Do Epic and interoperability interface? Depends on whom you ask

"There's been a lot of misinformation out there."
By Erin McCann
02:32 PM
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The nation’s largest electronic medical record vendor has an image problem. Verona, Wis.-based Epic has come under fire this year over its lack of interoperability, spurring the company, once well known for its mum relationship with the press, to speak up.

Just this August, Epic inked a deal with lobbying firm Card & Associates to work on its interoperability image – one that has left a perception that Epic has a closed system that does not easily work well with other EHR systems.

"There's been a lot of misinformation out there," said A. Bradford Card, the firm's principal, to Politico. "I've had a number of productive meetings with Congress to educate members and staff so they know who Epic is and the great story they have to tell. They are the most interoperable EHR company."

But many industry stakeholders don’t seem to agree.

“Epic's plan for interoperability is for everyone to use Epic. … or pay a boatload for data transfer,” wrote Rebecca Coelius, former medical officer for innovation at ONC, in a Healthcare IT News comment. “It’s going to take a strategy update, not a PR firm, to fix this one.”

Congressman Phil Gingrey, R-Ga., MD, in a July hearing on Capitol Hill was among the most outspoken over the vendor's supposed lack of interoperability, mentioning Epic by name.

"And Congress has spent, as we all know, something like $24 billion over the past six years buying products to facilitate interoperability only to have the main vendor under the program, Epic, sell closed platforms," Gingrey told the Energy & Commerce Committee back in July. "Do you believe that the federal government and the taxpayers are getting their money's worth subsidizing products that are supposed to be interoperable but they are not?"

A month earlier, Edmund Billings, MD, chief medical officer at Medsphere Systems, the developer of the OpenVista EHR, made similar charges. "While Epic preaches interoperability, it practices non-interoperability and vendor lock," he wrote back in June.

Then in August, Epic President Carl Dvorak went on the defensive in a testimony before ONC's Health IT Policy Committee.

“We connect to 26 other vendors systems, 21 HIEs, 29 HISPs and 28 eHealth Exchange members," with 20 more coming online soon, Dvorak told the committee. Moreover, the company has enabled "about 20 billion data transactions per year, over 12,000 different interfaces across our 320 customers, to about 600 other vendor systems – including 88 public health agencies, 18 research societies, 51 immunization registries across 46 states and 17 research registries."

Just this May, research firm KLAS released a report finding that Epic to non-Epic clinical data sharing can be done, but it is not without challenges. The report examines what health organizations not using an Epic system have to do in order to share data with health systems that employ an Epic EHR.

Providers using non-Epic clinical systems say that while it isn't easy, they are able to share data with Epic.

"Epic is seen by many competitors and providers as not playing well with others," said report author Mark Allphin, in a news release. "Yet the providers we interviewed told us a more complex story. Data is being shared, but the effort required to get there can be very different depending on whether you are on the Epic side of the exchange or with some other vendor."

Epic's interoperability image also proves critical at this time, as the company just announced early this summer it was teaming up with tech giant IBM to compete for the DoD Healthcare Management Systems Modernization Contract, a system that heavily relies on full integration capabilities. Epic will go against other EHR heavyweights Allscripts and Cerner in competing for the bid.