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Comment by ShirtlessRod | Hacker News Reader

I'm not really sure what to say to that, since you seem to be implying that no one likes it, which is pretty patently false.

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.

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I'm not saying no one likes it, I'm saying none of the several dozen providers and nurses I know (between two different hospitals in the area using Epic) like it.

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...

I fundamentally disagree with the idea that the system can somehow overcome poor implementation; guardrails can only do so much. At the end of the day you can set up almost any piece of software in a way that hinders rather than helps a user. At some point the organization needs to take some responsibility for that.

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 used to work in IT where I worked with sizeable Epic installations... and now I’m a clinician amongst other things.

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.

> I fundamentally disagree with the idea that the system can somehow overcome poor implementation

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.

You’ve just described Jira, or really any other heavily customisable tool that can fit multiple complex workflows.

Having used a dozen EMR systems and Jira, I'd say Jira is much better at its job than most EMRs are at theirs. In fact, now that you mention it: you could easily model each patient as an epic, assignments to various people on various teams (ICU, pharmacy, lab, etc), to-do/in-progress/done. Holy cricky, you may have just cracked the EMR nut.

Just make sure you don't move the epic to "Done" status.

I'll take 5% as an innovators fee please and thank you.

They already have an option like that. The problem is a lot of organizations still want to do their own thing or have their own requirements they want to impose on their users, which is where the large amounts of "implementation" comes from.

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