An Epic Controversy

Verona-based Epic Systems looks to be in some hot water. An electronic health records management system of theirs has been rolled out and is now having lots of problems, though not necessarily all due to the Epic software.

An electronic health records management system being rolled out by Kaiser Foundation Health Plan/Hospitals has been nothing short of an IT project gone awry, according to sources at the company and an internal report detailing problems with the HealthConnect system.

Questions about the project arose last week at about the same time Cliff Dodd, the company's CIO, resigned. Dodd stepped down last Monday after another Kaiser employee, Justen Deal, sent a memo to every company worker warning of technological and financial repercussions related to the rollout of the nearly $4 billion system from Epic Systems Corp.

When fully implemented, it is supposed to give more than 100,000 of Kaiser's physicians and employees instant access to the medical records of some 8.6 million patients, along with e-messaging capability, computerized order entry and electronic prescribing. In addition, the system is supposed to integrate appointment scheduling, registration and billing functions and will offer various features to Kaiser members through KP.org.

But according to the report, that doesn't seem to be happening with any degree of regularity.

...part of the problem with the HealthConnect system is that the Citrix Application Delivery infrastructure implemented by Kasier just can't handle the load of the Epic Systems.

part of the problem with the HealthConnect system is that the Citrix Application Delivery infrastructure implemented by Kasier just can't handle the load of the Epic Systems.

They said the software was written in MUMPS (Massachusetts General Hospital Utility Multi-Programming System) -- a health care programming language originally developed in the 1960s.

"Basically, the problems really do follow the entire scope of the platform in that we have these issues with the adaptability of Epic and we have these issues with the information security of Epic -- so we implemented Citrix to try and protect that, and we're facing the scalability issues with that," Deal said. "Using Citrix is something that defies common sense. It would be like trying to use a dial up modem for thousands of users. It's just not going to work, and it's not something anyone would tell you a dial-up modem should work for.

I guess this is what happens when you "hodge-podge your architecture", as my friend said.

I never knew there was a health care programming language. And this company has the largest Citrix server farm on the planet? Holy crap!