ShandsHealth is a large health system located in Gainsville and Jacksonville, Florida. Like many of the high-end and academic health systems with 500 beds or more, it is converting to the Epic EMR (see: Shands' new records system should simplify things). Here is a brief listing of the new features of this EMR as listed in the press release:
- Shands patients will no longer have to fill out their medical history and prescription information every time they visit a Shands hospital, faculty clinic or emergency room....
- All Shands patient records are instantly available to all Shands health-care providers.
- Patients will no longer have to fill out their medical history and prescription information every time they visit a Shands hospital, faculty clinic or emergency room.
- Prescriptions are sent directly to pharmacies or are printed out instead of handwritten.
- Patients will be able to access their health information and make appointments online....
In my opinion, Epic has gone quite far in dominating the market for EMRs in the high-end health systems (see: HP Unveils New Business Strategy: Cloud Computing and Business Analytics). Here is quote from this latter note:
A good example is the EMR market where Epic has a near monopoly at the high end and can almost name its own price without much push-back from hospital customers (see: Why Does Epic Keep Hammering Cerner? Mr. HIStalk's Opinion; The Secret to Epic's Success in the Hospital EMR Market).
Tucked in near the end of the Shands press release cited at the top of this note is the following quote:
Epic has 240 health-care organization customers with 220,000 physicians, including about one-fourth of the physicians in the U.S., according to the company. Florida customers include the University of Miami, Tampa General Hospital and Mt. Sinai Medical Center in Miami Beach, among others. When all system installations are complete, about 110 million patients will be in Epic systems, approximately 38 percent of all patients in the U.S.
If it's true that one-fourth of the physicians in the U.S. use Epic systems, than a much higher percentage than this use the system in our larger hospitals. What's the significance of all of this? Simply put, a major consolidation of IT power and influence is developing in the hands of the executives of privately-held Epic. Much of the most significant clinical research and complex care is conducted in the large academic and teaching hospitals in the U.S. The physicians working in these facilities will only be comfortable working with the Epic software.
Epic also has a reputation of closely controlling the installation and development of its EMR software products. This is the basis for its record of successful system installations and part of the appeal of the product to hospital CEOs and CIOs. Furthermore, the evolution of clinical hospital systems (e.g., EMRs, LISs, RISs, etc.) is a critical element in the overarching strategy of our rapidly expanding health systems. Within a few years, any significant discussion of healthcare strategy in the U.S. will require the active participation and support of Judith Faulkner, the founder and CEO of Epic, and her executive team.
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