Epic Carries on an Industry Tradition: Resistance Masquerading as Patient Advocacy


Michael Abrams, MA, is the co-founder and managing partner of Numerof & Associates, a firm that helps businesses across the healthcare industry define and implement strategies for winning in dynamic markets. He has more than 25 years of expertise working helping clients navigate an evolving healthcare landscape, across hospital systems, payers, and Fortune 500 pharmaceutical, device, and diagnostics companies. He has co-authored several books and has been featured in leading business journals and news outlets.

A few short months after Google came under fire for not being forthright about Project Nightingale — its data-sharing partnership with Ascension – EHR vendor Epic Systems warned hospitals that it would halt further work with the company’s cloud-based system, aligning itself with the many individuals who felt the partnership violated patient rights.

This was for optics, and a strategic decision to boot. Just days later, CEO Judy Faulkner asked hospital executives in an email to stand with Epic against the Department of Health and Human Services’ proposed interoperability rule. In the email, Faulkner said that while those at Epic, “ … fully support helping patients have access to their data,” unintended consequences of the proposed rule might be “ … that health care costs will rise, that care will suffer, and that patients and their family members will lose control of their confidential health information.”

Certainly, all these are possibilities without the right controls. And that’s just the point — the issues Epic and others have raised about interoperability can all be managed, but we can’t justify more of the status quo because of it.

After all, it’s taken a substantial amount of time to get this far. EHRs came into being in the 1960s, and only now are we aggressively discussing them in terms of a barrier to patient empowerment.

Indeed, timing is everything. Patient empowerment and all that goes into it — affordability, quality, or, in fewer words, “value” – is having a moment right now. Consumer frustration with a system that refuses to acknowledge patients as customers has finally come to a head. The public is demanding greater insight into this opaque industry, and legislators are responding with incremental action.

We’re seeing this in health tech with the interoperability rule. We’re seeing it in the payer space, and we’re definitely seeing it in care delivery.

In all instances, demands for reform seek greater transparency and accountability; two things our current system sorely lacks, and two things healthcare organizations would be wise to adopt. The shift to value is coming — more quickly than most realize – and those that prepare for the new reality now will be in a much better position culturally and operationally than those still trying to stonewall the inevitable.

Interoperability should have happened a decade ago, but eventually, it is going to happen. Consolidation has only put increased pressure on EHR vendors to create easy-to-use, compatible software to ensure patient information doesn’t fall through the cracks during the acquisition process. And as consumers become even more accustomed to having what they need at their fingertips, they will not just expect the same from healthcare, they will demand it.

Consumers aren’t going to settle for constant skirmishes between reformers and defenders of the status quo. Interoperability is key to what patient advocates want to see in healthcare: a competitive market, a value-based system and empowered patients.

The freedom provided by interoperability accomplishes each of those things. Without interoperability requirements, manufacturers are in control of who gets to see what data and under what circumstances. Interoperability puts patients back in control. It frees health systems to shop around for the best value in their EHR, without being locked into their vendor by proprietary data management features. It stands to increase patient health literacy, and to Epic’s concern about app developers taking advantage of this information, that might actually have a positive impact on population health.

In sum, what we’ve recently seen from Epic is reminiscent of the resistance we’ve seen from others in the industry. But this won’t go on forever, with legislative efforts starting to focus on fundamental issues and manageable concerns inching us closer to the final destination: Value.

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