The End...For Now...

I recently left the Epic project I had been working on and it's safe to say I'm done for now.  I reached the point in my consulting gig where I was carrying the entire project.  It's a big strain when organizations don't hire quality employees and rely on consultants to do all the work.  It's not a balanced system and it's not a cohesive team.  I hope that my departure shakes up the project and they hire better staff and get rid of the people who don't understand anything about Epic.  My gripe here is  mostly on the healthcare organizations and not Epic.  Although Epic should do a better job of advising organizations on how technically complex the system is and how normal clinical folks can not do this job and more specifically will not enjoy this job.

I continue to receive a lot of e-mails from people reading this blog, but for now I'm going to take my e-mail down.  You can probably find most of the answers to your questions somewhere in my blog posts.

Best of luck in your job search.

Last Post Erased

I removed my last post titled "Epic Systems still Inexperienced and Overworked." I became a little worried that perhaps my Epic counterparts would read it and it could lead to awkwardness on our project.

My hope was that upper management at Epic read the posts and makes much broader changes to the way they staff projects and how they hire and fire. It is such a struggle to progress through implementations when you are working with Epic staff who are either overworked/tired or fresh out of college and have no experience with the applications.

E-mails

Post Edited...

Best of Breed Systems Losing Ground

Here's a very interesting article about the state of healthcare IT.

http://www.healthdatamanagement.com/news/ER_vendor_survey_ratings-39595-1.html

For those who don't know what Best of Breed means, it defines a software program that is tailored to a a specific use within Healthcare such as in the ER and the company making it does not have a full line of applications for other areas of Healthcare.

Best of Breed systems are still the easiest to use and have the best functionality. As the article states doctors like using them more. However, more Healthcare organizations are choosing completely integrated software (i.e. from Epic) because it's cheaper than piecing together many different systems. The most important thing is that integrated systems are safer for patients and will likely reduce costs. In that regard I am all for Epic.

Now for my rant :-)

First thing, I think it was silly that in staff meetings Judy many times talked about how our products were just as good as best of breed systems. She wanted to completely get rid of the term best of breed because she thought Epic was nearly/already the best in every category.

More importantly, how come Best of Breed systems are still beating out the giants of the industry like Epic in terms offering functionality? I would opine that this is primarily due to lack of clinical knowledge at Epic. Epic invests heavily in development, but not in actual clinicians to guide the developers.

I believe when I left there were roughly 12 MDs there. It's an incredibly low number considering the size of the company and how much money Epic makes. Plus the MDs they have don't cover every area of practice. How can you create clinical software for neurologists when you don't have anyone with any kind of experience on staff or as a resource you could pull in every once in a while. This is why best of breed continues to win in functionality because they do have the proper physicians guiding them and they actually tailor their software for them.

I was personally in charge of creating clinical content that needed to be reviewed by Epic physicians and the content could not be sent to QA until physicians had signed off on it. It was a constant battle to get physicians to review the content in a timely matter. Even after they did review another physician would jump in and tell me to do it a different way. There was a lot of in-fighting between certain doctors and definitely a power struggle between them that every manager on clinical applications knew about. Maybe this kind of thing happens at other companies too? I really have no clue. But it always seemed weird to me.

I think they are short on physicians because this is where Epic tries to be cheap and save money. It ends up hurting the customer because they don't get enough clinical content or they have to fix all of the poor content that Epic gives them in the model system.

An interesting little twist here is that once a customer complains that they don't have enough content you could be asked to work some long hours to help them build out their content, which only benefits them and not other Epic customers. If you had just been given the proper time, resources (and clinician review) ahead of time then every Epic customer could have benefitted. It's a really twisted situation, and I may not have explained it in a way that non-Epic employees could understand. I'm sure most Epic PMs (IS) and TS know this situation well and it can be frustrating.

Reading

FYI - If you're new to the site, I recommend you read from the first post and then work your way back up.

Epic Systems Hiring Practices and Inexperience

It appears that the big G still has not indexed this site, so I will have to continually add new posts until it gets indexed. I know that once the site is indexed, many employees at Epic will receive automatic alerts to read it.

I'll talk a little about Epic's hiring practice in this post. Everyone knows they tend to hire people straight out of college without any experience. How exactly do they get away with it? First, the interview process is long and tedious. Expect it to take at least two months and you will jump through many hoops. You will have to provide college transcripts and high school ACT and SAT scores. You will have to take SAT type tests, as well as speed challenge tests and very in-depth personality tests. It's difficult to find adults who have the time to go through all of these hoops when they probably already are busy with a current job and their families.

I had a friend who went through all of this, plus four interviews only to ultimately get rejected from Epic after an interview with Judy. I'm surprised she even interviewed him, but it must have been because he was applying for an HR position. He told me Judy asked him a question such as "What do you do with an employee who has demonstrated a weakness in a same area on a few occasions?" He had a straight out of the book response saying that you should provide more training to the employee to focus on those areas of weakness. Judy said that you should just fire them.

I think the speed test is the best way for Epic to eliminate older people. It's a 10 question math test, with simple to moderately challenging problems and you have 2 minutes to finish. I was told nobody ever correctly answered all 10, but I'm pretty sure I answered the first 9 right and took a stab at 10, which amazed HR at the time.

These are still somewhat minor grievances with their hiring process. I'm sure there have been some candidates they've eliminated simply because they are not fresh out of college. It's impossible to know because I haven't seen all the resumes they receive. I do know plenty of top-notch people get rejected. I tried referring some older friends who had close to 4.0 GPAs and amazing work experience only to see them rejected without ever receiving a single interview. I think there's some illegal activities that goes on behind the scenes of HR, but I have no proof.

The only little thing I do know is that they will essentially figure out how old you are in a slightly discriminatory way. It's required that you give out your graduating year from college. Plus one of the first questions they ask during the phone screen is whether you went from high school straight to college. I know they still ask this question to this day because my officemate asked it all the time when he did phone screens. This type of question seems illegal in my mind because it has nothing to do with how someone will perform at their job. It's clearly used to determine if they took years off before college and possibly coming to the conclusion that they might be a "slacker" for doing so.

A lot of software companies tend to hire young, so what's the big deal? The big deal is that this is extremely complicated healthcare software. It's somewhat easy for the younger crowd to learn the software as compared to older adults, but quite difficult to actually provide advice on how it should be setup. This is especially true of all clinical apps. Customers consistently tell Epic year after year that they are too young and inexperienced, and while Judy says she want to improve this area, that is simply not true. Not based on the fact that they still fire so many people and replace them with younger faces.

I was on the outpatient app and my first install I was teamed up with a manager (AM as in application manager in Epic speak) who had never done an install before. Neither of us had any experience with outpatient clinic workflows, leading design and validation sessions, or providing any sort of advice. I can't even count how many times we were both asked what our recommendation was, and we would either have to slightly BS or would tell them we would need to research and get back to them. I can attest that this delayed our project and caused many problems throughout. I just couldn't believe at the time that Epic would staff an entire project with people who had no experience. Usually the AMs do have experience, but its not a guarantee they have been through an entire install before.

This is what lead to many late nights at Epic Systems for me because I was not only learning the software, but I was reading tons of information just to learn how clinics actually operate on a day-to-day basis. While the training provided at Epic is quite good, I learned a lot more from my customer. I was essentially taught by my customer how a clinic operates.

I often felt like I was contributing to some of the high costs in healthcare while working at Epic. While Judy stresses that we not nickel and dime our customers, which is a good philoshopy, budgets still get overblown. Almost every project would go overbudget and miss deadlines. This is pretty common throughout the industry even with Epic's competitors though. Epic just tends to be less over budget than others and that's alright with the clients. Judy banks on the fact that young, enthusiastic individuals can install systems faster than older, experienced people. Epic's had so much success that it's hard to deny it's worked. That doesn't mean that it will always work. I think it's likely worked for Epic because as you may have heard they are picky on who they let become a customer. They only work with organizations that have very established and large IT departments, so you know there's much less risk in the project failing.

My advice to Epic is that they should hold on to their experienced people. Like I mentioned in the first post, the software itself is becoming extremely complicated and you will need to keep your experienced people for that reason alone. Plus why do you make every new customer suffer through inexperienced implementations? It's just silly and the systems never get setup correctly. Some systems are actually really well implemented and use all of Epic's functionality. On the other hand some are very poorly implemented because of inexperience and physicians literally hate the software and will complain to the highest levels.

But this is also how Epic makes their money as they provide Upgrade Assistance with their project managers and make more money. This is often to fix things setup poorly during implementation or to improve workflows that were never programmed correctly by developers in the first place.

I would have to say that looking back on Epic they are just are broken as the healthcare industry itself. It still boggles my mind they are that they are best for large-scale implementations. I can easily see one of the smaller companies over-taking Epic in terms of offering a better product. But healthcare organizations will not want to invest in a new system anytime soon, so Epic will always be around.

Don't Judge a Company by Its Appearance - Epic Systems Corporation

If you've ever been to Epic Systems Corporation in Verona, WI you know it's an amazing work environment. That's the first thing you notice and most people would lunge at the opportunity to work at such a fun place. I was a project manager for over 2 years, which abruptly came to a close. The company comes off as a very liberal company because they have a green campus and because they stood up to the Wisconsin Manufacturers & Commerce terribly slanted political advertisements. The company receives many industry awards and has the most satisfied customers. Behind the scenes of Epic, it is run in a much different manner, which is something newer employees don't see immediately. Management rules with an iron first and runs the company as if they were arch conservatives. They will do anything to keep customers 100% happy and that includes disposing of their own employees left and right. Upper management cares much more about their customers than their employees.

Up until the last two months of my career, everything had been going very well. I received praises from Epic physicians (including the director of the model system) on my work, received company awards, and big raises.

Yes, the hours were long. I was warned during the interview process to expect to put in 50 hours per week, so the long hours were never a surprise and not a problem for me. After leaving I looked at my time logs for the past year and I actually had put in about 54 hours per week. When I was not travelling I worked about 50 hours and when I was on the road it was usually 60. I did not have much of a personal life during the work-week, but that was fine by me. I never complained or whined about long hours like some people on the Jobvent and Glassdoor websites. The hours only felt long during the dark winter months. I always thought it was odd that my managers never commented on my hours. Even when I put in 60-65 hour weeks I never was commended for working hard. This was my first sign at not feeling respected at the company. You can work like a slave and your manager won't say anything. This likely occurs because they're too busy with their own customer projects to even realize that you're working hard and putting in long hours. Managers don't have time to be real managers, nor do they have the training. I have friends who were managers and they secretly admitted to this.

The management structure is also setup poorly. Your manager will likely have no direct involvement with your project, so you meet weekly or bi-weekly to discuss what you're working on with your manager. Your manager's sole duty is to assign you work, work, and more work. They are not there to help you grow as an employee or person. My manager, Cristin Napier, told me this on my way out that I won't ever forget: "Epic is not in the business of growing it's employees." It's such a disrespectful thing to say on so many levels. I'm sure this sort of statement came directly from Judy and just shows how little they really care about you. They want people who know how to do their jobs perfectly and never make mistakes. When you only hire college kids with no healthcare experience, mistakes will happen.

The problem with Epic is that the work never stops piling up. The longer you stay at the company, the more projects you will get assigned to. You really aren't allowed to say no to the work or they will question your commitment. They will squeeze you as hard as possible until you either break or prove that you are a superstar employee. Only the Superstars stick around. This is how they keep up the extremely fast-paced, hard-working environment. Nobody wants to be the one doing the least amount of work, so everyone works very hard and the culture is quickly passed onto new employees.

By the time I left I was a manager of two different internal workgroups, working with three different customers, and supporting various go-lives. This is definitely a lot of work, but I thought I was handling it well up until I had one mistake.

The reason that I was fired was that one of my customers, who I was just assigned to, complained about me. Basically they thought that even though I completed the work on-time, I was coming too close to the deadlines and it made them nervous. The customer was late in giving me a login to their environment, which was the primary problem. It was hardly a bad situation since all the work was completed. Nobody seemed to care that I did all of the system build for them and their go-live was entirely successful because of me (the ambulatory portion).

To this day I still can not figure out why I was fired when the project was a success. I can somewhat understand being taken off the project if the customer was uncomfortable, but not actually being fired. Not when I had such a good record on all of my other projects and received praises for my work and leadership. There was supposed to be a process where you receive verbal and written warnings before getting fired. Epic usually doesn't follow their own internal process here.

My manager all of the sudden said that I had a history of problems and blew up tick-tack things about me that she didn't even know anything about nor could she name any specific examples. She pretty much decided based on a gut feeling that I was not right for the company. They want to blow up these little things so that you are less likely to sue them for wrongful termination or something like that. Epic usually settles out of court from what I have heard.

It was funny how at the end of my tenure I had been working there longer than half the people in my division of 100. Total turnover in the project management role by my calculations is somewhere around 30% per year. The other high turnover positions are Technical Services, EDI and Developers (Programmers), but Project Managers have the highest. At the October '09 staff meeting, Judy tried to address the burnout/turnover issue that many people write about on blogs. So she throws up a very one-sided graph that shows voluntary turnover is only 7% per year. Involuntary turnover is much higher, but she doesn't want to talk about that even though clearly people who were fired were probably burning out too. I felt slightly burnt out, but only during the >60 hour work weeks.

The staff meetings were always interesting. I admit they were a very effective way to communicate ideas, strategy, and company goals. I learned a lot about running a business from Judy during these meetings. However, a few things she would say were really inappropiate and these are the things that make others call these meetings 1984ish. She has mocked past employees who said they were working long hours by displaying their hours logged for everyone to see. Like I mentioned above, she throws up slanted figures like our voluntary turnover. She has said that too many people are getting sick on Mondays and Fridays for obvious reasons. She tries to be a grammar Nazi at all times, which is kind of annoying. Overall the staff meeting is a good thing, but I want to warn new employees to keep your mind open about some things. A lot of information is filtered and the meeting can feel like a large pep rally.

The sabattical and stock options are nice, but you have to make it to your 5 year mark to get these and a low percentage of people actually do.

No severance pay was offered to me, but I was allowed to work 7 more weeks so that I could turn over all my projects to someone else. I was fired right before UGM (Epic's annual conference with customers) and was still expected to run one of the booths and give demos to customers. To put me in front of customers again after being told to leave is such a slap in the face and they were taking a big risk in doing so because I could have done something bad. I seriously thought of doing something to hurt the company at UGM. I reconsidered because I didn't want Epic to say anything negative about me to possible future employers.

Most people who are fired from Epic are too embarassed to admit they were fired, so they just leave quietly. It's tough to admit to your friends when you're fired at your first job out of college. If the company wasn't filled with people who have only worked for Epic there would be more revolting over the treatment of people who are dismissed. People don't cause a big scene on their way out because it's their first job and they hope for some kind of recommendation.

I was even slightly threatened (by Lars) that I had to be good during my last 7 weeks or I would be terminated immediately and I would not receive good references. Well, as I am applying for new jobs I found out that Epic will not give references anyways. They will only give out dates of employment and your job title. This is something Epic is forced to do because they have been sued many times in the past. To protect themselves, all managers must refer reference requests to HR and HR will not give any information. It was pretty rude to be told I would receive references and then not get them.

The company I applied to would not hire me without getting more information, so I had to refer the company to an employer I interned at during college for 3 months instead of Epic who I dedicated 29 months of my life too. Luckily I still got the job, but again Epic made my life very difficult.

The non-compete agreement is a completely illegal agreement. I have had friends who work in the Wisconsin unemployment office read it and tell me that its invalid. This doesn't matter because Epic clients and consulting firms won't touch you anyways. Epic threatens that if someone hires you, you would not be able to attend training at Epic, which can be very important for learning the applications. Entire consulting firms can be completely blacklisted from training and from UGM if they hire any former Epic employee before their 1 year mark.

As a recent (or soon to be) college graduate you probably are not already thinking about life after Epic before you even get a job there, but it is something you should consider. The reason Epic employees want to work with Epic clients or consulting firms is because they can make a lot more money doing this than most types of jobs. Being blacklisted especially in a bad economy like this is not a good thing.

To top it off, Epic will even try to prevent you from getting unemployment insurance after you're fired. They told the unemployment insurance office that I had work rule violations and should not be awarded unemployment (because Epic would have to pay part of it). Unemployment asked them for examples and they could not provide any, so I was awarded the insurance after a lengthy delay. Again, once Epic is done with you, they do a good job of making your life difficult.

Overall this job is such a mixed bag that I don't even know if I would or would not recommend it. Most of the positive things you can read in posts on Jobvent and Glassdoor, which did make the job fun. I really loved working there and went in most mornings with a smile on my face thinking I had such a cool job. One good thing, not typically mentioned in other blogs, is that I felt I learned a lot about myself and I enjoyed being pushed hard to see what I was capable of accomplishing. In a way I've been battle-tested and I already feel like a rockstar in my next job. I did have some great coworkers as well who I miss very much.

The point of this vent is that I hope it gives applicants a better sense what they're getting into when you decide to work for Epic. If you have other good job opportunities I would take those over Epic in a heartbeat. If this is all you can find then I would recommend putting in one or two years and then leaving on your own volition before you're forced out.

I hope Judy reads this and will make changes in the way this company is run. It's odd, but I still want them to be successful because I know they are doing a lot of good things in Healthcare. They just need to start treating their own employees better. The company can't continue to keep cycling through employees the way it has been. It's worked for a while, but the software applications are getting increasingly complex and experience will eventually triumph youthful exuberance.

If you have questions about working at Epic Systems Corporation you may contact me at runner123@gmail.com

I don't check the e-mail often, so don't expect quick responses.