[phren0logy]

I have not used all of them, but every one of them I've touched is hot garbage. Like much enterprise software, the people who decide to buy it are not the people that use it. It would seem, from the outside looking in, that the majority of the effort goes into maximizing billing in the byzantine world of US insurance rather than the work of actually making people well.

What concerns me most about the larger players in the field is their dedication to minimizing interoperability to lock people into their software.

[jen20]

A few years ago I did a very thorough analysis of every dose-based electronic prescribing system suitable for secondary care available in the UK market (and several which were not officially). They fell into three categories:

- Home-grown systems which were fit for purpose but not operable or available outside the organisation for which they were designed. The Birmingham (UK) University Hospitals system [1] is a great example of these.

- "Enterprise" (pejorative) systems which generally came from the US and focused almost entirely on billing capture, and had almost no thought put into clinicians workflow. This encompassed Epic, Cerner Millenium and so forth.

- "New" systems which were UX first, but were often little more than front-end mockups. A good example was "Alert", a Portuguese system written in Flash which had almost nothing in the way of basic medicine management safeguards, and the team demonstrated zero aptitude for the ability to build them.

In the end the hospital in question used paper-based prescribing.

[1]: https://www.digitalhealth.net/2017/05/birmingham-childrens-g... is a reasonable story about this.

[2]: http://org-portal.alert-online.com/products-services

[wslack]

> Like much enterprise software, the people who decide to buy it are not the people that use it.

Hard agree. There's also an incentive for hospital systems to "hold onto" patient data, which is not great.

[JshWright]

In many cases those "incentives" are legal requirements.

[killjoywashere]

Yeah, for clinical laboratories, for example, data retention requirements can stretch back 10 years. And yes, the inspectors will inspect that.

[jdhn]

I know that Epic was hiring UX designers a few years ago. I didn't make it through their interview process, but I'm kind of glad I didn't due to the invasive nature of the remote test that I had to take.

[briffle]

They wanted my high school GPA and SAT scores to complete my application. I had my bachelor's, and 12 years of experience at the time. After moving to Madison, was glad I refused to give that info. They like their implementation teams right out of school, and work them to death

[underdown]

Did you type this out on an iPhone?