Verona to Madison, Wisconsin Tuesday, June 29, 2021
Today was a big deal for me, a marriage of my past life and my present trip. Just approaching that logo along the entrance walkway brought it all back.
All my colleagues have a love-hate relationship with Epic, but we go way back.
Back in 2002, I was on a task force with a handful of doctors to select UVM’s electronic medical record, and we went all over the country. Almost as an afterthought, we went to this suburb of Madison to visit Epic, a small player in a big field at the time. We met the founder, Judy Faulkner, who struck us as an eccentric hippie lady. The company was small, but scrappy, and we were impressed, it wound up being our first choice.
The first choice of the doctors, but the suits up the hill didn’t see it that way. It was too small, too untested, and besides, the chairman of our board of trustees was also the CEO of IDX, one of the big players. Surprise, surprise, IDX was the system that was selected.
Long story short, that was only one of the abuses rampant in our corporate structure at the time, and within a year our CEO had been fired and sentenced to jail, the entire board of trustees had resigned, and we wound up with no electronic record at all.
A massive frustration for me, who had been waiting for decades to be free of paper charts. It took years for the smoke to clear, but in 2009, we wound up choosing Epic after all, which by this time had become a big player. I was ecstatic, but my enthusiasm was not shared by others. Many were leery of the upcoming go-live, one partner actually quit to avoid having to make the change (only to have Epic implemented at her new job a few years later. You can run but you can’t hide). The big day was January 13, 2010; we closed off a patient room and put in a lounge chair, with muted lighting and soft music, it was the “stress room”. Our productivity dropped by 50% as we got used to paperless charts, some of us called it the winter of our discontent. Everything took twice as long to do. It was paperless, but patients complained that with all the forms printed at check out, they were getting twice as much paper as before.
We all got used to it, partially embraced the system, but when this video came out it struck a chord. https://youtu.be/xB_tSFJsjsw
The salient line: If some be sayin’ it’s Epic, We sayin’ it’s Epic fail.
After 10 years, I left my career feeling that Epic was no picnic, but light years better than what we’d had before, and superior to the other systems that my counterparts in other centers are using. To paraphrase Churchill, Epic is the worst electronic record, except for all the others. It’s been embraced by most of the major academic centers like Harvard, Stanford, Mayo, Cleveland Clinic, not to mention Dartmouth and UVM. I check it even now, 15 months after retirement, to get updates on my beloved patients and to stay current. A couple of weeks ago I zoomed in to a provider meeting, and heard about the latest Epic upgrade. It brought it all back.
So I wasn’t sure what to expect, revisiting the Epic campus after all these years. Normally closed to the public on weekdays, I called and as a member of the Epic community I was welcome to tour. I knew better than to ask to see Judy, it would be like waltzing in to Facebook and asking to see Zuckerberg. The reviews compared it to Disney World without the rides.
Well, it was huge, eye popping, but to my expectations, a little underwhelming. I don’t know what I thought it would be. Basically it’s a huge complex of meeting rooms and offices, with whimsical landscaping, art, and sculptures centered around distinct themes, and lots of low-key, contented looking employees strolling around. I only had time to tour one of these campus areas, called Prairie, although the buildings were named with an astronomical theme. I never saw a computer or an Epic screen, only people, vegetation, and art.
I only scratched the surface, but my alarm went off and it was time for my weekly therapist call, so I found a secluded but idyllic outdoor spot and talked for an hour, reliving some of my Epic trauma. Using the bathroom, I chanced upon the Epic credo on the wall.
Note the right column, Epic is still privately owned, still Judy’s baby.
I was long overdue for a haircut, found a Supercuts in town that could take me in an hour, 10 hilly miles away. I had to cut short my Epic visit to cut short my hair. I arrived, as always, a sweaty mess, but they let me cool down. Thence to a couple of bike shops, dinner, and my next Warmshowers hosts, Mary and Charlie, whose house had that prairie style too. More about them tomorrow.
Distance 23 miles, 3,280 total. Time 7 hours with stops. Elevation gain 949 feet.
©️ 2021 Scott Luria
The Ends of the Earth 
Fascinating history for me. For many of those years that I was your patient I worked for IDX (and then for GE when they purchased the company). I worked on the radiology product (IDXrad, later Imagecast, now some GE-compliant name) I was proud of our product, but we were almost a separate company within IDX. I never had a very high opinion of the other IDX products. I think your story is fair and honest. It’s been interesting seeing Epic grow into the monster that it is today (in fact, I’m writing this on my lunch break between interfacing my current employer’s systems with Epic at several hospitals). Epic succeeded because it was far better than the competing products, but that’s not saying much. I’ve been in Healthcare IT for over a quarter of a century and I can’t help but agree with what ZDoggMD’s video says: “EHRs suck.” My career has mostly been about making them suck a little less.
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