Lisa Frank and Epic

I saw this article show up on my facebook feed and was intrigued, because my wife still talks about Lisa Frank artwork on occassion: Inside the Rainbow Gulag: The Technicolor Rise and Fall of Lisa Frank. Read it now. I'll wait.

The first thing that jumped out is the similarities between Lisa Frank and Judy Faulkner.  From starting the company in 1979 to million-dollar sales shortly thereafter, to this quote: "Thirty-five years and one mega-brand later, there are only two photos of [the company's founder] floating around the Internet." I counted only 4 distinct photos of Judy on the first page of a Bing search. Last, the description "a very passionate lady, although a little manic and not always all there" could apply equally to Faulkner as it does to Frank. Anyone who was around when she was comparing Epic to Facebook and suggesting that we come up with a Farmville-esque game related to healthy children can attest to that.

As I read through the first few paragraphs describing the workers' attitudes about their place of employment, it felt like I was reading Glassdoor reviews of Epic. Lisa Frank's artists, like Epic's staff, were overworked, under-appreciated, and prone to early burnout.

Deeper in the article, however, LFI and Epic's differences begin to emerge. Lisa Frank, Inc took a more top-down, aggressively insulting approach to management, with equal rage directed at employees and middle management. Epic, in contrast, is apathetic at the top and useless in the middle. Faulkner appears to be too caught up in schmoozing hospital CEOs and directing EMR legislation as an Obama appointee to effectively manage her company. (I define management as "encouraging and providing resources for the growth and development of a company's assets, whether those assets are material or personnel.) Her lack of focus combined with Epic's much-vaunted "flat hierarchy" lead to a frustrating organizational structure for the bottom-rung employee. Instead of one unified company led by an actively participating CEO,  Epic instead has hundreds of tiny fiefdoms run by managerially-inexperienced Team Leads. These Team Leads, who are thrust into the position armed with nothing more than their previous experience as One Who Takes Orders and a couple of books, learn to lead with either the unforgiving iron fist of Power Gone To The Head; or fearing conflict, they lead with Friendliness, Understanding, and Avoidance Of Any Criticism Constructive Or Otherwise. One leads to burnt out employees who quit in disgust, while the other leads to employees who don't know if they're meeting expectations or not until they get fired.

Either way, it's a problem. Lest Epic go the way of Lisa Frank Incorporated, I suggest they invest in their employees by drastically changing their management structure. Big companies need Middle Management. Epic hasn't been a small startup in over a decade. It's time for Judy to accept that, and make adjustments to her company. 

ICD-10

If you ignore the ridiculous amount of effort needed to implement ICD-10, and the consistently-delayed deadlines, ICD-10 can be hilarious.

With diagnoses like V95.40XA, Unspecified Spacecraft Injuring Occupant, Initial Encounter and W55.3, Contact with non-horse, non-cow hoof stock; it's hard not to chuckle once in a while.

Enter Struck By Orca, ICD-10 Illustrated. Featuring full-color artwork from more than 30 artists, it shows some creative interpretations of the more interesting causes of morbidity that will be available to clinicians this time next year (or the year after that, depending on CMS's procrastination).

At only $20, I think this should be in every waiting room in every clinic across the country. Order now and get it in time for Christmas.

According to the site's admin, the project has a few ex-Epic folks involved. I'm assuming some of them are sitting out their non-compete year. That non-compete year is a great opportunity to get in touch with your inner creativity, as well as put project management skills to use by taking an abstract idea and turning it into a solo art exhibition. There is absolutely nothing preventing you from creating GANTT charts in gouache.

Send Me Your Resumes

Since the initial objective of this website was to provide resources for weathering the non-compete year, I've decided to start sharing job opportunities that I've come across. This one is from Parker Healthcare IT, a company that I used to work for (and would definitely work for again).

Healthcare IT Business Development Position

Parker Healthcare IT has been placing technologists in the healthcare space since 2005.  We have a stellar reputation and a value proposition that will create immediate credibility.  Our company was recognized as one of the best workplaces in the state of Washington in 2013.

We think there is a best employee out there waiting for a company like ours to show their true talents.  Come work in a class A building in the Denny Triangle area of Seattle.  Experience all that Seattle has to offer; a spectacular haven for outdoor activities, world renowned restaurants, professional football and baseball, a robust cultural scene and some of the smartest people in the nation.   

We are looking for a professional to join our very successful and established team as a business development manager.   Your role is to identify new business opportunities while managing the delivery of our services.  If you are an overachiever and can prove it then you will want to consider our position.  We are looking for experience in technology sales and/or a healthcare IT background.  Travel is minimal and our compensation package is above market.

What they need is someone to help find new clients and maintain those client relationships.

Parker's staff is personable, accommodating, and growing. They once hosted me at their corporate headquarters in downtown Seattle (it was a dinner shindig), and Seattle looked like a much more interesting place to live than Madison, Wisconsin.

This position would not use technical support skills as much as require excellent customer service experience. If this sounds like something you're interested in, either leave a comment with an email address where I can reach you; point me to your resume on LinkedIn, Dice, or Monster; or respond directly to Parker as per the instructions in this link. As always, I won't post any comments with PII unless you specifically want me to. If you email Parker directly, mention this blog so I can get some referral credit.

UGM

It's UGM this week, which means that the lucky few are in Madison on a work-vacation and the rest of us are in the office, with less support than we're used to since all the Epic staff are making UGM run smoothly.

This week always reminds me of the thing I enjoyed most about working at Epic: directing traffic at UGM.

More than the swank office buildings with the fancy decor, more than the above-average cuisine, more than the relationships that I made with the customers I supported, I enjoyed directing traffic. It's one of those childhood dream things, you know? That's probably the closest I'll ever get to working on a road construction crew. 

However, since that's positive about Epic (and Epic doesn't like positive publicity: see this post) It behooves me to add something negative to even the balance. While as a TS I enjoyed the different opportunities that UGM offered, I definitely don't feel the same way about it now that I'm employed at a customer site.
Epic support disappears almost completely for this week, but the hospital doesn't shut down. There are still issues that need resolving, and Epic is too busy this week to help.

There are several ways Epic can handle this:

1. They can keep doing what they're doing. Epic can keep pulling from all current staff to fill all the various positions necessary to make UGM successful. Cons: From the staff's perspective, it's just added work. Just because I was directing traffic didn't mean I had less actual TS work to do. It didn't go away, and it was expected that I still complete it--this, combined with a couple hours of UGM support, a couple hours of schmoozing with customers, and a couple hours of actually attending presentations. It makes for long, stressful days--one of the leading causes of burnout amongst Epic employees. Pros: It's cheaper for Epic. They don't have to hire temps and they don't have to pay their current staff extra; everyone is salaried.
2. They can use staff only from non-customer facing positions. Use QAers and developers all day for one week. The world won't end if dev cycles are put on hold for one week. Cons: I don't know how many QAers and developers are currently on staff. There might not be enough to cover all the UGM staffing needs. TS who enjoy directing traffic don't get the opportunity to live the dream. Pros: Customers still get the support they're used to. There's no "downtime" or "delay in care". TS and IS get less burnout.
3. They can hire temps. Event companies usually have staff for this. Epic can use them for a week. Cons: it'll be more expensive. Pros: These guys have experience. They know how to direct traffic. (We had to be trained in a 1-2 hour long course. Topics covered were how not to send mixed messages, how to sync the flag waving with hand signals, how not to have weak floppy wrists that confuse drivers.) It won't affect dev cycles or customer support. 

As Judy is fond of saying that "A company is just a collection of processes," I think it's beneficial to evaluate those processes every once in a while. Just because UGM runs smoothly every year is no reason not to seek ways to improve it. 

Does Judy know what happens at her company?

A coworker of mine showed me this article: Healthcare IT News: Go-live Gone Wrong. It details a couple of organizations that had huge monetary issues after going live with Epic. Apparently, no one told the clinicians that they'd have to take charge of some of their billing workflows (e.g., Charge Capture), therefore the hospitals had huge budget shortfalls.

It brings to light an old problem with Epic: lack of training. I'm not sure what Epic provides for trainers at customer sites, but this shouldn't have even been an issue--Epic's implementation staff should have covered this in their project plan. However, Epic doesn't always provide IS for existing customers. Everyone has a TS, but they certainly aren't trained in any kind of project management skills--I don't think it was just me, but during my tenure TS received no training (there's that word again) in project management. We weren't even given a book on the subject. Project Plans are just not something TS know about. The tools given to IS at the start of their new employee orientation are geared to helping new customers and getting someone with no healthcare experience a chance of successfully completing a large-scale multi-million dollar project.

I don't know any specifics about these implementations other than what's in the article--I don't know if it was an IS or a TS who screwed up. I do know that Epic is giving itself a bad reputation with this kind of thing. Training is, at its core level, a somewhat rapid way of imparting experience. As the target audience of this blog can attest, Epic has a problem with giving anyone more experience than the bare minimum necessary. While I don't know if it was an IS or TS who failed here, I'm >80% certain that that employee had less than two years of Epic experience. Anyone who had been there longer would have known better and this wouldn't have happened.

And that brings me to Epic's biggest problem: its turnover rate. Whether its from employees getting burned out and leaving on their own volition or the employees being forced out--there is an unmistakable dearth of experience at Epic. My current employer, when I started working here, had an experienced TS. We've been live on Epic for a while, and the TS had been at Epic for most of that time. That TS had seen the changes Epic had gone through, been through the transition from table-based order transmittal to rule-based, helped us with our build decisions and, in short, knew the differences between our system and Epic's Model. Well, that TS left, amazingly without exhibiting any outward signs of burnout, and was replaced by a fresh out of training newb. Two years later, after dealing with I don't know how many "I don't know" responses on weekly issues calls, the replacement has burned out and left. We're now on our third TS in as many years, and the replacement's replacement shows all the outward signs of being new, as well.

From a personal standpoint, the team feels betrayed by Epic. I know my customers from my TS days felt that way when I was pushed out and replaced by newer folks. (They told me as much when I asked if I could use them as references.) It's a problem that has been going on for years now, and based on Judy's high and mighty rhetoric about how much support Epic customers receive, I get the impression that no one in her circle actually has the boots-on-the-ground perspective--or maybe they're too scared to tell her.

The current impression at my organization is that Epic doesn't care about live customers. New, implementing customers are great, and Epic will move mountains to make sure things are done right (or not, I've heard interesting things about Duke's implementation). But existing customers adding new clinics and new hospitals can figure it out themselves. Epic's already got their money.

My advice to Judy, if she (or her delegates) are reading: You actually need to retain your staff. Free health insurance and a month-long sabbatical aren't enough--you will have to quit firing people. It is not, in fact, easier to train someone new than to re-train someone with experience. Experience matters to your customers, and Epic's lack of it is starting to show.

Forbes interviews Judy Faulkner

A friend of mine forwarded this to me: An Interview With The Most Powerful Woman In Health Care

Judy finally said yes to an interview, and she got a better picture taken. It's worth a read.

Edit: 6/18/13

I found this article, published around the same time as the Forbes article:

Michelle Malkin--The Obama Crony in Charge of Your Medical Records

I worked at Epic when Judy was tapped for Obama's HITECH / MU / EMR panel, and I have always wondered about that apparent conflict of interest.

Oh, Epic...

I was doing research the other day, trying to find what a particular medical abbreviation stood for, and I found myself looking at the Epic Survival Menu. It looks like it's written by a provider, one who is not terribly pleased with his organization's implementation. A lot of it is organization-specific, like the slowness in bringing new clinics up on Epic, but some of it is advice that Epic needs to hear.

I encourage you to visit the site (link opens in new tab/window), but I'll share a few gems here:

•  Epic's "vanilla" version is too primitive and requires too much refining and training.  Epic needs to sell a better "vanilla" version. 
•  Standardize all process!  We should not have to close somethings, sometimes by closing the tab, other times "Alt A," F9 or clicking on "Close Encounter."  Such a waste of time!
•  I was told I will give out trade secret by writing positive changes.  So I will no longer post positive changes. 

I admit I laughed out loud at that last one. It's far better to post a thousand things that are terrible with Epic, than post one thing they do extremely well. It makes about as much sense as their HR practices or their Caché code.

Consulting Firms to Avoid

I'm tired of getting spam from certain firms, so I'm going to start calling them out in public.The list so far:

• Med Career Advisors
• Patriot Consulting (mentioned in the comments)
• Profero/Advantage Consulting (see comments)

Med Career Advisors (www.medcareeradvisors.com--not a hyperlink because I don't wish to drive traffic their way. If you want to check out their website, copy and paste.)


Here's why I recommend against them: I received an email from them a couple weeks ago, on my work email account. (Strike 1--it's bad form to poach, and really bad form to email a potential person on their current employer's email address.) I respond, saying that I'm not looking for new consulting gigs. I rather like where I am right now. The email says I was referred to them by someone, so I ask for the name of the referrer--it's got to be someone I work with, I assume, since who else would know my current work email address? They avoid the question saying they don't give out that information. Policy is policy, so it's an answer I can live with. (We can call that a foul ball. Strike 2. I would like to know who's tossing my name out there so I can correct their behavior; I don't want my boss to mistakenly think I'm looking for new jobs.) I don't respond, because I've said what I need to say.

One week later: same form email, same sender, to my same work email address.Strike 3, and they're out. This time, my work's email flagged the sender as junk email.



Share your own bad experiences in the comments.

Update:
This is something that just bothers me about the industry as a whole: the constant pushing for referrals. I still get calls from consulting firms that go like this: 

Consulting Firm: "Hi Anonymous, I ran across your resume in our database and I'm wondering if you're interested in a new position."
Me: "No, I'm in a full time position. I'm not seeking a change right now."
CF: "Do you know anyone who is?" 

It reminds me of how the D.A.R.E. classes we had to take in elementary school described drug pushers. The dealer would get a hold of you, and before too long you'd be trying to get all your friends hooked, doing the dealer's work for him.

It stands to reason that the only people I know in the industry are my current coworkers. By definition, they're currently employed. Furthermore, it's just not good to talk about seeking other employment while on the clock. The only time I find out that my coworkers are seeking new employment is after they announce their two week's notice. At that point, they almost always have plans for their next engagement.

It just bothers me when consulting firms want me to do their recruitment for them. I don't work for these companies, so what's in it for me?