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Epic HIE 2014

Epic HIE 2014
Everywhere, Elsewhere, or Nowhere Else?

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Wide-ranging praise from customers has made Epic a top-ranked software vendor in many KLAS reports. One area, however, is often a subject of criticism: Epic’s ability to share clinical data outside of an Epic ecosystem. Among many customers and competitors, Epic has a reputation as a closed system that is unsuitable for the collaboration and interoperability seen as vital for patients and providers alike. The goal of this report is to test that reputation among organizations said to be sharing clinical data between Epic and non-Epic systems today, examine how that is being accomplished, and highlight the strengths and weaknesses of Epic’s approach. Via 28 provider interviews, we look through the eyes of both Epic customers and the non-Epic organizations with which they share patient information.

WORTH KNOWING

EPIC-TO-NON-EPIC SHARING IS REAL:

KLAS validated twenty-seven unique instances of Epic customers sharing data with providers using other EMRs. Four out of five are doing so through an intermediary such as a non-Epic HIE or HISP solution. One out of five is achieving interoperability directly between EMRs. In most cases, information is delivered in a CCD format via industry-standard protocols for pushing (XDR) and pulling data (XCA, XDS.b).

EPIC STANDS FIRM:

While interoperability standards are supposed to facilitate sharing, most say significant effort is needed to bridge the gap between vendors’ unique implementations of those standards. HIE organizations and non-Epic providers say Epic is capable but inflexible and that other vendors must meet Epic where Epic stands. This report did not compare standards adherence, but for providers, variability among vendors underscores the value proposition of intermediary HIEs and HISPs.

EASIER FOR EPIC CUSTOMERS:

For Epic end users, sharing with other health systems is a stress-free experience. Epic handles the configuration, and then the already-familiar Care Everywhere tool suddenly has access to outside data. For non-Epic providers, interoperability is often a bumpier ride. When a vendor does not already support the standards Epic uses, providers often face extensive development and expensive interfaces. Once interoperability is in place, usability varies for non-Epic users: some enjoy easy access to Epic data inside their own EMRs, but others must use HIE portals outside their clinical workflow.

AFFORDABILITY NOT A PROBLEM:

While sharing with other Epic facilities incurs no extra charge, providers mentioned that it does result in new volume-based fees. Some objected to such charges on principle, but most cost-related feedback centered on interfaces—whose costs were seen as reasonable when coming from Epic but prohibitive when coming from other EMR vendors.

STILL NO PLUG AND PLAY

Overall, Epic is ready for prime-time sharing with non-Epic systems, but this does not mean that interoperability is without bumps. Providers described some turbulence that is not always unique to Epic: Vendors do not all support the same standards in the same way, preserving a role for HIEs and HISPs. Vendor teamwork is needed, and providers may have to referee. Non-Epic vendors typically must be more flexible in closing gaps. While CCDs have a standard structure, providers fill them out differently based on their EMR's capability, quality of available data, and willingness to share. Even as designed, CCDs don't deliver the depth, breadth, and timeliness of data many desire. Some describe CCDs as no more than electronic faxes. CCDs often contain a mix of discrete and read-only data. The ability to import and reconcile data elements varies by EMR and provider source.

KLAS Report: Epic HIE 2014

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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2018 KLAS Enterprises, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.