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Today on Insights. We go back to a conversation Host Bill Russell had with Drex DeFord the Executive Healthcare Strategist at CrowdStrike. The topic of discussion was What Would You Suggest To Epic To Instill Innovation And Benefit The Entire Healthcare Community? The answer is complicated.


Hello and welcome to another episode of Insights. My name is Bill Russell. I'm a former CIO for a 16 hospital system ???? and creator of This Weekin Health IT. A channel dedicated to keeping health IT staff current and engaged. Our hope is that these episodes serve as a resource for the advancement of your career and the continued success of your team. Now onto the ???? show.

Today on insights, we go back to a conversation Host Bill Russell had with Drex DeFord, Executive Healthcare Strategist at CrowdStrike. The topic of discussion was what would you suggest to Epic, to instill innovation and benefit the entire healthcare community? The answer it's complicated.

It's hard to not like Judy Faulkner. If you've run into her at all, it's hard not to like her. Cause I was actually interviewing somebody and it was a female leader for a company and she was just saying, man, I would really like to meet her. And I'm like, she'll talk to you. Let's walk over there and talk overto her.

And sure enough, we walk over, Judy engages her. They have like a 30 minute conversation. Trade information. It's hard not to like Judy. I mean, that's who she is. And when somebody says, Hey, you've been an inspiration and those kinds of things, she doesn't say, thank you. She says, she's does say thank you and then she says, well, tell me about it. Tell me what you're doing. And there was a genuine interest and anyway. But I will tell you, I had a couple of conversations, which was, if you were able to tell Judy one thing that she should do with Epic or change one aspect what would you do? I'm going to give you my answer to that. Cause we get a group of people batting it around and if you want to answer, that's fine. I know I never want to put you in a place where you get in trouble for saying something.

I might very well pile on whatever your answer is. Let's hear it.

So I was sitting there and I'm not the first one who has said this I'm sure. But it's, Epic should be a platform. It shouldn't be an EHR. And what it requires is a change of thinking. Instead of focusing so much on the hospital workflow, they should really try to figure out how to enable the world to innovate on top of Epic.

And I think they would answer that by saying, oh, that's what App Orchard does. Well, it's not what App Orchard does. It's not a platform. It's not the kind of thing that you would step back and say, Look, I'm going to redo the interface for Epic, because I think I can make a better interface for, I don't know, the the oncologist on top of Epic than what Epic has.

And that's, that's what a platform is. A platform is essentially, Hey, the components are available for you, the entrepreneur, the, thinkers, even the clinicians to say, I'm going to tinker with this. I'm going to see, and I know there's physician builders and those kind of things, but again it's not a platform it's not easily accessible APIs common language that I can tap into it.

It's not really designed to be a platform. And I just don't think it would take, well, I don't want to say it wouldn't take much. It would take a fair amount to make it into a platform, but I think it would be worthwhile because I think if they ever got the entire community and now they can, again, with a platform, you control certain aspects to make sure you sure ensure data quality ensure all those things.

Man, if we unleashed a community to really go to town on top of that, I think it would do great things for healthcare. That was my answer to that question. I don't think it was any better than anybody else's I just, when I look at their market share and I look at their position, I think they could really benefit from a change in culture that says we have to build it.

Yeah, I think it's, so it's interesting. You and I have been doing this for a really long time. And I remember when we first started building things that were electronic health records, that we didn't really call it electronic health records.

We have best of breed systems. So we bought a lab system from one vendor and we bought an emergency department system from another vendor and we bought a transplant system.

Those were the days weren't they.

Best of breed, best of breed. We try to strap them together through an interface engine. And we had all the problems that you're talking about. One data element that says first name isn't actually the same kind of thing as first name in another system. Or dead doesn't mean dead or right arm doesn't mean right arm. But we struggled with it. And at some point we got so sick and tired of it that we went to best insuite systems and we bought Epic or Cerner or Meditech because they had put lots of things together, workflow wise and automated those in a single database. So we didn't have to wrestle with that part of it. Although our clinicians would tell us, ah, it's suboptimal compared to things that I use to use that were really built for me. And now I feel like as with many things in information technology, we've gone all the way around the circle.

And maybe we're back to this point to where we can really start thinking about best of breed again. But with the anchor being an EHR company who we've saw, ultimately we solve all of the problems around data and semantics and, data quality and all of those things. But we let lots of back to the health sort of conference, right.

We let lots of companies who build really awesome specialized systems for particular kinds of clinicians ride that backbone. Ride that platform. And it's a situation where ultimately you could make everyone more efficient, more effective, happier with their experience, interacting with the EHR because they would be interacting with the EHR through some gateway that they really love through some application that they're really, really comfortable with because it was built for them.

So I'm kind of with ya. I think it's just a matter of time until we finish making that whole circle. And whoever decides to jump on that first, whoever leans into that first, maybe the next EHR company that has a different name,

I've asked some people about what EHR 2.0, looks like, and maybe it's 5.0 at this point. I'm not really sure. It's interesting because Epic is still winning deals. I mean, they had financials at Atrium. Now they have clinicals and financials at Atrium. That's a significant win.

There was somebody else I heard who, who actually, there was a handful of people as we were sort of doing the introductions that would say things like, yeah during the pandemic, we also did an Epic go live and I thought that, so they're still, they're still winning deals. Plus the M and A activity.

Exactly. The community connect stuff still continues to put Epic in more places than it's ever been before.

That's the other thing I would say is there's a point of diminishing returns. We've seen this in some other industries, specifically the ERP, the SAP's, the Oracles and the others.

When it goes from 50 players to 20 to 5 to 3, the innovation starts to slow pretty dramatically. And this is Epic's push to foundation. They're pushing the foundation because there's no way for them to keep up if all of their core clients have one-off implementations because they'll just keep breaking stuff.

And so you have to force them back to a foundation build and we'll see what happens.

I want to thank Tracey for another great episode. If you have feedback regarding the content and materials that you just heard and would like to help us to amplify great thinking to propel healthcare ???? forward, please send us a note Thanks for listening. That's all for now. ????

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