Habush Habush and Rottier

Tuesday, December 20, 2016

Merry Christmas! (You're welcome)

The ICD-10 and Meaningful Use Illustrated books are still great Christmas gifts. I thought I saw an email that the books were now available at your favorite retail website, but I must have been mistaken.

Here's a list (about a year out of date) of Epic's customers. It's alphabetical--if you want to sort it, copy it into excel. Pipe delimited for convenience.

Name | State | Country
Access Community Health Network | Illinois | US
Admiraal De Ruyter Ziekenhuis |  | Netherlands
AdvantageCare Physicians | New York | US
Adventist Health West | Oregon | US
Akron Children's | Ohio | US
Alberta Health Services |  | Canada
All Children's Hospital | Florida | US
Allegheny Health Network | Pennsylvania | US
Allina Health System | Minnesota | US
Altru Health System | North Dakota | US
AMC - Vumc |  | Netherlands
Amphia Ziekenhuis |  | Netherlands
AnMed Health | South Carolina | US
Ann & Robert H. Lurie Children's Hospital of Chicago | Illinois | US
Anne Arundel Medical Center | Maryland | US
Asante Health System | Oregon | US
Ascension Health | Indiana | US
Ascension Health - Providence Healthcare Network | Texas | US
Aspirus | Wisconsin | US
Atlantic Health | New Jersey | US
Atrius Health | Massachusetts | US
Aurora Health Care | Wisconsin | US
Austin Regional Clinic | Texas | US
Banner – University Medical Center | Arizona | US
Baptist Health | Arkansas | US
Baptist Health System (AL) | Alabama | US
Baptist Healthcare System | Kentucky | US
Baptist Memorial Health Care | Tennessee | US
Bassett Healthcare | New York | US
Bayhealth Medical Center | Delaware | US
Baylor College of Medicine | Texas | US
Baylor Scott & White Health | Texas | US
Beacon Medical Services | Colorado | US
Beaumont Health | Michigan | US
Bend Memorial Clinic | Oregon | US
BJC HealthCare & Washington University | Missouri | US
Bon Secours Health System | Maryland | US
Chesapeake Regional Medical Center | Virginia | US
Boston Children's Hospital | Massachusetts | US
Boston Medical Center | Massachusetts | US
Bronson Healthcare Group | Michigan | US
Brookdale University Hospital and Medical Center | New York | US
Buffalo Medical Group | New York | US
Cambridge Health Alliance | Massachusetts | US
Cambridge University Hospitals NHS |  |
Care New England | Rhode Island | US
Carilion Clinic | Virginia | US
Carle | Illinois | US
Carolinas HealthCare System | North Carolina | US
CaroMont Health | North Carolina | US
Catholic Health Initiatives National | Colorado | US
Alegent Creighton Health | Nebraska | US
Franciscan Health System | Washington | US
St Luke's Health System (TX) | Texas | US
Catholic Health Services of Long Island | New York | US
Cedars-Sinai Health System | California | US
CentraCare | Minnesota | US
Centura Health | Colorado | US
Cheyenne Regional Medical Center | Wyoming | US
Children's Health System of Texas | Texas | US
Children's Healthcare of Atlanta | Georgia | US
Children's Hospital & Medical Center, Omaha | Nebraska | US
Children's Hospital Colorado | Colorado | US
Children's Hospital Eastern Ontario |  | Canada
Children's Hospital of Philadelphia | Pennsylvania | US
Children's Hospital of the King's Daughters | Virginia | US
Children's Hospital of Wisconsin | Wisconsin | US
CIGNA Medical Group of Arizona | Arizona | US
Cincinnati Children's Hospital Medical Center | Ohio | US
Cleveland Clinic | Ohio | US
Cleveland Clinic Abu Dhabi |  |
Community Health Network | Indiana | US
Community Healthcare | Indiana | US
Community Medical Centers | California | US
Cone Health | North Carolina | US
Conemaugh Health System | Pennsylvania | US
Confluence Health | Washington | US
Connecticut Children's Medical Center | Connecticut | US
Contra Costa Health Services | California | US
Cooper University Health Care | New Jersey | US
Cottage Health System | California | US
Covenant HealthCare | Michigan | US
CVS Health | Rhode Island | US
Dartmouth-Hitchcock | New Hampshire | US
Dayton Children's Hospital | Ohio | US
Deaconess Health System | Indiana | US
Denmark Capital Region & Region Zealand |  | Denmark
Denver Health | Colorado | US
Dreyer Medical Clinic | Illinois | US
Driscoll Children's Hospital | Texas | US
Dubai Health Authority |  |
Duke University Health System | North Carolina | US
Dutch Demo System |  | Netherlands
East Boston Neighborhood Health Center | Massachusetts | US
Edward Hospital & Health Services / DuPage Medical Group | Illinois | US
El Camino Hospital | California | US
Elliot Health System | New Hampshire | US
Erlanger Health System | Tennessee | US
Eskenazi Health | Indiana | US
Essentia Health | Minnesota | US
Everett Clinic, The | Washington | US
Fairview Health Services | Minnesota | US
Florida Hospital | Florida | US
Foundation System |  | US
Franciscan Alliance, Inc. | Indiana | US
Franciscan Missionaries of Our Lady Health System, Inc. | Louisiana | US
Froedtert Health, Inc. | Wisconsin | US
Geisinger System Services | Pennsylvania | US
Geisinger Affiliates | Pennsylvania | US
Genesis Healthcare System | Ohio | US
Glens Falls Hospital | New York | US
Grady Health System | Georgia | US
Greater Baltimore Medical Center | Maryland | US
Greater Hudson Valley Health System, Inc. | New York | US
Greenville Health System | South Carolina | US
Self Regional Healthcare | South Carolina | US
Group Health Centre |  | Canada
Group Health Cooperative | Washington | US
Group Health Cooperative - South Central Wisconsin | Wisconsin | US
Gundersen Health System | Wisconsin | US
GW University Medical Faculty Associates | District of Columbia | US
Hackensack University Medical Center | New Jersey | US
Hamilton Health Sciences & St Joseph's Healthcare Hamilton |  | Canada
Harris Health System | Texas | US
Hartford HealthCare | Connecticut | US
Hattiesburg Clinic and Forrest County General Hospital | Mississippi | US
Hawaii Pacific Health | Hawaii | US
HCA National | Tennessee | US
HCA Central and West Texas | Texas | US
HCA Mountain | Utah | US
Health Ventures of Central Iowa | Iowa | US
HealthEast Care System | Minnesota | US
HealthPartners | Minnesota | US
Park Nicollet Health Services | Minnesota | US
Heart of Texas Community Health Center | Texas | US
Hennepin County Medical Center | Minnesota | US
Henry Ford Health System | Michigan | US
HonorHealth | Arizona | US
Hospital for Special Surgery | New York | US
Hospital Sisters Health System (HSHS) Division - Eastern Wisconsin | Wisconsin | US
Houston Methodist | Texas | US
Hurley Medical Center | Michigan | US
Indiana University Health Arnett | Indiana | US
Infirmary Health System | Alabama | US
Inova Health System | Virginia | US
Valley Health | Virginia | US
Institute for Family Health | New York | US
INTEGRIS Health | Oklahoma | US
John Muir Health | California | US
Johns Hopkins Aramco Healthcare |  |
Johns Hopkins Medicine | Maryland | US
JPS Health Network | Texas | US
JurongHealth |  | Singapore
Kadlec Health System | Washington | US
Kaiser Permanente - National | California | US
Kaiser Permanente - Colorado | Colorado | US
Kaiser Permanente - Georgia | Georgia | US
Kaiser Permanente - Hawaii | Hawaii | US
Kaiser Permanente - Mid-Atlantic | Maryland | US
Kaiser Permanente - N Cal | California | US
Kaiser Permanente - Northwest | Oregon | US
Kaiser Permanente - S Cal | California | US
Kelsey-Seybold Clinic | Texas | US
Kettering Health Network | Ohio | US
King's Daughters Medical Center | Kentucky | US
Lahey Health System | Massachusetts | US
Lakeland Healthcare | Michigan | US
Lancaster General Health | Pennsylvania | US
Lee Memorial Health System | Florida | US
Legacy Health | Oregon | US
Lehigh Valley Health Network | Pennsylvania | US
Leon Medical Center | Florida | US
Lexington County Health Services | South Carolina | US
Lifespan | Rhode Island | US
Loma Linda University Medical Center | California | US
Louisiana State University | Louisiana | US
Loyola Medicine | Illinois | US
LSPQ |  | Canada
MaineHealth | Maine | US
Maricopa Integrated Health System | Arizona | US
Martin Health System | Florida | US
Mayo Clinic | Minnesota | US
Medical University Of South Carolina | South Carolina | US
Medisch Centrum Leeuwarden |  | Netherlands
MediSys Health Network | New York | US
Memorial Health Services (MemorialCare) | California | US
Memorial Health, Inc. | Georgia | US
Memorial Healthcare System | Florida | US
Memorial Sloan-Kettering Cancer Center | New York | US
Mercy Health - MO (fka Sisters of Mercy) | Missouri | US
Mercy Health - OH (fka Catholic Health Partners) | Ohio | US
Summa Health System | Ohio | US
Mercy Health Services (MD) | Maryland | US
Mercy Health System - WI | Wisconsin | US
Mercy Medical Center | Iowa | US
Meriter Health Services | Wisconsin | US
Methodist Health System | Texas | US
Methodist Hospitals | Indiana | US
Metro Health - MI | Michigan | US
MetroHealth - OH | Ohio | US
Momentum Health | Oklahoma | US
Monroe Clinic | Wisconsin | US
Montefiore Medical Center | New York | US
Mount Auburn Hospital | Massachusetts | US
Mount Sinai Health System | New York | US
Mt Sinai - FL | Florida | US
MultiCare Health System | Washington | US
Nationwide Children's Hospital | Ohio | US
Nebraska Medicine | Nebraska | US
Nederlands fundamentsysteem |  | Netherlands
Nemours | Florida | US
New Hanover Regional Medical Center | North Carolina | US
New York City Health and Hospitals Corp | New York | US
North Memorial Health Care | Minnesota | US
North Oaks Health System | Louisiana | US
NorthShore University HealthSystem | Illinois | US
Northwest Community Hospital | Illinois | US
Northwestern Memorial Healthcare | Illinois | US
Cadence Health | Illinois | US
Norton Healthcare | Kentucky | US
Novant Health | North Carolina | US
NYU Langone Medical Center | New York | US
Oakwood Healthcare | Michigan | US
OCHIN | Oregon | US
Ochsner Health System | Louisiana | US
St. Tammany Parish Hospital | Louisiana | US
OhioHealth | Ohio | US
Oregon Health & Science University | Oregon | US
OSF HealthCare | Illinois | US
Overlake Hospital Medical Center | Washington | US
Owensboro Health | Kentucky | US
Pacific Medical Center | Washington | US
Palos Community Hospital | Illinois | US
Parkland | Texas | US
Parkview Health | Indiana | US
Partners HealthCare System | Massachusetts | US
PeaceHealth | Washington | US
Peninsula Regional Medical Center | Maryland | US
Piedmont Healthcare | Georgia | US
PinnacleHealth | Pennsylvania | US
Premier Health | Ohio | US
Presbyterian Healthcare Services | New Mexico | US
Presence Health | Illinois | US
Prime Healthcare | California | US
ProHealth | Wisconsin | US
ProMedica Health System | Ohio | US
Providence Health and Services | Washington | US
Providence Alaska | Alaska | US
Providence EMFI | Washington | US
Providence Oregon/California | Washington | US
Providence Washington | Washington | US
Swedish Medical Center | Washington | US
Queen's Health Systems, The | Hawaii | US
Radboudumc |  | Netherlands
Rady Children's | California | US
Reading Health System | Pennsylvania | US
Reliant Medical Group, Inc. | Massachusetts | US
Renown Healthcare | Nevada | US
RiverBend Medical Group | Massachusetts | US
Riverside Health System | Virginia | US
Riverside Medical Center | Illinois | US
Riverside Medical Clinic | California | US
Rochester Regional Health System | New York | US
Rockford Health System | Illinois | US
Royal Children's Hospital |  | Australia
Rush University Medical Center | Illinois | US
Saint Francis Care | Connecticut | US
Saint Francis Health System | Oklahoma | US
Saint Francis Healthcare System | Missouri | US
Saint Luke's Health System (MO) | Missouri | US
Salem Hospital Regional Health System | Oregon | US
Salem Clinic | Oregon | US
Samaritan Health Services | Oregon | US
Sanford Health | South Dakota | US
Sansum Clinic | California | US
Santa Clara Valley Medical Center | California | US
SCL Health | Colorado | US
Scripps Health | California | US
Seattle Children's Hospital | Washington | US
Sechaba Medical Solutions |  | South Africa
CHEIRON-GEN HEALTH |  | South Africa
Select Medical | Pennsylvania | US
Sentara Healthcare | Virginia | US
Singing River Health System | Mississippi | US
Sint Lucas Andreas Ziekenhuis |  | Netherlands
SLUCare / SSM-SLUH | Missouri | US
South Dakota State Lab | South Dakota | US
Southcoast Health System | Massachusetts | US
Spaarne Gasthuis |  | Netherlands
Sparrow Health System | Michigan | US
Spartanburg Regional Healthcare System | South Carolina | US
Spectrum Health | Michigan | US
SSM Health | Missouri | US
SSM Health Care of Wisconsin | Wisconsin | US
St Anthony's Medical Center | Missouri | US
St Elizabeth Healthcare | Kentucky | US
St Jansdal Ziekenhuis |  | Netherlands
St Joseph's Hospital Health Center | New York | US
St Luke's Health System (Idaho) | Idaho | US
St Luke's University Health Network | Pennsylvania | US
Stanford Children's Health | California | US
Stanford Health Care | California | US
Stormont-Vail HealthCare | Kansas | US
SUNY Upstate Medical University | New York | US
Sutter Health | California | US
SwedishAmerican Health System | Illinois | US
Tampa General Hospital | Florida | US
University of South Florida | Florida | US
TempleHealth | Pennsylvania | US
Texas Children's Hospital | Texas | US
Texas Health Resources | Texas | US
Texas Scottish Rite Hospital for Children | Texas | US
The Christ Hospital | Ohio | US
The Guthrie Clinic | Pennsylvania | US
The Ohio State University's Wexner Medical Center | Ohio | US
The Portland Clinic | Oregon | US
The University of Vermont Medical Center | Vermont | US
ThedaCare | Wisconsin | US
Bellin Health | Wisconsin | US
Thomas Jefferson University Health System | Pennsylvania | US
TriHealth | Ohio | US
Trinity Mother Frances | Texas | US
Tucson Medical Center | Arizona | US
UC Health | Ohio | US
UCLA Medical Center | California | US
UCSF Benioff Children's Hospital Oakland | California | US
UCSF Medical Center | California | US
UMass Memorial Health Care | Massachusetts | US
UNC Health Care | North Carolina | US
United States Coast Guard | District of Columbia | US
UnityPoint Health | Iowa | US
University Health (BRF) | Louisiana | US
University Health Care System | Georgia | US
University Hospital | New Jersey | US
University of Arkansas for Medical Sciences | Arkansas | US
University of California Davis | California | US
University of California San Diego | California | US
University of Chicago Hospitals | Illinois | US
University of Colorado Health | Colorado | US
University of Florida | Florida | US
University of Iowa Hospitals and Clinics | Iowa | US
University of Kansas Hospital | Kansas | US
University of Maryland Medical System | Maryland | US
University of Miami | Florida | US
University of Michigan | Michigan | US
University of Mississippi Medical Center | Mississippi | US
University of Pennsylvania Health System | Pennsylvania | US
University of Pittsburgh Medical Center | Pennsylvania | US
University of Rochester Medical Center | New York | US
University of Texas MD Anderson Cancer Center | Texas | US
University of Texas Medical Branch | Texas | US
University of Texas Southwestern Medical Center | Texas | US
University of Utah Hospitals & Clinics | Utah | US
University of Virginia Medical Center | Virginia | US
UT Medicine San Antonio | Texas | US
UW Health | Wisconsin | US
UW Medicine | Washington | US
Valley Medical Center | Washington | US
Vancouver Clinic | Washington | US
Vanderbilt University Medical Center | Tennessee | US
Vidant Health | North Carolina | US
Wake Forest University Baptist Medical Center | North Carolina | US
WakeMed Health and Hospitals | North Carolina | US
Washington Hospital Health System | California | US
Weill Cornell Physician Organization | New York | US
Wellmont Health System | Tennessee | US
WellSpan Health | Pennsylvania | US
WellStar | Georgia | US
West Virginia University Healthcare | West Virginia | US
Wheaton Franciscan | Wisconsin | US
Wisconsin State Lab | Wisconsin | US
Wolcott, Wood & Taylor (UIC) | Illinois | US
Women's College Hospital |  | Canada
Yakima Valley Farm Workers Clinic | Washington | US
Yale New Haven Health System and Yale University | Connecticut | US
Yuma | Arizona | US

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.

  • 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.