, but they didn’t. Gov­ern­ment and busi­ness won. I think that’s when burnout started hap­pen­ing.

MH: So it’s much larger than just the EHR.

Faulkner: Yes. I don’t think that adding lots of gov­ern­ment-re­quired things to the elec­tronic health record helps the physi­cians with burnout, be­cause it’s just more things that have to be done. For some of them, it’s ap­pro­pri­ate. But for many of them, it is just in the way.

MH: There is a lot of dis­sat­is­fac­tion among pol­i­cy­mak­ers that we’re just not get­ting in­ter­op­er­abil­ity fast enough. Con­sumers can’t get access to their records in a timely fash­ion. How do you see in­ter­op­er­abil­ity evolv­ing in the next five years?

Faulkner: We started back in 2005, well be­fore the Health IT Pol­icy Com­mit­tee and mean­ing­ful use said you have to do it.

Here’s some of the things that we’re do­ing that you’ll see the rest of the in­dus­try fol­low. One, 100% of our cus­tomers are con­nected. No other ven­dor does that yet. I think un­til they all do it, it’s hard for them to talk about con­nect­ing be­tween ven­dors be­cause their own cus­tomers aren’t con­nected.

They have to start publishing mea­sure­ments about how many times have they shared in­for­ma­tion with some­one else. One pa­tient leav­ing a health

“I think physi­cian burnout be­gan maybe 20 years ago when it be­came, who’s go­ing to run ev­ery­thing? Is it go­ing to be the doc­tors or is it go­ing to be the gov­ern­ment and busi­ness? I thought the doc­tors would win, but they didn’t. Gov­ern­ment and busi­ness won.”

sys­tem to go to an­other health sys­tem is one record ex­change. We do 1.3 mil­lion of those a day. I’d like to see every­body pub­lish their num­bers, be­cause then they’ll have a lot more sense of what’s go­ing on.

Other things that we’re do­ing that are really neat in­clude the abil­ity for our cus­tomers to give an­other health­care or­ga­ni­za­tion a web­based por­tal into our cus­tomer’s sys­tem so they can fol­low the progress of the pa­tient. We’re com­bin­ing Care Ev­ery­where with EpicCare Link so that if we have a pa­tient go to a place where they do not have the abil­ity to do a trans­fer, we will, if they agree, im­plant EpicCare Link in there and they can still see what’s go­ing on with that pa­tient.

MH: Let’s turn to con­sumer­driven medicine. Highd­e­ductible health plans, al­ter­na­tive care sites, concierge prac­tices—it’s cre­at­ing a whole new set of data about a pa­tient that is not in­te­grated. What are you do­ing to in­te­grate that kind of in­for­ma­tion into your over­all health­care record sys­tem?

Faulkner: We do take in­for­ma­tion that comes from ma­chines that can send it to us, wire­lessly or con­nected, and put it into our sys­tem. We’ve been do­ing that for quite a few years. But I ab­so­lutely agree with you, there will be more and more. Re­cently, some­one was show­ing me a ma­chine where at home, with one drop of blood, you can do your own CBC (com­plete blood count) and a whole bunch of other things. That can go to the doc­tor to an­a­lyze so you don’t have to go to the clinic to get your blood drawn and sit there and wait un­til the doc­tor looks at the re­sults.

It’s go­ing to be­come much more pa­tient­fo­cused. What you, the health­care or­ga­ni­za­tion, think of as work I think of as free­dom. The pa­tient is say­ing she wanted to sched­ule her­self, she wanted to do things her­self, and she wanted to be able to elec­tron­i­cally or­der her re­fill and things like that. That’s where it’s go­ing.

MH: Has Epic been in­volved in any of the cy­ber­se­cu­rity breaches?

Faulkner: As a cor­po­rate en­tity, we’re con­stantly be­ing at­tacked. But to the best of my knowl­edge, never suc­cess­fully. We read now and then about our cus­tomers hav­ing been at­tacked, but never, to the best of my knowl­edge, through our soft­ware.

MH: Are you get­ting de­mand from your cus­tomers to do more to help them pro­tect their data?

Faulkner: Sure. We have se­cu­rity meet­ings with them to go over what we’re do­ing, what we rec­om­mend.

I have been told by our cus­tomers that those meet­ings are very valu­able. And we rec­om­mend every­body do this. We hire peo­ple reg­u­larly who try to at­tack us and see if we have any weak ar­eas. We do fake phish­ing among our own staff to see who is go­ing to re­spond. The scary thing is, you al­ways get peo­ple who re­spond. So we put in mul­ti­ple lev­els of au­then­ti­ca­tion so that it makes it harder and harder for that to hap­pen.

MH: What are the prospects for Epic to grow its share of the mar­ket?

Faulkner: It is a more ma­ture mar­ket. We’re still see­ing a lot of turnover as or­ga­ni­za­tions leave their ex­ist­ing ven­dor and come to us.

So, we had a lot of new sales last year. I think the in­ter­est­ing thing is we’re go­ing in more di­rec­tions—work­ing with re­hab com­pa­nies, lab-only com­pa­nies, smaller health­care or­ga­ni­za­tions, and much more over­seas. There is a lot beyond the tra­di­tional or­ga­ni­za­tions.

MH: Is Epic help­ing its clients with pop­u­la­tion health man­age­ment? Are you in the con­sult­ing busi­ness in that space?

Faulkner: At this point, we’re train­ing our users about how they an­a­lyze the data, rather than do­ing analysis for them.

MH: Do you see this as a new busi­ness op­por­tu­nity?

Faulkner: It might be. We’re find­ing that all over the place, our cus­tomers are say­ing that they like ser­vices from Epic. We have some­thing now called Sup­ply Shop. It’s in re­port­ing; it’s in an­a­lyt­ics; it’s in pop­u­la­tion health; it’s in physi­cian pro­duc­tiv­ity, nurs­ing pro­duc­tiv­ity and op­er­at­ing mar­gins. Sup­ply Shop has peo­ple who are ex­perts in all those ar­eas. We are staffing more and more peo­ple. So there cer­tainly is a de­mand for ser­vices.

MH: How do you see your own role evolv­ing at Epic over the next five years?

Faulkner: Not much dif­fer­ent from what I’m do­ing right now. On a per­sonal level, I’d like to read more books, but I don’t seem to get the chance. Maybe gar­den a lit­tle bit. I like gar­den­ing. Maybe be with fam­ily to take a lit­tle bit more va­ca­tion, but I would’ve wished that for the past 20 years. I don’t see much chang­ing right now. I want to visit our cus­tomers more. I like vis­it­ing our cus­tomers.

“We hire peo­ple reg­u­larly who try to at­tack us and see if we have any weak ar­eas (in cy­ber­se­cu­rity). We do fake phish­ing among our own staff to see who is go­ing to re­spond. The scary thing is, you al­ways get peo­ple who re­spond.”

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