Former CEO of Beth Israel Deaconess, Paul Levy has noticed some disturbing similarities between the characteristics of Stockholm syndrome and the attitudes of customers of the Epic Systems toward to the electronic health record (EHR) vendor. Yesterday on his blog, Not Running a Hospital, Levy is raising plenty of eyebrows with his most recent entry, “The Stockholm Syndrome and EMRs,” in which he covers the company’s recent success in acquiring multi-million and billion dollar contracts with some of the nation’s top hospitals.
Most recently, Partners HealthCare signed on with Epic Systems to invest between $600 and $700 million over a ten-year period. As Levy claims, an obvious disconnect is emerging between what Epic customer’s believe the partnership will lead to and what the Epic EMR hasn’t been able to achieve as of yet, interoperability. Despite spotty history of insufficient interoperability, Partners Chief Health Information and Innovation Office David Blumenthal, MD (former National Coordinator for Health Information Technology) viewed the agreement with Epic as a step in the right direction. “The new health care landscape will challenge us to engage in population health management, improve the coordination of health care, and accept financial risk for the care of our patients. This new system will enable us to meet those challenges,” read the organization’s press release on May 18.
For Levy, this doesn’t mesh with statements made by Judy Faulkner, Founder and CEO of Epic:
What is striking about this company is the degree to which the CEO has made it clear that she is not interested in providing the capability for her system to be integrated into other medical record systems. The company also “owns” its clients in that it determines when system upgrades are necessary and when changes in functionality will be introduced.
Whether Levy’s assessment of Epic customers is fair, given his rather tenuous standing in the Massachusetts healthcare community, there is much truth to his comments pertaining to Epic’s increasing market share in the EHR space. As Levy observes, this dominance could lead to serious problems down the road, not only for the vendor but also its customers:
Now that it controls this big a piece of the American market — paid for by federal appropriations — if something ever goes wrong (e.g., a coding or decision support error that results in harm to patients), you can expect a bunch of Congressional committees to come down on the firm like a ton of bricks. It doesn’t matter which political party is in the majority.
Over the past few months, a few reported blunders with vendor’s EHR have come to light. Both stories came out of the experience of clinicians working in Contra Costa County in California. The first dealt with a near-fatal dose of medication being administered to a patient with a known heart condition that a nurse was able to catch in time. The second comprised provider complaints about the implementation of the EHR system and its negative effects of clinical efficiency.
Levy’s entire post is worth the read.