How is it "garbage software"?
It's garbage on the backend because the update process is ridiculously manual. Every minor change sends out a ticket with incredibly detailed instructions, e.g. to update a single element somewhere. The role of the analyst is essentially to execute a script, by hand. Not only is this more costly and slower, it's more error prone. But it creates an ecosystem of these Epic-trained and -approved technicians which helps lock in customers and ensures another steady stream of income to epic.
You're basically saying that software can be used in a shitty way. That's not exactly unique to this space.
A lot of it does depend on the organization you're working with, as some are more dysfunctional than others when it comes to setting up best practices and build for their physicians. Others actually listen to their clinical users and tailor the system for them.
I also don't disagree with the fact that some of the issues arise from the implementation requirements. But at some point, it's still the system's fault if it allows its users to be burdened like that. It shouldn't take clicking across three different pages and who knows how many modals to triage one patient in an emergency room. It's silly that I've had to learn which order to provide my transfer of care report so the nurse doesn't have to keep clicking back and forth between different pages...
At any rate, this all started with a glib "garbage software" comment, so I suppose I should happy that you acknowledge that the implementation requirements set by the organization have at least something to do with overall user satisfaction.
I’m going to agree with the garbage software sentiment.
I will say that Epic implementations tend to be liked better than alternatives... but when it replaced some piece of shit Meditech implementation nursed from 1980 that’s not really high praise dude.
If very large amounts of 'implementation' have to be done on top of the software, then that's also a sign of bad design. It should be handling more of the implementation and making it more streamlined.
My main point I wanted to make was 1) that I also hated Epic the first time I used it in residency (we switched from Cerner to Epic for outpatient only). 2) I have so far never met someone who prefers another EMR over Epic, which really says something since Epic is also bad.
You should check out who leads wins KLAS awards.
As for the MUMPS code, there was a node size limitation for the code. Which included variable names and comments. So each code segment (identified by inscrutable five-letter (or less) names like "^ZHMRG") was jam-packed as tightly as possible with one-letter variable names and zero comments. Basically unmaintainable, but I bet they're still using it.
Garbage software. I left in 2007.
They like to hire straight out of universities. It was the second job for me, so I didn't really know to jump ship earlier.