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Friday, July 25, 2014

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.


  1. From a TS viewpoint:

    Here's the problem with root causes - they burn out the few good TS. Few TS (new and experienced) are ready to do root cause on complex issues. So it goes to a SME TS, who has the same customer burden but now has to deal with all the crappy questions from the occassional TS too lazy to do their TS jobs, but are gunning for that appearance of looking good at resolving complex issues. To me, the truly good TS are probably 10% of the population. About 60% have potential to swing any way, to truly amazing or truly bad. But a solid 30% absolutely do not belong at Epic, some creating cringeworthy fails that cause unplanned downtimes.

    There are plenty of solid TS with potential that leave too early. You just end up with TS who are terrible at finding issues, but great at finding people to do their work for them (finding devs, SME TS).

    I find those non-technical TS, who are great at the illusion of issue resolution, are the ones who become TLs. One of the division leads was just that, with horrible, incomprehensible code DLGs/ZRZLs full of bugs, actively gave out poor feedback to other TS to light a fire under them to get her answers, and has caused at least 4 TS to leave Epic.

    This is Epic's TS management, but nobody in management has addressed this. I spoke to a TS TL-TL who wasn't a division lead, and he basically wanted to keep anonymous and things hush-hush. The TLs do not fight for you, they sit in their ivory tower. For all the processes that the Epic TS group does well, this is the one failure bleeding out the talent from the massive hiring IV keeping Epic TS alive.

  2. Sorry kids, Epic (and all other EHRs) makes a product that, on a good day, does the same job a piece of paper performed admirably for a hundred years. On a normal day it causes at least as many problems as it solves.