EPIC EMR
In 2016, our practice made the leap to EMR. We chose a company now called Elation Health. Their user contract was very reasonable. In fact, our practice consultant believed it was the most reasonable and affordable contract he’d ever seen.
Moving from paper to computer is never easy. Every visit in the new system is a struggle. After about 6 to 12 months, you now have the patient’s basic health data entered into the system and life gets easier. As we entered the second year of the transition, we agreed: The EMR was user friendly, common sense and faster overall. How many doctors say “I like my EMR”? We did!
Fast forward to this year. We transitioned from owning our practice to becoming health system employees. This meant moving to EPIC.
For those of you living under a rock, EPIC has become the standard for large health systems. The exception is the HCA system, which insists on living on its own island, utilizing an EMR that still shows its underpinnings of basic MSDOS command lines.
Yep! EPIC is well on its way to total world domination. If you’ve ever seen their Madison, Wisconsin campus, it looks like something out of Disney World. At first glance, everyone involved with working with EPIC says the same thing: “No wonder it is so damn expensive!”
EPIC is here to stay. It will be here long after I’m dead. What I say here cannot impact that.
Here is the bottom line: EPIC is a massive, complicated beast. It is incredibly frustrating. It is the absolute model of “warning fatigue”. I’ve never clicked so many times per minute as with EPIC. Patients who watched me in earlier years all now comment: “You are really doing a lot of clicking, doc!”
If you try and order an NSAID, it will demand a recent creatinine. Heaven help you if you just did the creatinine a day ago, but it was done at an HCA owned lab which does not feed into EPIC. You’ll be left screaming four letter words and telling your patient to “Just buy your own damn ADVIL and get the hell out of my sight!”
EPIC is like your three-year-old, constantly asking “Why? Why? Why? Why?” no matter what you say or do.
EPIC decides to blot out a quarter of your screen to promote a new video that describes how they just moved the menus around. Maybe it has a staff message that blips up in a big bubble covering the note you are trying to type out. If you look at the message, you’ll forget what you were typing. If you click the X on the message, somebody somewhere in your clinic dies. It is the model of perpetual sensory overload. It interrupts your thoughts. It breaks your chain of concentration. It makes you forget to order the antibiotic you planned to order because you stupidly thought you could order someone Meloxicam without a creatinine IN THE SYSTEM.
EPIC is doing what they do to make your life easier, they claim. Yet, even the experts who occasionally appear are often equally baffled when I show them a dead end I’ve encountered in a patient’s chart, totally stopping me in my tracks and killing all abilities to finish the person’s encounter. How is it that these people are teaching EPIC for years and they can be thwarted by a few diabolic clicks from a newbie such as myself?
EPIC feels like it is the ultimate committee creation. It is a tool that attempts all things but is a master of none. Even simple tasks make me groan. The system wants you to get rid of all paper, but the health system still uses paper. We still fax, do DMV forms, sign Home Health paperwork and fill out Assisted Living forms. Nothing is simple. Everything requires a lot of clicks and a lot of steps.
The scary thing is I’m getting better at it. Sure, I had to push out some less important stuff I kept in my brain to learn it. Gone are those years of Quantum Physics I learned in Undergrad. I also had to forget my kids’ names, but… hey… I’m getting older so it’s okay to forget them, right?
EHR:
Worst thing that happened to primary care medicine as opposed to dictated and signed records. I came from that age. Did electronic and the administration was surprised I dissed the system as I regaled folks on how I’d constructed high powered computers from parts as a hobby at home. Considered me a computer geek but far from it.
EHR: Using electronics to make a doctors life more miserable and the “electronic” paperwork time more intolerable.
Plus it costs a “buttload” of money to rent. Probably easier to pay local transcriptionists to take dictation.
Greatest thing that happened to me is when I retired at age 64, 2 and a half years ago. Had some good years of practice by the last 7 doing EHR sucked the big “D”. Took more time away from family endeavors too. So glad I’m gone from this profession. I DO NOT recommend primary care to anyone. Did hospital work, office and took call so that made it a “full service practice”. Throw EHR in there and really “Eff’s up” one’s life. So good to get out.
Oh, I still dabble in Linux and have done so since 1992. No MS stuff on my laptop.
Kurt Savegnago, M.D. (retired happily)
We made a conscious decision to stick with “dictated and signed records,” and have never regretted it.
It’s surprising how few docs, even those in private practice, can give a well-reasoned explanation of why they abandoned paper records. Usually it’s something along the lines of “I thought we had to.”
Just remember, if the AAFP is for it, it’s very likely a bad idea.
I have been offered a more lucrative option for the membership model I am going to, but it required me changing over to epic. I will stay with my EClinicalWorks, the evil, that I know is better than the evil that I do not know. Thank you for reassuring me that my choice was a good one.
I used to have to use Epic. It is a system made to give bureaucrats a job. Thank goodness I am now independent and can happily use Elation.
EPICs owner was Obama’s largest campaign donor.
Thus the mandate before being user friendly.
They used the vast sums of money to become a little better, like the Microsoft Monopoly on the 90s. We paid for the development.
BTW the owner went from net worth 100 million to 8 BILLION.
You are preaching to the choir. This needs to be out for the public to see, so that nobody will go into the medical field without a lifelong scribe to be paid for by EPIC. My hospital (ADVENTHEALTH) just went on EPIC. Now I have to punch in a unique 9 digit identifier required for each dictation. Logging on from my office takes several minutes. Can’t wait to call it quits!!!!