Life After Epic: 2016

Tuesday, December 20, 2016

Merry Christmas! (You're welcome)

Friday, December 9, 2016

New Lawsuit Filed Against Epic, and more!

A new lawsuit was filed against Epic this week, and it's pretty much Nordgren v Epic, version 2. The only change is the time frame for the class: QAers who worked at Epic after Epic implemented its arbitration-only rule. As ever, Epic could not be reached for comment, which at this point deserves to be a 14th Principle: Never talk to the press (Epic does this one really well).

Other news: I've been asked a few times about including a bona fide forum on this site, and I'm having trouble making a decision. Some feel it would be helpful, but I'm worried about maintaining anonymity. Leave a comment, and let me know how you feel about it. When I get enough meaningful feedback, I'll install a forum (or not).

This is from an email I received about a year ago, concerning the job prospects for someone leaving the Developer role at Epic:

On job opportunities - This is from a developer perspective, naturally, though some parts may apply to QAers too.

a) Your skills are useless outside of Epic. Unless you are one of the privileged few to be working on mobile apps or Web stuff, your skills will not transfer at all. Cache is not used as much as it used to be, Wikipedia is wrong. Wall Street doesn't use it in any significant amount, and even if there is a hedge fund or two that still does, you ain't getting that job without a PhD, a half decade of experience, and contacts within the industry. And VB6 is a goddamn joke, don't even list it on your resume if you can help it. The sooner you get used to this, the sooner you can work around it.

b) It's not hopeless, but expect an uphill battle. If you want to stay in Madison, Epic has an iffy reputation among other development shops. I was flat out told in one interview that the only reason I didn't get the job is that Epic's technology and taught skill set is too old to transfer to the new company. I would highly advise you to (a) move out of Madison to an area where Epic doesn't have such an entrenched reputation, (b) consider a technical non-dev position (QA, IT analyst, technical writer, etc) where specific skills in specific languages don't matter as much, or (c) have a damn good Github or personal projects page. The reason I got so many calls back/interviews was because I did a lot of independent work in modern programming languages. Definitely brush up on Java and relational databases, that's what most (local) jobs want to see. If you really are struggling, find a community college and take an intro to Java class to refresh.

c) Even if you get an offer, don't expect anywhere near Epic salaries. The benefits Epic offers are standard, perfectly mediocre, so you probably won't notice much of a change in those. But it is a shock to go from making 6 figures to accepting a 30-40% pay cut. Thankfully, my new job is in an area I've always loved to work in, so that's personally a tradeoff I don't mind making. But you do need to consider that. Expect most entry-level jobs (which, let's face it, you need to apply for) to offer $60k-$70k. If you're a good negotiator, you can probably swing a $1k-$2k sign-on bonus. Long gone are the days of 5 figure sign-on bonuses like Epic gives.

Friday, July 1, 2016

A Patient-Centric Database

I've been thinking a lot lately about patient registries, accountable care networks, and Healthy Planet-type stuff. Personal fact: I'm prone to think up conspiracy-theories and am, at the macro-level, a glass-half-empty person. When you put the two together, it makes this blogger concerned about the future of healthcare.

"With the Patient at the Heart" is printed on the back of Epic's business cards, and emblazoned proudly on company vehicles. I've worked at different organizations that had similar slogans about patients being first and foremost and the most important thing. The underlying sentiment with these slogans is that each patient is a unique individual, and each patient deserves personalized care.

Healthy Planet (and its primary drivers, Obamacare and MU) are active obstacles to that. No longer is Joe Smith a relatively healthy male and a compliant patient with diabetes whose lab tests happen to run slightly abnormal, he's now the 37th entry on the list of patients with an A1C over 7. He's been on that list for a year now, and gets a letter every month saying he needs to come in for a checkup. Mr Smith's doctor is worried, because even though Joe is healthy and doing everything to correctly manage his diabetes, the lab tests run high enough that the doctor gets dinged on his metrics. The doctor is therefore considering dropping Mr Smith as a patient.

Enter Accountable Care Networks. Now, not only is Medicare tracking all your stats, but your employer is too. And because your employer is paying the hospitals, your employer has a vested interested in your health. The healthier you are, the cheaper it is for your CFO, and those savings can be passed directly to the stockholders. Taken to its logical conclusion, given equal experience, equal qualifications, and identical answers during the interview, it's going to be the younger/skinnier/male candidate who gets the job. Age/Gender Discrimination will morph into Health Discrimination.

Discuss below. Are my fears irrational? Is your organization re-working existing teams to meet a growing list of reporting needs that must be available in prod yesterday?

Thursday, May 26, 2016

Jacob Lewis v Epic Systems Corporation: Appellate Court Decision

This just in:
Lewis, J v. Epic Systems Corporation, 7th Circuit Decision

Epic's no-collective-arbitration agreement is illegal.

Epic Systems, a health care software company, required certain groups of employees to agree to bring any wage-and-hour claims against the company only through individual arbitration. The agreement did not permit collective arbitration or collective action in any other forum. We conclude that this agreement violates the National Labor Relations Act (NLRA), 29 U.S.C. §§ 151, et seq., and is also un-enforceable under the Federal Arbitration Act (FAA), 9 U.S.C. §§ 1, et seq. We therefore affirm the district court’s denial of Epic’s motion to compel arbitration. (emphasis mine)

What this means: Epic cannot stop its employees from availing themselves of the protections afforded by the National Labor Relations Act, including but (I assume) not limited to:

Section 7 of the NLRA provides that “[e]mployees shall have the right to self-organization, to form, join, or assist labor organizations, to bargain collectively through representatives of their own choosing, and to engage in other concerted activ-ities for the purpose of collective bargaining or other mutual aid or protection.”

Congratulations to Mr Lewis and his expert legal team.

Tuesday, March 22, 2016

Interview-ish article with Judy Faulkner

Courtesy of Healthcare IT News: Epic CEO Judy Faulkner talks EHR Interoperability, Need for a National Patient ID, Physician Productivity

The comment "Unique patient ID has to happen" intrigued me, because that's patently untrue.

Consider:

We already have a national ID: Social Security Number. However, that doesn't account for recent immigrants or tourists.
It's possible that every single person living on planet Earth may visit the United States at some point and while visiting may need health care.
You'd need to be able to account for >7,000,000,000 people (and counting).
Tourists may visit the USA multiple times and years apart, and they can't be expected to remember an MRN.
A national ID does no good if the potential exists for one patient to have multiple IDs. Within a single hospital, Patient Merge gets used all the time. If you've ever had to deal with Patient Merge AND Care Everywhere, then you know the problems that arise when a hospital can't match the person to the chart. Multiply that by the entire nation. Or the entire planet.
Biometrics are unique and they can't be forgotten because they don't have to be remembered in the first place.
A national (international?) database of biometric information with bi-directional interfaces to every hospital system will need to be created and maintained.
Remember Obamacare?

That seems a good place to stop. Discuss.

Habush Habush and Rottier