[nradov]

Most of that seems rather pointless. Epic is the worst EHR — except for all the others. There aren't a lot of Epic IT integrators out there as potential customers: Epic does most customer implementation and support in house. They do offer an extensive set of APIs for third-party developers including SMART on FHIR but there aren't many IT integrators focused on that either.

As for usability feedback to Epic engineers, they generally aren't interested in what you have to say. I mean Epic does make product changes based on customer feedback but they don't listen to input from random other companies and they certainly don't pay for it. Their culture is more that they know the correct way to do things and customers should change their processes to fit the software.

https://www.acquired.fm/episodes/epic-systems-mychart

[cmiles74]

Watch out for Epic. I worked for a company that was excited to integrate with them, due to customer interest (we did SMART on FHIR and couple of HL7 interfaces). We had paid to have an Epic TS (technical services) person work with us, they asked for a demonstration so that they could point out any integration points that we might have missed.

We demoed the product and at the end, the Epic person says, with a straight face, that they think our product should really be part of Epic. This Epic person, he wonders on the spot if maybe it could be implemented with flowsheets and a little logic.

Not surprisingly, Epic did exactly that. We had a potential customer put implementation on hold because they felt they had to evaluate it before making any decisions. Needless to say we lost that customer as Epic undercut us on cost, despite their atrocious UI.

[digitaltzar]

My friend who works now as an engineer at Apple interviewed with Epic 6 years ago - he got a guidance from a fellow to make a few mistakes in test tasks to increase chance of getting a job offer, and it worked - he got the offer

[nradov]

Whatever Epic has been doing from a hiring perspective seems to work pretty well. They are highly profitable, have a near zero customer churn rate, and many employees have been there for decades. The software might not be ideal from a usability or interoperability perspective but it's reliable, secure, and gets the job done. We could all learn something from how they operate.

[queuebert]

An EMR will necessarily have low churn rate because the cost of switching is tremendous. I've been doing this a long time, and Epic is kind of the "EMR of the day". No doubt a new one will come along, solving the UI problems, offering new capabilities, and hospitals will switch over.

[nradov]

Eventually Epic may be replaced but it's really hard to break into the hospital market. Any new competitor would have to meet all of the ONC Health IT Certification requirements, plus a bunch of other checklist requirements imposed by hospital purchasing departments. It doesn't matter whether they solve the UI problems or offer new capabilities if they don't have the basics finished first, and that takes many person years of work.

https://www.healthit.gov/topic/certification-ehrs/certificat...

The only way a startup might be able to eventually replace Epic is to target a niche ambulatory care specialty first where meeting all the checklist requirements is less important than really nailing an optimal clinician workflow. Then gradually expand out from that foothold by adding the features that hospitals need.

[digitaltzar]

Agreed, many reasons to admire them