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.