Epic rose in market share and power due to the ObamaCare requirement of electronic medical records. Hospitals were afraid of being penalized for lack of compliance. They therefore through millions into the Epic hole for a solution.
Once a legitimate alternative arises Epic will fall fast from its pedestal. Their product is so incredibly overpriced and may well be a contributing factor to higher medical costs. Their payroll burden alone, due their business model, will be their undoing. A competitor with a smarter, less cluttered and more intuitive interface should not be far down the road.
When someone says that Apple can do it all by themselves, it would be good, before saying that to realize that Apple buys over two dozen small companies a year - because they can’t do it all by themselves.
cramer was saying that this company already does a lot of what Apple is trying to do, and that acquiring it would save Apple a lot of time and effort, while also having an “in” with medical practitioners. That’s not wrong. Even if some don’t like the system, which medical system is universally loved? The answer is none.
so maybe buying this is a good idea, if they would sell. If they won’t sell, then it doesn’t matter. But sometimes, things change.
Epic is full of epic user problems. Just talk to any medical receptionist who’s had to transition to Epic. Why would Apple even consider wasting their money buying out this company? Work with them but be able to ditch them whenever they want to.
Yes. My doctor agrees wholeheartedly. Spends more time filling in records/forms than spending time with patients (he said). He alluded to the system being broken and ultimately detrimental to the patient recovery time & rate.
Fucking insurance companies. And this mentality of profits before people.
Yeh, that's what everybody is missing about this: Electronic Health Records had great potential, but as implemented, have little or nothing to do with healthcare --- and everything to do with Wealthcare (mostly for the hospitals and other large organizations).
They do very, very little for the patient. They do very, very little for the physician (at best!)
But, what they do very well is help large organizations generate profit.
And that is why EPIC says they WON"T EVER MAKE DEALS and WON"T EVER BE SOLD.
... Because they are a central player in the healthcare scam ravaging this country and driving it into bankruptcy.
......... Very simply: they don't want to kill the goose laying the golden eggs. Omerta!
Epic rose in market share and power due to the ObamaCare requirement of electronic medical records. Hospitals were afraid of being penalized for lack of compliance. They therefore through millions into the Epic hole for a solution.
Once a legitimate alternative arises Epic will fall fast from its pedestal. Their product is so incredibly overpriced and may well be a contributing factor to higher medical costs. Their payroll burden alone, due their business model, will be their undoing. A competitor with a smarter, less cluttered and more intuitive interface should not be far down the road.
Uh, no...
Hospitals and large "healthcare" organizations are primarily concerned with generating profit. Epic's main thrust is to help them do that. From that perspective, Epic is highly successful and unlikely to be dislodged by what we would consider a better, cheaper system.
Americans continue their delusional belief that their healthcare system gives a damn about their health. Yes, most of the doctors and nurses do -- but not the organizations who employ them and tell them what to do and how to do it.
When someone says that Apple can do it all by themselves, it would be good, before saying that to realize that Apple buys over two dozen small companies a year - because they can’t do it all by themselves.
cramer was saying that this company already does a lot of what Apple is trying to do, and that acquiring it would save Apple a lot of time and effort, while also having an “in” with medical practitioners. That’s not wrong. Even if some don’t like the system, which medical system is universally loved? The answer is none.
so maybe buying this is a good idea, if they would sell. If they won’t sell, then it doesn’t matter. But sometimes, things change.
This won't change: In fact, it would be a VERY bad mix of oil and water. Apple focuses on making their (individual) customer's lives better (and derives its profits from the products that do that). Epic focuses on making their clients (meaning large healthcare organizations) richer.
Apple and Epic would make a Jekyll & Hyde like debacle. To say there would be no synergy would be a gross understatement. Cramer only understands profit -- so that's how he measures everything. So, to him, both companies are profitable so both are quality organizations with similar values. He's an ass.
When someone says that Apple can do it all by themselves, it would be good, before saying that to realize that Apple buys over two dozen small companies a year - because they can’t do it all by themselves.
cramer was saying that this company already does a lot of what Apple is trying to do, and that acquiring it would save Apple a lot of time and effort, while also having an “in” with medical practitioners. That’s not wrong. Even if some don’t like the system, which medical system is universally loved? The answer is none.
so maybe buying this is a good idea, if they would sell. If they won’t sell, then it doesn’t matter. But sometimes, things change.
This won't change: In fact, it would be a VERY bad mix of oil and water. Apple focuses on making their (individual) customer's lives better (and derives its profits from the products that do that). Epic focuses on making their clients (meaning large healthcare organizations) richer.
Apple
and Epic would make a Jekyll & Hyde like debacle. To say there
would be no synergy would be a gross understatement. Cramer only
understands profit -- so that's how he measures everything. So, to him,
both companies are profitable so both are quality organizations with
similar values. He's an ass.
Epic rose in market share and power due to the ObamaCare requirement of electronic medical records. Hospitals were afraid of being penalized for lack of compliance. They therefore through millions into the Epic hole for a solution.
Once a legitimate alternative arises Epic will fall fast from its pedestal. Their product is so incredibly overpriced and may well be a contributing factor to higher medical costs. Their payroll burden alone, due their business model, will be their undoing. A competitor with a smarter, less cluttered and more intuitive interface should not be far down the road.
Uh, no...
Hospitals and large "healthcare" organizations are primarily concerned with generating profit. Epic's main thrust is to help them do that. From that perspective, Epic is highly successful and unlikely to be dislodged by what we would consider a better, cheaper system.
Americans continue their delusional belief that their healthcare system gives a damn about their health. Yes, most of the doctors and nurses do -- but not the organizations who employ them and tell them what to do and how to do it.
Go and check out Gruber’s DF. At last, Goldman-Sachs officially raised the question that is elementary in the current setup across most “civilized” countries: whether investing in people’s health is actually a good long term business model. I have a feeling you might guess what the answer to that is.
Epic is full of epic user problems. Just talk to any medical receptionist who’s had to transition to Epic. Why would Apple even consider wasting their money buying out this company? Work with them but be able to ditch them whenever they want to.
I worked as a developer at Epic early in my career.
Extremely outdated tech from the 1970s that nobody else in the world is using (like the MUMPS language etc.). Most of the effort at the place goes into managing that historic tech. I left because I would have been unemployable in the software industry after working there for a few years (though it was obvious that I could have earned a lot and it was going to capture the market). Then there is the development processes inspired from microsoft - deliver first and fix later.
EPIC was the first reasonably sized company who had a fairly comprehensive product ready when the EHR market caught heat in the 2000s. So, it zoomed past everybody else in market share. The software is unbelievably rickety inside.
Epic software is universally hated. I talked to a hospital CIO who talked about the $100 million project to adopt Epic. It was not a good experience, and I believe he lost his job within a year. Yeah, great company for Apple to acquire. Not.
A bit OT, perhaps: I think Apple should follow SJ’s advice to say 1000 times ”no” before saying one “yes”. In other words, focus, and then be consequent.
You're a little confused. Jobs resigned in 2011 and Tim Cook became CEO. The Thousand No's was a short Apple produced for WWDC in 2013, two years later.
I’m a little confused. Did Apple make an offer that was refused or is this just a hypothetical? I also don’t understand the quote that finishes with “They all said they laughed”. Who was doing the laughing and what was the laughing in reference to?
Good questions. Epic is probably a cash cow as is and why would Judy want to give that up. All this came about from an off-hand comment, and Apple had and probably won't have anything do to with it.
It's weak sauce self-back patting on Judy's part, but it's all she's got, I imagine.
Apple has enough irons in the fire and doesn't have enough talent to devote to an Epic oil spill without sacrificing other projects.
* The intrinsic complexity of EHRs. * Epic and most of the EHRs out there are rubbish. * The US health system (being profit-based) cares only about the financial health of the medical organization, not you, the patient. However, there is another perspective.
I've been designing and building EHRs, all my life, and the news is this: * Yes EHRs are complex, but it's all doable. ICU is one module, cardio is another . . . design to the needs of the professional and link them together - one step at a time. * The main problem (in countries where the patient, rather than profit, is supposed to come first) is lack of political will to do something for the benefit of the constituent. For example: * Proline mentions the Ontario eHealth project which went down mostly because the selected "consultants" were taking the government to the cleaners for $5:50 lattes etc., as they also billed their daily rate. * Alberta's attempt at a Shared Health Record failed because there were 14 EMR vendors in the province and no one (Doctors, vendors) wanted to make the financial/intellectual/work effort to connect and the health ministry didn't care.
Bottom-line? EMRs are doable: they need political will & support - but they also need medical professionals to stand up and say "we demand this!"
Epic is full of epic user problems. Just talk to any medical receptionist who’s had to transition to Epic. Why would Apple even consider wasting their money buying out this company? Work with them but be able to ditch them whenever they want to.
Yes. My doctor agrees wholeheartedly. Spends more time filling in records/forms than spending time with patients (he said). He alluded to the system being broken and ultimately detrimental to the patient recovery time & rate.
Fucking insurance companies. And this mentality of profits before people.
Yeh, that's what everybody is missing about this: Electronic Health Records had great potential, but as implemented, have little or nothing to do with healthcare --- and everything to do with Wealthcare (mostly for the hospitals and other large organizations).
They do very, very little for the patient. They do very, very little for the physician (at best!)
But, what they do very well is help large organizations generate profit.
And that is why EPIC says they WON"T EVER MAKE DEALS and WON"T EVER BE SOLD.
... Because they are a central player in the healthcare scam ravaging this country and driving it into bankruptcy.
......... Very simply: they don't want to kill the goose laying the golden eggs. Omerta!
EHR has great potential to help medical care and patients, but unfortunately, its true reason for existence is not for patients or clinical care. The EHR exists for billing, actuaries and for regulation. There is a spiral occurring - the government was told that 'modernizing' health records and converting to an EHR would allow for better tracking and quality improvement. Now that we have an EHR, various organizations say 'great, now we can track...' and there is an ever increasing, endless onslaught of documentation requirements to 'document quality care.' On top of this, insurance companies are saying 'we won't pay unless you document in this way.' The end result is providers spend more and more of their time documenting not for clinical care but to satisfy billing and regulatory requirements. Beyond that, because there are so many requirements and missing one can mean a denied payment, the only way to make sure you satisfy all the requirements is by using a template that includes all the required elements for every entity that is auditing the chart, whether they are relevant or not. The end result is the chart is packed full of random notes that are all templates, virtually meaningless, and so full of random information that you can't find what's actually relevant.
I work in healthcare and I had a patient who came in to the ER with gall stones. She had an endoscopy one day and was going to have her gall bladder removed the next. Before her surgery she had been in the hospital less than 48 hours and had 48 separate notes in her chart. Of those, only one or two had any meaningful information.
Patient Care Record software vendors basically ship garbage, where the user and the patient are an afterthought, and their core system components are truly ancient. None of that helps Apple sell devices in Healthcare , but none of the players seem interested in modernizing. There are also huge differences between the US market and the rest of the world (the US spends way more per patient than most Western countries , but gets clinical outcomes closer to a third world country). Producing a 1 size fits all solution for a global market will be masterful if someone pulls it off.
A few years ago, I was on a long term IT contract to work in an office near the Epic campus in Madison. They were ramping up hiring in a massive way, and I met many database engineers over beers and asked them about how their system worked. Without going into too much detail, essentially the Epic database backend engine is a non-relational database model (think NoSQL). Unlike a traditional relational database model (ie MySQL), medical records and patient encounters don't fit neatly into organized tables, and the record widths and data types can can vary widely. The structure of every table and every database can vary widely, and the system needs to be highly distributed and scalable to handle billions upon billions of patient records.
Another popular system that is built on NoSQL is iCloud. They use Apache Cassandra, and recently open-sourced their software called FoundationDB. And it's a well-proven example of a highly scalable database.
Apple could only improve iCloud by hiring more NoSQL engineers. They would be hard-pressed to do spin up their own health care non-relational database in-house without unwittingly violating patents (again). I think they've learned from the fiascos of FaceTime / VirNetX and Qualcomm, that no matter how hard you work to develop a technology in-house, there is someone else doing the same thing elsewhere and it's only a matter of who files the patent first.
Apple has a pretty good track record of making great end-user experiences, and they spend a lot more energy on UI / UX than other companies.
Notwithstanding their struggles with China and Russia vis-à-vis iCloud, Apple has a stellar track record when it comes to defending and safeguarding user privacy.
Apple and its devices have made great strides in the health care space: the Apple Watch and its fitness metrics; the Health apps and services; DEP for automatic enrollment and management of iOS devices; and Jamf Pro's Healthcare Listener component for easy wipe / provision of mobile devices when rooms are turned over for new patients. These technologies have greatly improved the patient experience, and transformed management of health care devices.
I think Apple should buy Epic and keep their database engineers. As for the UI, they have two choices: retrain the UI engineers in "the Apple way," or give them a nice severance and use their own staff.
I’m a little confused. Did Apple make an offer that was refused or is this just a hypothetical? I also don’t understand the quote that finishes with “They all said they laughed”. Who was doing the laughing and what was the laughing in reference to?
The confusion was intentional. AI knows the truth but decided to hide it.
Back in January 2019, Jim Cramer pulled another far fetched idea from his b*tt hole that Apple should buy Epic. Some of his followers immediately laughed at him and told him how off base he was. A week later Cramer apologized for not having done enough research (I.e., no research) before making the suggestion then proceeded to make more “Apple should buy” suggestions.
I thought the matter had been dropped, but nope. The CEO was asked a question about the buy suggestion. Both CNBC and sadly, AI, decided to skew recent events to mask Cramer’s blunder while attempting to push more shade at Apple.
Following in the footsteps of CNBC, AI cherry picked the CEO’s response to mask the truth of what was really said and what really happened. Here is a picture of the question asked of the CEO and the CEO’s full response.
Apple isn’t the story, Cramer is the story. Both CNBC and AI felt it absolutely necessary to make Apple the story.
I’m a little confused. Did Apple make an offer that was refused or is this just a hypothetical? I also don’t understand the quote that finishes with “They all said they laughed”. Who was doing the laughing and what was the laughing in reference to?
The confusion was intentional. AI knows the truth but decided to hide it.
Back in January 2019, Jim Cramer pulled another far fetched idea from his b*tt hole that Apple should buy Epic. Some of his followers immediately laughed at him and told him how off base he was. A week later Cramer apologized for not having done enough research (I.e., no research) before making the suggestion then proceeded to make more “Apple should buy” suggestions.
I thought the matter had been dropped, but nope. The CEO was asked a question about the buy suggestion. Both CNBC and sadly, AI, decided to skew recent events to mask Cramer’s blunder while attempting to push more shade at Apple.
Following in the footsteps of CNBC, AI cherry picked the CEO’s response to mask the truth of what was really said and what really happened. Here is a picture of the question asked of the CEO and the CEO’s full response.
Apple isn’t the story, Cramer is the story. Both CNBC and AI felt it absolutely necessary to make Apple the story.
Epic is full of epic user problems. Just talk to any medical receptionist who’s had to transition to Epic. Why would Apple even consider wasting their money buying out this company? Work with them but be able to ditch them whenever they want to.
I worked as a developer at Epic early in my career.
Extremely outdated tech from the 1970s that nobody else in the world is using (like the MUMPS language etc.). Most of the effort at the place goes into managing that historic tech. I left because I would have been unemployable in the software industry after working there for a few years (though it was obvious that I could have earned a lot and it was going to capture the market). Then there is the development processes inspired from microsoft - deliver first and fix later.
EPIC was the first reasonably sized company who had a fairly comprehensive product ready when the EHR market caught heat in the 2000s. So, it zoomed past everybody else in market share. The software is unbelievably rickety inside.
I have a coworker that was a bit more recently a developer at Epic, and I have other sources of information to know that while they're not using something so old as MUMPS anymore, they still have a codebase the size of a modern complex GUI OS written in a language that's been End Of Lifed for over 10 years now, that's not got support for threading, and the Epic software is its own health-related platform unto itself.
And yes, if you were to find yourself employed to maintain/extend the old codebase in its current primary language, that would make you unemployable in doing anything else other than working with ancient codebases in dead languages, typically chosen by companies that are too cheap to do things the right way the first time in a language that has a long-term future.
Comments
cramer was saying that this company already does a lot of what Apple is trying to do, and that acquiring it would save Apple a lot of time and effort, while also having an “in” with medical practitioners. That’s not wrong. Even if some don’t like the system, which medical system is universally loved? The answer is none.
so maybe buying this is a good idea, if they would sell. If they won’t sell, then it doesn’t matter. But sometimes, things change.
They do very, very little for the patient.
They do very, very little for the physician (at best!)
Americans continue their delusional belief that their healthcare system gives a damn about their health. Yes, most of the doctors and nurses do -- but not the organizations who employ them and tell them what to do and how to do it.
Apple focuses on making their (individual) customer's lives better (and derives its profits from the products that do that).
Epic focuses on making their clients (meaning large healthcare organizations) richer.
Apple and Epic would make a Jekyll & Hyde like debacle. To say there would be no synergy would be a gross understatement. Cramer only understands profit -- so that's how he measures everything. So, to him, both companies are profitable so both are quality organizations with similar values. He's an ass.
Apple focuses on making their (individual) customer's lives better (and derives its profits from the products that do that).
Epic focuses on making their clients (meaning large healthcare organizations) richer.
Apple and Epic would make a Jekyll & Hyde like debacle. To say there would be no synergy would be a gross understatement. Cramer only understands profit -- so that's how he measures everything. So, to him, both companies are profitable so both are quality organizations with similar values. He's an ass.
Extremely outdated tech from the 1970s that nobody else in the world is using (like the MUMPS language etc.). Most of the effort at the place goes into managing that historic tech. I left because I would have been unemployable in the software industry after working there for a few years (though it was obvious that I could have earned a lot and it was going to capture the market).
Then there is the development processes inspired from microsoft - deliver first and fix later.
EPIC was the first reasonably sized company who had a fairly comprehensive product ready when the EHR market caught heat in the 2000s. So, it zoomed past everybody else in market share. The software is unbelievably rickety inside.
https://daringfireball.net/linked/2014/02/24/thousand-nos-yes
It's weak sauce self-back patting on Judy's part, but it's all she's got, I imagine.
Apple has enough irons in the fire and doesn't have enough talent to devote to an Epic oil spill without sacrificing other projects.
* The intrinsic complexity of EHRs.
* Epic and most of the EHRs out there are rubbish.
* The US health system (being profit-based) cares only about the financial health of the medical organization, not you, the patient.
However, there is another perspective.
I've been designing and building EHRs, all my life, and the news is this:
* Yes EHRs are complex, but it's all doable. ICU is one module, cardio is another . . . design to the needs of the professional and link them together - one step at a time.
* The main problem (in countries where the patient, rather than profit, is supposed to come first) is lack of political will to do something for the benefit of the constituent.
For example:
* Proline mentions the Ontario eHealth project which went down mostly because the selected "consultants" were taking the government to the cleaners for $5:50 lattes etc., as they also billed their daily rate.
* Alberta's attempt at a Shared Health Record failed because there were 14 EMR vendors in the province and no one (Doctors, vendors) wanted to make the financial/intellectual/work effort to connect and the health ministry didn't care.
Bottom-line? EMRs are doable: they need political will & support - but they also need medical professionals to stand up and say "we demand this!"
I work in healthcare and I had a patient who came in to the ER with gall stones. She had an endoscopy one day and was going to have her gall bladder removed the next. Before her surgery she had been in the hospital less than 48 hours and had 48 separate notes in her chart. Of those, only one or two had any meaningful information.
Please do the other participants the courtesy of actually reading what has been said before - before doing your own thing . . .
A few years ago, I was on a long term IT contract to work in an office near the Epic campus in Madison. They were ramping up hiring in a massive way, and I met many database engineers over beers and asked them about how their system worked. Without going into too much detail, essentially the Epic database backend engine is a non-relational database model (think NoSQL). Unlike a traditional relational database model (ie MySQL), medical records and patient encounters don't fit neatly into organized tables, and the record widths and data types can can vary widely. The structure of every table and every database can vary widely, and the system needs to be highly distributed and scalable to handle billions upon billions of patient records.
Another popular system that is built on NoSQL is iCloud. They use Apache Cassandra, and recently open-sourced their software called FoundationDB. And it's a well-proven example of a highly scalable database.
Apple could only improve iCloud by hiring more NoSQL engineers. They would be hard-pressed to do spin up their own health care non-relational database in-house without unwittingly violating patents (again). I think they've learned from the fiascos of FaceTime / VirNetX and Qualcomm, that no matter how hard you work to develop a technology in-house, there is someone else doing the same thing elsewhere and it's only a matter of who files the patent first.
Apple has a pretty good track record of making great end-user experiences, and they spend a lot more energy on UI / UX than other companies.
Notwithstanding their struggles with China and Russia vis-à-vis iCloud, Apple has a stellar track record when it comes to defending and safeguarding user privacy.
Apple and its devices have made great strides in the health care space: the Apple Watch and its fitness metrics; the Health apps and services; DEP for automatic enrollment and management of iOS devices; and Jamf Pro's Healthcare Listener component for easy wipe / provision of mobile devices when rooms are turned over for new patients. These technologies have greatly improved the patient experience, and transformed management of health care devices.
I think Apple should buy Epic and keep their database engineers. As for the UI, they have two choices: retrain the UI engineers in "the Apple way," or give them a nice severance and use their own staff.
The confusion was intentional. AI knows the truth but decided to hide it.
Back in January 2019, Jim Cramer pulled another far fetched idea from his b*tt hole that Apple should buy Epic. Some of his followers immediately laughed at him and told him how off base he was. A week later Cramer apologized for not having done enough research (I.e., no research) before making the suggestion then proceeded to make more “Apple should buy” suggestions.
I thought the matter had been dropped, but nope. The CEO was asked a question about the buy suggestion. Both CNBC and sadly, AI, decided to skew recent events to mask Cramer’s blunder while attempting to push more shade at Apple.
Following in the footsteps of CNBC, AI cherry picked the CEO’s response to mask the truth of what was really said and what really happened. Here is a picture of the question asked of the CEO and the CEO’s full response.
Apple isn’t the story, Cramer is the story. Both CNBC and AI felt it absolutely necessary to make Apple the story.
And yes, if you were to find yourself employed to maintain/extend the old codebase in its current primary language, that would make you unemployable in doing anything else other than working with ancient codebases in dead languages, typically chosen by companies that are too cheap to do things the right way the first time in a language that has a long-term future.