Epic and the Non-Compete

My google alert for the QA class action lawsuit notified me of something interesting this week. Apparently, some of the local consulting companies were poaching from Epic. Thanks to some shady practices which have all been mentioned in the comments on this blog, Epic got Vonlay (which is in the process of being bought by Huron Consulting Group in Chicago) to agree to a two year non-compete for ex-Epic employees. Read the article here.

There are several noteworthy items. I've italicized quotes from the Isthmus article.

1. The Healthcare IT world knows that Epic underpays and overworks its employees. As soon as the ex-employee goes to consulting, they start to make double the pay with fewer hours. "You can make $180,000 to $200,000 a year," says a consulting executive, compared to the $100,000 that same employee might have made back at Epic. "And for us, it's 40 hours billable, maybe 50 total including travel."
2. Non-competes are bad for job-seekers, bad for companies looking for qualified staff, and bad for communities. There is, in fact, compelling evidence that broad no-compete clauses suppress economic activity and damage wage levels, according to the Ewing Marion Kauffman Foundation, which promotes entrepreneurialism. It reports that "job creation and economic growth will be hindered" by the clauses, and workers subject to strict noncompete terms suffer "lower compensation in their next job, skill atrophy and a degradation of professional networks."
3. Epic is shady. Epic had successfully intervened at the 11th hour to insist that Huron not hire Epic employees within two years of them leaving the company. 
4. Epic operates with questionable legality. [Speculation] circles around Epic fearing it might be treading on federal antitrust laws and being accused of anti-competitive business practices.
5.  Epic doesn't want what's best for its customers or what's best for its employees. Epic only wants what's best for EpicJudy. Epic enforces its no-hire clause through "conspiring" with its customers, which include all of the hospitals and major physician practices, and through the third-party consulting companies.  Epic... effectively dictates job terms and other matters to the consulting companies, whose business is augmenting staff and fine-tuning software for Epic clients once their system is up and running. If those consulting firms fail to toe the Epic line, the company can deny them access to the technical documentation for a health system's Epic software. And that means the consultants can't do their job.
   Clients, on the other hand, are rewarded for agreeing to honor Epic's noncompete clause in their own hiring -- in the form of receiving substantial "preferred customer" discounts to their yearly maintenance fees.
   In the end, this means a hospital can't turn around and hire the young Epic whiz kid who just spent two years installing its Epic software. Nor can that Epic wiz kid quit her job and walk across the street to work for an Epic consultant who might have a contract with that hospital
6. If there were enough backlash, Epic might back down further on the non-compete. Huron and Vonlay officials did not respond to queries, but Epic spokesman Brian Spranger confirmed that Huron had agreed to a two-year noncompete term. And then the shocker: "This is being reverted to a one-year term." Spranger offered no explanation in his email for the reversal. "We'd rather not comment on the policy as a whole." 

This was one of the more interesting articles I've read about Epic in a long time. Perception is reality, according to the pre-staff meeting powerpoint slides. I wonder how Judy feels about her company being perceived as a shady, strangleholding, antitrust-worthy corporate giant.

Epic's Principles, Part 10

Epic's 13 principles
1. Do not go public.
2. Do not be acquired.
3. Expectations = reality.
4. Keep commitments.
5. Be frugal.
6. Have standards. Don't do deals.
7. Create innovative and helpful products.
8. Have fun with customers.
9. Follow processes. Find root causes. Fix processes.
10. Don't take on debt for operations, no matter how good the deal.
11. Focus on competency. Do not tolerate mediocrity. 
12. Teach philosophy and culture.
13. If you disagree, dissent. Once decided, support.

We've arrived at the final installment, and the one I'm least qualified to write about, as my tenure at Epic predates this principle.

Business books describing streamlined, high-functioning teams or companies generally agree that there is value in hearing all viewpoints regarding a given issue. Leaders don't always have the best view of what's happening on the ground, and smart leaders like to know if they're rapidly progressing to a cliff. Also, a team cannot be high-functioning if its members are working at cross purposes. Once the decision-makers have had their say, the team must unify their efforts. This is a sound business principle, and a good idea.

However, this requires that leaders be able to admit that they're wrong. I don't think Epic's leadership has that ability. Those stillborn ideas that I remember from staff meetings were never spoken of again, and no documentation existed in the first place. I can't imagine any of the power holders at Epic admitting that they thought developing a Farmville-esque Facebook game about healthy kids* was a good idea. For dissent to be valuable, leaders have to listen to it, and to listen to it means they have to acknowledge that they may be wrong. Epic's culture doesn't permit the rank and file to question authority.

I saw this article about the Pontiac Aztek, and it seems appropriate.

The 13th principle is a good goal, but I don't see how Epic can actually follow it--they'd have to change a lot about their culture and philosophy to make it happen. It's admirable that Epic has considered it, and that Epic is encouraging it (at least on paper), but I don't see their cultural inertia changing directions any time soon. On behalf of all current and future Epic employees, I'd love to be proved wrong here.


*I remember Judy talking about this idea several times over a period of a couple months.

Epic's Principles, Part 9

Epic's 13 principles
1. Do not go public.
2. Do not be acquired.
3. Expectations = reality.
4. Keep commitments.
5. Be frugal.
6. Have standards. Don't do deals.
7. Create innovative and helpful products.
8. Have fun with customers.
9. Follow processes. Find root causes. Fix processes.
10. Don't take on debt for operations, no matter how good the deal.
11. Focus on competency. Do not tolerate mediocrity. 
12. Teach philosophy and culture.
13. If you disagree, dissent. Once decided, support.

If Epic actually meant "philosophy and culture" as it's understood by most people, then it's an abject failure. But if they meant "Drink the kool-aid until you drown in it," then they're doing pretty well. Paraphrased as "Teach Epic's philosophy and culture," then the principle makes perfect sense.

Epic has a particular philosophy and culture which many businesses don't adhere to, so the business philosophies that new Epic employees just spent 4-6 years studying in college don't always apply. Epic has to instruct these new employees in the specific way that Epic runs. Sometimes Judy provides this instruction bluntly in the monthly staff meetings, at other times the employee just picks it up by diffusion.

One of Epic's unique business philosophies is that "it's better to hire someone with no relevant experience and train them from the ground up than to hire a seasoned software developer and have them unlearn everything so they can do Epic development." As flawed as I think that belief is, it is fully in tune with Epic's philosophy, and it is definitely taught.

I'm drawing blanks on other examples of Epic's philosophy. Add your own in the comments.

As for Epic's culture, they don't teach this as explicitly. In theory, it's laid back (e.g., no dress code) and  flexible (work hours). In practice, there is a distinct dress code that successful Epic employees follow--nice blue jeans and at minimum, a nice-looking "casual" shirt. Holey sweat pants and Packers jerseys might work once in a while if worn ironically, but if you show up every day looking like that, you're not going to work there long. The flexible hours (as I've written before) amount to "Come in as early as you'd like before 9 am, and stay as late as you need to after 5 pm." You either learn the culture and drink the kool-aid, or you leave the company.

Epic does teach its philosophy, but it doesn't teach its culture. You're expected to learn and follow both.

Epic's Principles, Part 8

Epic's 13 principles
1. Do not go public.
2. Do not be acquired.
3. Expectations = reality.
4. Keep commitments.
5. Be frugal.
6. Have standards. Don't do deals.
7. Create innovative and helpful products.
8. Have fun with customers.
9. Follow processes. Find root causes. Fix processes.
10. Don't take on debt for operations, no matter how good the deal.
11. Focus on competency. Do not tolerate mediocrity.
12. Teach philosophy and culture.
13. If you disagree, dissent. Once decided, support.

Principle 10 is interesting--it used to be "Don't take on debt, no matter how good the deal," but apparently Judy had to buy some buildings on credit. It's nice that day-to-day fiscal responsibility is a priority, but unfortunately, I'm in no position to know how well Epic is doing on that. The company is privately owned specifically to keep this kind of information out of the public.

Epic gets a bye on this one, due to my lack of insider information.

Because of that, you get a twofer this week. "Focus on competency. Do not tolerate mediocrity." As with most things, Epic takes an inconsistent approach to this.

Judy most assuredly does not tolerate perceived mediocrity in its employees, but she sure is happy to have the least mediocre EHR out there. There's a difference between Best and Least Bad. Epic is adequate, but the volume of user complaints and bug reports preclude any claims of excellence. Epic does try, though; they're just hampered by how they enforce their ban on mediocrity.

I'm talking about how Epic churns and burns through its employees. New employees are trained to a level of adequacy, then left to sink or swim on their own. If they start to sink, rather than fish them out of the pool and enroll them in swim lessons, Epic lets them drown.

Most business knowledge that I've come across (google: retraining vs replacing employees) advocates that retraining is the more sound business decision. In terms of lost productivity and monetary expense, replacing costs more. Consider Epic: When I was there, communal wisdom stated that it took about 9 months for a TS to become self-sufficient after being hired. Retraining the under-performing employee should take about a month or two of concentrated effort. Replacing that employee starts the 9 month counter over. If most people are leaving sometime between 1.5 and 2.5 years, then the customer is getting minimal competency from their TS.

If training were better, and could be compressed into a shorter time frame, that would help Epic live up to its principle. Get the employee competent faster. If Epic retrained the underperformers--time management skills, prioritization, troubleshooting shortcuts, etc--then they wouldn't have to give up 9 months of non-productive time. Epic wouldn't have to pay that new employee for 9 months on the promise of only a couple months of productivity after that.


While Epic tolerates mediocrity in their product, they are quick to fire mediocre employees, which is a no-tolerance response. Epic has historically struggled with getting its employees the right training, and Epic never retrains. Competency is assumed, never questioned, and never corrected if necessary. There's little proof of a focus on competency. Epic fails on this principle.

Epic's Principles, Part 7

Epic's 13 principles
1. Do not go public.
2. Do not be acquired.
3. Expectations = reality.
4. Keep commitments.
5. Be frugal.
6. Have standards. Don't do deals.
7. Create innovative and helpful products.
8. Have fun with customers.
9. Follow processes. Find root causes. Fix processes.
10. Don't take on debt for operations, no matter how good the deal.
11. Focus on competency. Do not tolerate mediocrity.
12. Teach philosophy and culture.
13. If you disagree, dissent. Once decided, support.

"Follow processes. Find root causes. Fix processes."

This one has always bothered me from a semantics angle. What is the Epic Employee to do with the knowledge of the Root Cause? Why was the employee told to find it? What if the process wasn't the root cause of the problem? I would have rephrased it to "Follow processes. Find root causes of problems. Fix root causes."

Epic has a lot of processes that need fixing, and since several of these processes have been flawed for the better part of a decade (at least), it's clear that Epic has no interest in fixing them. The most obvious example of this is their HR practice. Epic follows the practice of hiring the best and the brightest of the inexperienced. Shortly after the employee becomes competent with solo work, the load gets bigger until the employee either buckles under the strain or decides that the strain isn't worth it. At that point, the employee starts looking for work outside of Epic, taking all that experience with him.

The root cause of that problem is firing the employee instead of investing in their growth. Since Judy has gone on record at a staff meeting to lament their employee retention numbers, she could kill two problems by fixing one root cause.

Then there's the problem of Epic's development. Everyone who's gotten a peek behind the curtains knows that Epic's code base is held together with chewing gum and baling wire. A bona fide Patient Safety Escalation comes out every other week, and there are about a dozen Care Concerns each week.

Development processes were followed; Epic has numerous checklists for that. Problems were introduced into the product. Root causes were discovered by the Patient Safety committee. The problems were fixed after the fact (mostly), but the processes that allowed those issues into the software weren't modified.

The root cause of a given PSE is relatively easy to discover, and the code change required to prevent that specific problem from occurring in the future is manageable. However, the root cause of Patient Safety issues in general hasn't been looked at. How can Epic prevent buggy software from going out? I've heard suggestions (and posited some of my own), but nothing has changed.

While Epic talks a big game about fixing processes, they don't really deliver on that.

Epic's Principles, Part 6

Epic's 13 principles
1. Do not go public.
2. Do not be acquired.
3. Expectations = reality.
4. Keep commitments.
5. Be frugal.
6. Have standards. Don't do deals.
7. Create innovative and helpful products.
8. Have fun with customers.
9. Follow processes. Find root causes. Fix processes.
10. Don't take on debt for operations, no matter how good the deal.
11. Focus on competency. Do not tolerate mediocrity.
12. Teach philosophy and culture.
13. If you disagree, dissent. Once decided, support.

Epic has a slide, so I guess that's got to count for something.

Seriously though, there's a fine line between having fun and frivolously wasting money. UGM walks that line nicely. There are loads of customer-centric events that (to me, at least) never appeared to be gross misuses of money. For customers visiting Verona's campus, Epic follows this principle pretty well.

However, for Epic employees visiting customer sites, fun with customers usually isn't a priority. While visiting Epic staff could suggest going out for a meal during lunch or after work, many Epic customers prefer that visitors' time be devoted more to resolving issues than extra-curricular socializing. Given various legal and ethical issues around vendors paying for clients' meals and vice-versa, the Epic employees that I've dealt with are doing the right thing, even if it's not necessarily following Epic's 8th principle.

Out of 8 principles so far, Epic's actually following 3 ½ of them (and two of those are gimmes).

Epic's Principles, Part 5

 Epic's 13 principles
1. Do not go public.
2. Do not be acquired.
3. Expectations = reality.
4. Keep commitments.
5. Be frugal.
6. Have standards. Don't do deals.
7. Create innovative and helpful products.
8. Have fun with customers.
9. Follow processes. Find root causes. Fix processes.
10. Don't take on debt for operations, no matter how good the deal.
11. Focus on competency. Do not tolerate mediocrity.
12. Teach philosophy and culture.
13. If you disagree, dissent. Once decided, support.

"Create innovative and helpful products." Having recently spoken to some brand new Epic users, I could have some fun with the "helpful" part of this, but since I did drink the kool-aid pretty heavily for my tenure at 1979 Milky Way, I'll abstain from most of the snarkiness.

When used well, I do think Epic is really helpful. As a MyChart user, it's great to be able to see my lab results whenever I feel like it. It's convenient to schedule appointments without having to wait on hold on the phone. As someone who's watched clinicians ooh and aah when they were able to see other providers' notes on their patients, it's obvious that Epic can be helpful.

However...
A couple of things have to align for Epic to be helpful: The customer has to have implemented the software correctly, and Epic's code has to work. It's not a principle, but it's shown at every staff meeting: "Rule #1: Software must work. Period." Judy used to enjoy mentioning how the Cerner CEO thought that was a personal dig directed at him, but I've seen enough Patient Safety Escalations and Care Concerns coming from hastily coded Epic software to say that Epic is guilty of breaking Rule #1, too.

Software that doesn't work isn't helpful. When Epic works, it's beautiful, but when it doesn't work it's downright dangerous. Epic needs to work on the safety of its products. That, in turn, will increase the helpfulness factor.

I'll give Epic half credit on the helpfulness bit of Principle 7. As for innovation, there's a good mix of innovation and stagnation happening in Verona.

On the one hand, they haven't done much that's truly groundbreaking since taking over the entire industry. Their new products are primarily focused on providing an Epic option for specialty software that used to be sold by best-of-breed vendors. On the other hand, MyChart is really cool, as is Haiku and Canto.

Meriam-Webster defines innovation as merely an improvement over something existing. By that definition, Epic is constantly innovating, as their software is consistently getting better over time. However, my own exacting standards demand more. I feel that innovation needs to be more earth-shattering, like what the iPhone did to the cell phone industry. Giving patients easy access to their own health records was that kind of game changer. There's a Chronicles quote that says "Talent hits a target that no one else can hit. Genius hits a target that no one else can see." MyChart was genius. Beaker, Phoenix, Beacon, Thumper or iHeartHearts or whatever they're calling Cardiant now--those  all stem from talent. Innovation requires genius, in my book.

tl;dr: Epic does a pretty good job with innovation and helpfulness, by the dictionary definitions. I wish they would do more and try harder to be more helpful and innovative.

Happy Returns

I've been maintaining this blog for over three years now, and I've had Google Adsense running on it from the get-go. This month is the month where I've finally crossed the minimum payment threshold. That couldn't have happened without you, my loyal readers.

Adsense's ToS prevents me from outright asking for people to click on the ads, but I do offer my heartfelt thanks for those who've done so voluntarily.

With my new-found wealth, I think I'll probably purchase the Struck By Orca book, and possibly even buy myself a nice meal from the dollar menu at my local fine dining establishment.

Edit:
Also, I'm starting to get spambot comments. That's a solid marker of success. If I didn't publish your comment and you're not a spambot, it's because you put some hyperlink in your comment. If you want your comment to be published, either don't include any links, or make the link relevant. I'm not going to publish your comment if it includes a link to your blog about cat-shaped coffee mugs, if the rest of the comment is just praise for how awesome this blog is. If you want to praise me, great! Just don't include random links. If you have something meaningful to say about Epic, the trials and tribulations of Epic consulting, or if you have inside information (like you've been to a recent Epic all-staff meeting), I might be more inclined to post your comment, cat blog link or not.

Epic's Principles, Part 4

It's been a while since I first posted the full list. Ergo:

Epic's 13 principles
1. Do not go public.
2. Do not be acquired.
3. Expectations = reality.
4. Keep commitments.
5. Be frugal.
6. Have standards. Don't do deals.
7. Create innovative and helpful products.
8. Have fun with customers.
9. Follow processes. Find root causes. Fix processes.
10. Don't take on debt for operations, no matter how good the deal.
11. Focus on competency. Do not tolerate mediocrity.
12. Teach philosophy and culture.
13. If you disagree, dissent. Once decided, support.

 This week brings us to Principle 6: Have standards. Don't do deals.

Whenever I heard Judy explain it at staff meetings, she related it to the price of the software. I.e., Kaiser pays the same price per license as Maine Health. Epic isn't going to give one customer a huge discount just to get its business. Like the first two principles, I never saw how it related to me, personally, as someone not in a position to make deals. As I'm thinking about it now though, with my embittered snarkiness in full bloom, Judy and the sales team are the only folks at the company who are even in a position where they could follow this principle, in Sales or otherwise.

If Epic employees had standards, they wouldn't allow themselves to work 60-80 hour weeks. If Epic employees had standards, they'd give their bosses realistic expectations of the work that they can realistically handle in a given week. If Epic employees had standards, they would politely but firmly inform their TLs that their customers are used to certain standards of support, standards that will no longer be achievable if the employee's customer load increases.

I've often said that one of the reasons Judy primarily hires recent college grads is because they don't yet know what is standard for work expectations. If they don't know any better, they're easier to exploit.

Realistically though, the Epic rank-and-file just aren't in a position where they can obey Principle 6. If they tried, they'd be out of a job faster than you can say "Fix processes." In fact, Epic actively encourages its employees to lower its standards. I remember a conversation I had with my TL, after he listened in on a weekly issues call with my customer.

TL: You said "I don't know" a lot.
Me:  That's because I didn't know the answer off the top of my head. I want to research it before giving them potentially incorrect information.
TL: Just tell them something, and then correct it later.
Me: ...Ok... (raised eyebrow)

After the next issues call the TL listened to:
TL: You told them some things that aren't right.
Me: But you said--!

You get the picture, and you've probably lived through it. It is possible in certain areas of life to have standards that are too high. However, in a situation with as much potential for harm as clinical software, there shouldn't be any compromises when it comes to accuracy. You shouldn't have to make a deal between response time and response accuracy.

The "don't do deals" aspect is also interesting, in that it's definitely one sided. Epic won't cut a deal for anyone, but boy-oh-boy will it wring every last advantage out of anything that comes its way. I'm thinking primarily of how it burns through its employees, but I'm sure Judy is reaping lots of rewards from her seat on Barack's EHR panel.

In any rate, the upper echelons at Epic are in a position to obey the principle as it relates to customer expectations. But internally, standards are always movable.

Epic's Principles, Part 3

See the previous posts here:
Part 1
Part 2

Epic's next principle is 5: Be frugal.


Good advice, but I don't think Epic actually follows it.

Dictionary.com defines frugal as:

economical in use or expenditure; prudently saving or sparing; not wasteful

Epic is not that. Epic wastes money (not in large sums, at least not that I've been privy to) on lots of little things that add up. Epic wastes its employees' time, and it wastes its employees in general. 

I remember when I was working there, every office received its own Dymo label maker. Previously, you could only find a label maker in the supply rooms. I'm not sure what the demand was that necessitated a label maker for every 1.5 employees--I don't think I ever had to wait to use it, even when there was only one per floor. The label makers in question have a current list price of $29.99 (available on Amazon). I doubt Judy paid full retail price for them, as I'm certain Epic has enough sense to get bulk discounts where available. Even so, my back-of-the-napkin calculation has the price of enough label makers for every office at Epic being close to one employee's yearly salary.

I would rather Epic had spent that money on hiring an additional TS, in keeping with Principle 3: Expectations = Reality. I expect my TS will be fully committed to my customer and no one else, and that is not reflected in reality.


Epic is not frugal with its employees' time. It takes 6-9 months for a new TS to become self-sufficient. Epic's customers are paying that TS for the time spent on the steep learning curve (which doesn't make the customers happy--no one likes paying master prices for apprentice work), which will then go to waste as the average employee will leave Epic (one way or another) after another 12 or 18 months. Epic is throwing a quarter of its salary expenditures down the drain--they're not reaping any rewards from retaining skilled workers--they train the employees and then fire them (or burn through them) just as they get the knowledge sufficient to do their job effectively. At that point, Epic adds multiple customers to a single employee's roster, which turns a functional, bright, excited little worker bee into a stressed, overworked, non-functional drone. Epic wastes (definitions 4 or 5) its employees.

And some of the uses that Epic puts its employees to just don't make good business sense. The "starting salary" of a TS, when put in hourly form, was about $28 when I started at Epic. Some employee duties included making popcorn for the Staff Meetings, and directing traffic at UGM. I don't know of any popcorn makers who earn $28 an hour, and that's not counting the lost productivity cost in taking that employee away from customer-facing work. The frugal thing to do would be to leave that employee in his office so he can work on billable tasks. Pay a local store to make all the popcorn--the increased productivity from Epic's employees will pay dividends, even if outsourcing the popcorn costs a little bit more per box. The same goes for all the UGM work, which is addressed in greater detail here.

Epic is frugal with employee salaries, so that's something. Compared to other software companies of similar size, and even the salaries of analysts at Epic's customer sites, the Epic employee is receiving less pay than people doing similar (sometimes identical) work at other organizations. Epic is very generous with its raises though, and those who are permitted to stick around make money hand over fist. But the average employee isn't going to last long enough to get that kind of salary. The low starting salary coupled with the huge raises for long-timers leads to a good-looking average salary, but chances are you're not going to hit that average during the typical short tenure of an Epic employee's employment. 

Further breaking the illusion of frugality, there's Epic's artwork, which can best be described by borrowing from Hooters: tacky and unrefined. Judy is on record saying that the art work is a miniscule amount of the yearly budget. But as perceptions also equal reality, it gives the appearance of wasting a lot of money. Customers do not feel as though installing a tube slide or putting a paper-mache giraffe in a forest of fake bamboo is a good use of the copious amounts of money they've paid into Epic's coffers.

There's also the campus, which grows like a tumor. All that construction isn't cheap, and I understand that Judy had to modify the 10th principle because of it. "Don't take on debt, period" is a completely different from "Don't take on debt except in these specific circumstances."

The key to frugality is the wise use of resources. I'm not sure what the return on investment was for those label printers, or if there was one to begin with. If Epic spent more on outsourcing those tasks that don't require extensive, specialized software knowledge (like making popcorn and directing traffic), and less on cool gadgets (like popcorn machines), the appearance of frugality would show more. As it stands now though, there is nothing frugal about Epic.

Epic's Principles, Part 2

See Part 1 here

Epic's next two principles also go together really well, so they'll share a blog post.

3. Expectations = reality.
4. Keep commitments.

If I remember correctly, Judy explained number 3 as "What the customer expects to happen is what they judge us [Epic] by." She went on to give an example, paraphrased here: If they expect flying monkeys to jump out of the screen and hand deliver an AVS to the patient, they'll be disappointed when that doesn't happen and that will reflect poorly on Epic when KLAS scores are being given. Therefore, Epic employees should manage their customers' expectations.

The fourth principle is like it: If you say you're going to do something, do it. I.E., if customers expect you to do something, make sure that you do that thing so that reality matches the customers' expectations.

Epic has a hit-or-miss track record with this, and it all depends on how much Epic overworks its customer-facing employees. When I was hired, one of Epic's differentiators was that they had umpteen employees per customer, instead of having each employee oversee several customers at once. As we all know, the ratio has changed somewhat--there are still more employees than customers, but pretty much everyone in a customer-facing role oversees several customers at once. During my tenure, this worked well for the lower-maintenance applications, like Cadence or Identity. It emphatically did not work for Epiccare Ambulatory or Inpatient, especially since the purchasers of those applications expected undivided attention from their TS.

The major clinical applications just have too many issues, too many customizations for one person to handle multiple customers. Deadlines will inevitably slip, one very verbal customer will get more attention the the customer with the extra-savvy analysts, and all customers will get upset because they're not getting the attention that they expect to get. Expectations did not match reality, and commitments could not be kept.

The work you promised to do to your one customer doesn't get done because your other customer had an unplanned downtime in addition to being affected by a new patient safety escalation.

Epic is not set up such that commitments can be kept or expectations can be met. They need to hire TS at the same rate as they take on new customers, and they need to retain the employees they have. A lot of burnout could be prevented by Epic having realistic expectations for its employees, and the voluntary turnover could be ameliorated somewhat. The involuntary turnover would be less of a problem as well, due to less burnout-induced mistakes.

Epic's 2 for 4 on their principles. They are NOT following these at all, and are, in fact, setting themselves up for failure on these fronts. It would be so easy for them to hire/retain/retrain the employees to meet the demands of the job; it just seems like Epic isn't interested in that.

Epic's Principles, Part 1

The first of a series, as alluded to in this post. In this mini-series, I'll explain where I think Epic is following its own principles, and where Epic is falling short. Since I haven't worked for Epic for several years now, my recollections may not reflect current reality. If this is the case, I humbly ask any current or recently-freed Epic employees to set me straight.

In this first part, we'll consider Epic's first two principles:

1. Do not go public.
2. Do not be acquired.

So far, success on both counts.  Hooray!

Ever since I first saw these principles plastered all over campus, I thought these were odd principles to put in front of the rank and file. Cerner can't write a check to me to buy the company. They'd have to go through Epic's army of lawyers, and Judy Faulkner and Carl Dvorak specifically. Neither of these principles are things that I will ever be in a position to break.

So why include them for all employees? Why not just leave them on a plaque in Judy's office, or as explicit instructions to the decision-making board in the event of Judy's retirement or inability to continue running the company?

Almost all the explanations I can come up with are cynical (surprise!). Those two principles could be included as a roundabout way of implanting the idea that even you, the lowly rank-and-file grunt, might be running the company one day and you WILL be in a situation where you'll have to think on these and make a decision.

It could be a roundabout way of discouraging other companies from even asking about potential buyouts or public stock sales. Epic goes through a lot of employees, and eventually those ex-employees leave Dane County and go to medical or tech organizations throughout the country. Judy knows we're all very intelligent (she's said so on numerous occasions), and she knows we will likely rise in authority in whatever company we find ourselves in. Since we've been implanted with these two principles, we know that when we become the CEO of X, we won't just be able to buy Epic outright. If I owned Epic, after all, there are a few DLGs that my users have been whining about that I'd fast-track for the next major version. 

I understand why Judy doesn't want the company to be acquired or to go public, and her reasons are sound. If it were a public company, then decisions would be accountable to a larger, possibly much less informed board. In practice, stockholders care more about dollars than about the company's mission, and I get the impression that Judy truly believes in Epic's mission (the part about providing better healthcare, not the part about galactic domination). Epic wouldn't have as much freedom to take risks or to adapt quickly to industry changes were it beholden to a board of stockholders.

"This company was founded on the principles of not going public and not being acquired," said no business owner, ever. They're good guidelines for the decision-making cadre, but I don't think they're worthy of being principles that the proles have to follow.

Epic in the News

I saw this article pop up in one of the various epic-related LinkedIn groups: Epic opportunity: The software giant is positioning Dane County for an economic breakthrough. Lots of interesting facts--Epic plans to add 800 positions a year for the next several years, and about 1200 employees leave each year. It also included Epic's 12 principles, which I'd forgotten about. There's enough in those 12 principles to fuel at least a couple of posts.

(Updated after a current Epic employee posted the comment below.)
Epic's 12 13 principles
1. Do not go public.
2. Do not be acquired.
3. Expectations = reality.
4. Keep commitments.
5. Be frugal.
6. Have standards. Don't do deals.
7. Create innovative and helpful products.
8. Have fun with customers.
9. Follow processes. Find root causes. Fix processes.
10. Don't take on debt, no matter how good the deal. Don't take on debt for operations, no matter how good the deal.
11. Focus on competency. Do not tolerate mediocrity.
12. Teach philosophy and culture.
13.  If you disagree, dissent. Once decided, support.

Class Action Suit Filed Against Epic. Seriously.

A reader of this blog brought this to my attention: Epic hit with class-action lawsuit on overtime wages. It appears as though ex-Epic QAer, Evan Nordgren, was not properly paid time-and-a-half for overtime work during his tenure as an Epic Systems Corporation employee. Habush, Habush, and Rottier are representing the case, and they have a form on their website if you were a QAer in the last 3 years and would like to join the list of plaintiffs.

Wisconsin state law stipulates that all employees are eligible to earn time-and-a-half for overtime, unless they fall under certain exemptions. I remember looking at those exemptions years ago and deciding that Epic TS were sadly exempt from time-and-a-half. Nordgren's lawyer, William Parsons, believes otherwise about QAers.

Epic had this to say in response, according to the numerous (albeit repetitive) articles I found on the subject:

We believe the lawsuit is without merit. We provide good, professional jobs to very talented people, and we value their contribution to improving health care. State and federal law make it clear that employees in computer-related jobs who primarily test software are appropriately classified as salaried professionals. That is precisely the role our quality assurance team performs.

After doing a quick calculation based on Wisconsin law DWD 274.04(15), if you work at Epic and make less than $53,460 yearly, you may be eligible for overtime pay (calculated by $23.67 hourly pay times 2000 hour work-year). As we all know, the 40-hour work week doesn't exist at 1979 Milky Way, so the real hourly wages for QAers are probably much less.

I'm very excited to see how this turns out. I'll post updates here as I learn more.

Update 4/7/14:
A commenter posted this on a separate page, but I thought it belonged here:

Epic recently responded to this internally. All new and current employees have to sign away their rights to litigation over wage and hour questions as a term of new/continued employment. An excerpt:

"I understand and agree that arbitration is the only litigation forum for resolving covered claims, and that both Epic and I are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration."

Caveat Emptor

 I did a brief search on the benefits of arbitration vs a trial. (Source: http://www.jdsupra.com/legalnews/arbitration-vs-bench-trial-55694/) Arbitration is more expensive than a trial, offers little ability to appeal, but offers more privacy. It's that last quality that I think Epic is more interested in. Everything they do internally is shrouded in secrecy, especially anything negative (like a lawsuit alleging they don't pay their employees fairly). Caveat emptor, indeed.

Update 12/4/14
I'm behind on posting this, but Epic settled the dispute.  Epic unsurprisingly admitted no guilt or wrongdoing, but did set aside $5.4 million for the settlement. With a class of around 1000 members, that boils down to at most $5400 per person. That's a bit over a single month's pay for your average QAer at Epic.

Go-Live Gone Wrong, Continued

I saw a co-worker reading this: Epic Installation Proves More Expensive, and I read the article over his shoulder. It's a follow up to the Go-Live Gone Wrong article that I wrote about a while back. In a testament to the state of modern journalism, the only new fact is that Maine Health is spending $55 million dollars more, solely because of Epic. Most of the money is for training and retraining users, with the remainder being used for the previously planned rollout of Epic throughout the organization.

 The comments on the article are interesting--especially the one about Stockholm Syndrome amongst Epic's customers. While technically Epic doesn't have a monopoly on the industry, free-market principles don't apply to EMRs. It is just too expensive (in dollars and hours) to take one's business elsewhere if an EMR vendor doesn't deliver.