THE push to move the nation from paper to electronic health records is serious business. That’s why a first look at the campus of Epic Systems comes as something of a jolt.
A treehouse for meetings? A two-story spiral slide just for fun? What’s that big statue of the Cat in the Hat doing here?
Don’t let these elements of whimsy fool you. Operating on 800 acres of former farmland near Madison, Wis., Epic Systems supplies electronic records for large health care providers like the Cedars-Sinai Medical Center in Los Angeles, the Cleveland Clinic, and Johns Hopkins Medicine in Baltimore, as well as health plans like Kaiser Permanente and medical groups like the Weill Cornell Physicians Organization in New York. In fact, Epic’s reputation as a fun-filled, creative place to work helps draw programmers who might otherwise take jobs at Google, Microsoft or Facebook.
Epic supplies software, systems, training and support so its customers can manage their data. As far as the general public is concerned, it operates far under the radar. Yet it helps keep track of 40 million patients, alongside a handful of large software companies and hundreds of smaller firms that have emerged to digitize health records.
Unlike some of those firms, Epic is no newcomer. Judith Faulkner, the chief executive, started the company more than 30 years ago, when, in all but a very few places, patient records were kept on paper. As such, she has a long-term view of the nation’s struggle to digitize medical records.
Ms. Faulkner understands why it’s taken much longer for the health care industry than, say, banks and airlines to move to electronic data. In banking, the types of data are much more limited and known, she says. In health care, by contrast, data is constantly changing based on information from doctors, nurses, patients and others. New discoveries, protocols and government requirements add even more complexity.
The way this data is stored and used can literally be a matter of life and death — which is why the transition to electronic health records is so sensitive. And why it’s so important, Ms. Faulkner says. Computerized record systems can actively search for and analyze information in ways that paper files never can, thereby improving patients’ health, she says.
Digital records are an invaluable tool for doing research and improving care, says Philip Fasano, executive vice president and chief information officer of Kaiser Permanente. “For example, we are able to follow decades of data on diabetes patients,” he says. “We can see which medicines are absolutely the best and personalize the doses. We can truly change the medical outcomes.”
Ms. Faulkner started digitizing patient records when she was just out of graduate school in computer science at the University of Wisconsin. That’s when a research group in the psychiatry department asked her to create a system to help keep track of patient data over time.
Her program, built on ideas from a few other pioneers, was a success. Other medical researchers began requesting their own versions, and eventually a business was born.
At first, Epic consisted of three part-time employees working at $10 used desks in the basement of an apartment house near the university. They bought a bulky computer from a company called Data General; it had two 50-megabyte disk drives that sounded like a noisy washing machine, Ms. Faulkner recalls. “You couldn’t touch it, or the data got messed up,” she says.
There may have been a learning curve, but “to the best of our knowledge, in the 32 years we’ve been in business, there has never been a breach of Epic’s data by a hacker,” Ms. Faulkner says — speaking to a concern that has some people nervous about the conversion to electronic health records.
Concerns about security are hardly groundless. A government Web site known as the “Wall of Shame” has documented hundreds of breaches that threatened patients’ privacy.
At Epic, “We have all sorts of firewalls and security systems in effect to prevent data breaches,” Ms. Faulkner says. On laptops used by doctors, files can be viewed but not stored. The same is true for smartphones and tablets. “We do not store patient data on them,” she says, so it cannot be misused if these devices are stolen.
Ms. Faulkner is an industry representative on a government panel charged with examining privacy and security issues regarding health data. She says she wants to strike a balance between ensuring privacy and making sure that information can be shared for better patient care.
“I’m worried if we put up too many barriers in order to make things private, and if that makes the flow of information slow and hard to share, in effect more people will be harmed,” she says. So far the committee has maintained that balance well, she says.
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