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.
Habush Habush and Rottier
Showing posts with label project management. Show all posts
Showing posts with label project management. Show all posts
Tuesday, October 14, 2014
Wednesday, August 7, 2013
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.
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.
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