Life After Epic

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.

Monday, October 26, 2015

EHRs Suck

And I think this video summarizes why quite nicely. The youtube comments (surprisingly) are intelligent and worth a cursory glance.

The video promotes #letdoctorsbedoctors, which in turn promotes athenahealth. I glanced at the athenahealth* website, and their demo looks an awful lot like Epic with a sleeker UI. I'm not exactly sure what they're offering, unless it's an "out of the box" version of Epic. Every feature in the demo is available in Epic, but in Epic it requires tons of analysis, build, debugging, and rebuilding.

Given the similarity to Epic, I'm curious to see how many of athenahealth's employees used to work in a certain cow pasture in Verona.

EHRs do suck. And with all of the MU regulations, EHRs are never going to get better. The government requires reportable data, and that requires data entry. Unless "exam room stenographer" becomes a new job title, doctors are the only ones able to enter all the data that the government wants. The other option is for the government to get out of the way (aka "deregulation") and let doctors be doctors.

*I'm assuming that the lower case and lack of spacing is part of their trademark. Unless you're e.e. cummings, you should use proper punctuation and capitalization.

Wednesday, September 23, 2015

Lawsuit follow-up: Epic's Arbitration Agreement Unenforceable

The Technical Writer class action lawsuit appears to be underway. According to Hawks Quindel (co-council with Habush Habush & Rottier), Epic attempted to have the case dismissed, citing their arbitration agreement. The judge called baloney on arbitration, citing labor union laws. Epic's writers will get their day in court.

This is a solid victory for IT employees, and obvious sign that IT workers need to unionize.

Update 11/3/15

A reader graciously submitted the full text of the arbitration agreement, which was too large to publish in the comment fields:

"If Epic is forced to operate in a more public manner, they might have to start treating their employees and their customers with a little more trust and respect."

Yes, exactly. For starters, in April Epic filed a copy of its pre-dispute employment arbitration "agreement" with the Federal court in the J. Lewis v. Epic technical-writers lawsuit. That is, for the first time as a result of this filing, to my knowledge, the full text of the agreement is in the public domain. People should read it and see what rights of access to the courts Epic's employees have been told they must abandon in order to work at Epic. I've copied (or tried to copy) the full agreement below for everyone's edification.

This agreement is truly egregious IMHO. Judy Faulkner, who styles herself as promoting progressive political principles, ought to be embarrassed to shackle her employees with these limitations to the rights to remedies through the courts that Americans take for granted as a birthright.

For hypocrisy and corporate expediency, she should be expelled from the progressive, enlightened political circles in which she has traveled so effortlessly.

For instance, Faulkner can't possibly reconcile her action in imposing this agreement on the Epic labor force with Senator Tammy Baldwin's co-sponsorship of S. 1133 (see also H.R 2087) the Arbitration Fairness Act of 2015 (https://www.congress.gov/bill/114th-congress/senate-bill/1133/text ). This bill would make pre-dispute forced employment arbitration agreements illegal. Senator Baldwin presumably agrees with her bill's finding that "A series of decisions by the Supreme Court of the United States have interpreted the [Federal Arbitration] Act so that it now extends to consumer disputes and employment disputes, contrary to the intent of Congress." It is these misinterpretations that permit Faulkner to force her employees to "agree" to forced arbitration as a condition of employment.

Here is the agreement -- I hope its details are widely discussed throughout Epic and the broader Madison community:

MUTUAL ARBITRATION AGREEMENT REGARDING WAGES AND HOURS

April 2, 2014

Agreement to Arbitrate. Epic Systems Corporation ("Epic") and I agree to use binding arbitration, instead of going to court, for any "covered claims" that arise or have arisen between me and Epic, its related and affiliated companies, and/or any current or former employee of Epic or a related or affiliated company. I understand that if I continue to work at Epic, I will be deemed to have accepted this Agreement.

"Covered claims" are any statutory or common law legal claims, asserted or unasserted, alleging the underpayment or overpayment of wages, expenses, loans, reimbursements, bonuses, commissions, advances, or any element of compensation, based on claims of eligibility for overtime, on-the-clock, off¬the-clock or other uncompensated hours worked claims, timing or amount of pay at separation, improper deductions of pay or paid-time-off, fee disputes, travel time claims, meal or rest period claims, overpayment claims, claims of failure to reimburse or repay loans or advances, claims over improper or inaccurate pay statements, or any other claimed violation of wage-and-hour practices or procedures under local, state or federal statutory or common law.

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.

The Arbitrator shall have the authority to award the same damages and other relief that would have been available in court pursuant to applicable law. The arbitrator shall follow the rules of law of the state which is the employee's principal place of work, any applicable Federal law, and the rules as stated in this Agreement. The arbitrator shall have the authority to grant any remedy or relief that the arbitrator deems just and equitable and which is authorized by and consistent with applicable law, including applicable statutory or other limitations on damages.

Waiver of Class and Collective Claims. I also agree that covered claims will be arbitrated only on an individual basis, and that both Epic and I waive the right to participate in or receive money or any other relief from any class, collective, or representative proceeding. No party may bring a claim on behalf of other individuals, and any arbitrator hearing my claim may not: (i) combine more than one individual's claim or claims into a single case; (ii) participate in or facilitate notification of others of potential claims; or (iii) arbitrate any form of a class, collective, or representative proceeding.

At Will Employment Unchanged by this Agreement. Nothing in this agreement changes or in any manner modifies my relationship with Epic of employment-at-will.

Claims not Covered by this Agreement. Covered claims under this agreement do not include claims alleging discrimination, harassment, or retaliation. Also excluded from this agreement are any claims that cannot be required to be arbitrated as a matter of law. I also understand that I am not barred from filing a claim or charge with a governmental administrative agency, such as the National Labor Relations Board or Equal Employment Opportunity Commission, or from filing a workers' compensation or unemployment compensation claim with respect to covered claims, though I am giving up the opportunity to recover monetary amounts from any such governmental agency related claim (e.g., NLRB or EEOC) and would instead be able to pursue a claim for monetary amounts through arbitration. I also understand that if a third party seeks to have Epic garnish my wages, I may be subject to third-party garnishment proceedings in court, even though such a dispute concerns my wages.

Right to Representation. Both Epic and I shall have the right to be represented by an attorney in arbitration. Neither side is entitled to its attorneys' fees except as provided for by applicable law.

How to File for Arbitration. To file a demand for arbitration:

1. The party desiring to pursue a legal dispute must prepare a written demand setting forth the claim(s). Epic will pay its own filing fees. If I initiate the arbitration, I will pay the lesser of the American Arbitration Association's then-current filing fee (as of this date, $200), or the then-current filing fee applicable in state court.

2. The employment dispute resolution rules of the American Arbitration Association ("AAA") effective at the time of my filing will apply. The current version of the rules can be found on pages 15-31 here: https://www.adr.org/aaa/ShowProperty?nodeld=/UCM/ADRSTG_004362&revision=latestreleased. These rules are modified by the terms of this Agreement, including the following:

a. Epic will pay the arbitrator's fees and the arbitration filing and administrative fees, less my initial payment for the applicable filing fee;

b. Epic and I will each have the opportunity to "rank" our preference for the appointed arbitrator from a list of nine proposed arbitrators and the AAA will then appoint the arbitrator;

c. The arbitrator shall have the authority to issue an award or partial award without conducting a hearing on the grounds that there is no claim on which relief can be granted or that there is no genuine issue of material fact to resolve at a hearing, consistent with Rules 12 and 56 of the Federal Rules of Civil Procedure ("FRCP");

d. Each party shall be entitled to only one interrogatory limited to the identification of potential witnesses, in a form consistent with Rule 33 of the FRCP;

e. Each party shall be entitled to only 25 requests for production of documents, in a form consistent with Rule 34 of the FRCP;

f. Each party shall be entitled a maximum of two (2) eight-hour days of depositions of witnesses in a form consistent with Rule 30 of the FRCP;

g. The arbitrator shall decide all disputes related to discovery and to the agreed limits on discovery and may allow additional discovery upon a showing of substantial need by either party or upon a showing of an inability to pursue or defend certain claims without such additional discovery;

h. The arbitrator must issue a decision in writing, setting forth in summary form the reasons for the arbitrator's determination and the legal basis therefor; and

i. The arbitrator's authority shall be limited to deciding the case submitted by the parties to the arbitration. Therefore, no decision by any arbitrator shall serve as precedent in other arbitrations except in a dispute between the same parties, in which case it could be used to preclude the same claim from being re-arbitrated.

Settlement. I may settle any dispute with the company at any time without involvement of the arbitrator.

Modifications and Amendments. I understand and agree that Epic may change or terminate this agreement after giving me 90 days written or electronic notice. Any change or termination will not apply to a pending claim.

Savings Clause & Conformity Clause. If any provision of this agreement is determined to be unenforceable or in conflict with a mandatory provision of applicable law, it shall be construed to incorporate any mandatory provision, and/or the unenforceable or conflicting provision shall be automatically severed and the remainder of the agreement shall not be affected. Provided, however, that if the Waiver of Class and Collective Claims is found to be unenforceable, then any claim brought on a class, collective, or representative action basis must be filed in a court of competent jurisdiction, and such court shall be the exclusive forum for such claims.

Controlling Law. I agree that this agreement is made pursuant to and shall be governed under the Federal Arbitration Act.

Habush Habush and Rottier