Epic's Faulkner steals the show at CHIME

Dr. David Blumenthal may have been the featured speaker at last week's College of Healthcare Information Management Executives Fall CIO Forum, but he wasn't the most sought-after attendee at the meeting in Indian Wells, Calif. No, that honor would have to go to Judy Faulkner, founder and CEO of Epic Systems, the Verona, Wis.-based EMR vendor that's celebrating its 30th anniversary this year.

As a company, privately held Epic tries to keep a low profile. It doesn't issue press releases or tout its contract wins, even though it's landed some huge customers, most notably Kaiser Permanente. Look for executive bios on the company's website and you'll be disappointed.

That image belies the fact that Faulkner is an outsize personality. She may shun the spotlight, but run into her at a meeting and she'll happily chat about her passion, computerizing medical records--highlighting the accomplishments of Epic customers rather than the company itself.

Faulkner was true to form at CHIME, holding court for a rapt audience at her table during an informal networking luncheon, then later taking some time to sit down with FierceHealthIT.

Faulkner clarified some rather eye-opening comments from earlier this year about the problems with interfacing systems from multiple vendors. "It doesn't work when you mix and match vendors....It has to be one system, or it can be dangerous for patients," she said in an April 23 BusinessWeek story. She was referring to compatibility issues between an Epic computerized physician order entry application, and another company's pharmacy database that caused multiple errors in a psychiatric unit at Geisinger Health System in Pennsylvania.

"It is difficult to do a good meds reconciliation if you have different information coming in," Faulkner explained to FierceHealthIT. "You need discrete data to trigger alerts."

Indeed, discrete data--or, more specifically, the lack of it--is one of Epic's toughest challenges, as the EpicCare EMR can contain somewhere in the range of 100,000 data elements, and competing systems have similar complexity. "It's taken years to standardize a few of them," Faulkner notes. "It will take ages to do them all." And until that happens, interfacing systems will remain a time-consuming proposition.

It is partially for this reason that Epic won't sell a free-standing pharmacy or ED system, Faulkner says, though she notes that Epic does not offer a PACS and thus must help each customers interface with another vendor's imaging repository.

This also explains why health information exchanges have been fairly limited to date. While there are standards for patient summaries such as the Continuity of Care Record and Continuity of Care Document, "Clinical summaries don't trigger discrete things," Faulkner says. They simply provide a summary that each new recipient must manually act on. With health information exchange, Faulkner adds, "You will either have to deal with discrete data or use in read-only mode."

And thus the quest for interoperability continues. - Neil

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