Why is Epic better than Cerner?

rninformatics, DNP, RN · May 10, 2011

Epic is currently considered the hotest Health Information System. Said to be the "Cadilac" of HISs. Some consider its integration and functionality better than other HIS vendor products .......such as Cerner,Meditech and McKesson.

Epic unlike many of the other HIS vendor products has a different methodoloy when it comes to implementation. Many other vendors will allow you (for additional fees/costs and time) to "customize" their products. Thus allowing an individual organization to alter the original functionality of the application(s) and how they/it works within the organization's idiosyncratic work flows and business processes. You know how Peds says they do things (documenting drsg changes or processing a specimen or even med reconciliation) differently on their unit than does the Med Surg unit or you know how Hospital A in New York processes and handles charging vs how its done by Hospital B in Chicago?

Some vendor's allow for these idiosyncrasies while Epic holds strongly to a more standarized implementation methodoloogy without customization.

Epic's thing is: "Customize it after we get it implemented". There is something to be said for avoiding customization, keeping to standardized functionality and processes and avoiding exspensive and time consuming retro fits and testing with each upgrade or enhancement.

I also want to say .......if memory serves me right..... that Epic was one of the first HIS vendor products to receive national certification.

I'm going to write an article (in the near future) comparing the top 4-5 vendor products..........so stay tuned.

So, I've been hearing about Epic a whole lot. What is the big deal when compared to Cerner? Is it really that much better for nursing documentation? What is your experience with these two systems? Which do you use and what do you absolutely love (or hate) about it? There's talk we're converting to Epic, so any details would be much appreciated

RN Zeke · May 15, 2011

Epic and Cerner user here (others also), Epic rocks. I would enjoy working during another Epic going live on the consulting end.

mydesygn · Jun 4, 2011

Course you do have to consider other items as well.

Recently our hospital considered changing from Meditech to Epic.

90 million pricetag to purchase both Epic and Lawson.

Would the docs / nurse love it - sure but here is what we would lose.

1) No integrated Blood Bank module - would have had to keep Meditech

2) No Human resource /payroll - would have had to purchase Lawson as part of the switch

3) No Ambulatory Documentation

Meditech is by no means the "best" - hard to integrate, requires extensive testing with each update, reporting (you have to be a programmer to write a report out of Meditech - whole companies make a living from the lack of reporting options available) akward workflow for cpoe, documentation etc.. but you do get an integrated system at a relatively cheap price

I would guess that there are some pluses in Cerner that are absent in Epic. and vice versa

rninformatics, DNP, RN · Jun 5, 2011

My Desygn and anyone else,

Can you give me additional specific and objective differences between Epic and Meditech, Epic and Cerner or Cerner and Epic or any other specific functionality limitations or restrictions in any other of the major HIS vendor products?

My Desygn, its SO nice to hear constructive criticism and objective short comings of useability, functionality, interoperability and or integration issues in specific applications! instead of non-specifc non productive crap such as "its not user friendly" its nice to hear how or exactly what the application can't do.

Course you do have to consider other items as well.
Recently our hospital considered changing from Meditech to Epic.
90 million pricetag to purchase both Epic and Lawson.
Would the docs / nurse love it - sure but here is what we would lose.
1) No integrated Blood Bank module - would have had to keep Meditech
2) No Human resource /payroll - would have had to purchase Lawson as part of the switch
3) No Ambulatory Documentation
Meditech is by no means the "best" - hard to integrate, requires extensive testing with each update, reporting (you have to be a programmer to write a report out of Meditech - whole companies make a living from the lack of reporting options available) akward workflow for cpoe, documentation etc.. but you do get an integrated system at a relatively cheap price
I would guess that there are some pluses in Cerner that are absent in Epic. and vice versa

HomeHealth Geek · Jun 14, 2011

I am not sure, these days, that paper is not better than Cerner. I've gotten very tired at their lack of customer service and their lack of caring about updates that make things worse. Their QA department on the most recent service pack for 5.0 must have been having a really bad hair day (month?) when working on this.

It is impossible to fill out an OASIS correctly, reports necessary for state survey have not worked in over a year, and every time you install a new SP, printing 485's breaks.

Cerner will not even let you go to class to learn to customize their forms until you have been on the system for a period of time. Another annoyance is that they use Braden scale information that is 12 years out of date.

There effectively is no careplan for the other disciplines so not sure how you could get away without building your own without a risk for a conditional level survey. All in all, I would recommend against anyone considering it's purchase.

RN Zeke · Jun 15, 2011

Not user friendly, no resource backup, manager not on board with training...could be good if made user friendly and hospital friendly> .....

rninformatics, DNP, RN · Jun 15, 2011

Greetings Cay,

Can you be more specific that "not user friendly, not hospital friendly"?

What exactly does that mean related to functionality, what Cerner (which application(s) are we talking about?) can't do or doesnt do?

Not user friendly, no resource backup, manager not on board with training...could be good if made user friendly and hospital friendly> .....

RN Zeke · Jun 15, 2011

Cerner charting/Example for discharge find PM Conversation on top of page with other information. Why not Discharge Conversation. There are multiple sites one must go to to do a D/C, not just one. Charting unit specific, one must hunt for various places to chart, hope one can figure out where they all are. Hope this makes some sense. I'm sure there are different packages hospitals may purchase, just like what ya want in a car? Classes needed to provide adequate training for nurses and others before going live is welcomed before going live with any program. Site navigation is difficult as there are so many ways to do one thing, this confuses me, don't know about the rest of the people.

mydesygn · Oct 9, 2011

It is pretty difficult to really understand the differences in the system without having actually worked in both. I think we put a little too much emphasis on user opinion. I realize that is a controversial statement so I am going to clarify it a bit.

We purchased a third party ambulatory record based on the preferences of our primary clinics. The users saw demos and the sales staff said that their system could do everything (integrate w Meditech, full support etc..)

Needless to say once the application was implemented - there were a lot of complaints from the users and the integration with Meditech didn't happen, the consideration of key departments were not even addressed in the decision making.

Users tend to focus on "looks" , the interface and not functionality. All they know of interface design is Ipod and Iphones. They think that the computer ought to think for them and don't understand the concept of "garbage in, garbage out". Anytime a doc tells me something is not "user - friendly" - I have to force myself not to ask them what other HCIS they have used and how they came to that conclusion.

None the less, every system has short comings. Most excel at certain aspects (Epic has good inpatient clinical but lacks key components, Meditech has an integrated platform but when you try to be a jack of all trades - you end up the master of none)

When I was a nurse, I remember thinking how "antiquated" a system was and having to remember keystrokes. However, I never noticed that the system never went down and don't remember ever having to call IS with a frozen screen or slow processing. As an IS analyst, I recognize the user frustration yet I recognize the larger considerations.

disenchanted RN, ADN · Mar 30, 2012

I don't think a user friendly computer charting exists ; It is cumbersome, time consuming, takes away from the bedside time, we are practically chained to these rolling computers ; I agree that site navigation is very difficult (to say it very kindly).

Whoever designed these programs are likely not nurses, or if they are, they are out of touch with what nursing is actually like anymore. The opinions of Nurses who currently work at the bedside are never consulted or asked anything when the hospitals purchases these programs. They are simply shoved down our throat. Oh well. I guess we don't have any choice but to keep on taking it.

I understand computer charting is necessary and the way of the future and all that ; but at least create a program that flows and is practical. The one we have is called Horizon Clinicals. I'm pretty much used to it now, but I still hate it.

stephenfnielsen · Apr 1, 2012

Epic is most definitely customizable, and most definitely has an ambulatory module (it was actually their bread and butter in the early days). In fact... I really don't know how Epic could be more customizable, they are known to build custom code for customers when their model system doesn't fit the bill. The reason why they encourage so strongly to stay close to their model is because if a system strays to far it can't use all their amazing training materiel out of the box. It's also true if you monkey around too much, future upgrades won't play nicely.

Two features that I haven't heard of outside of the VA that Epic provides is their "Care Everywhere" and "Lucy" modules. Care Everywhere allows completely unaffiliated facilities to share patient information. Lucy gives a patient a repository for all their health information from any different Epic shop. Since so many level I trauma centers are going live with Epic, Care Everywhere becomes especially useful. We see a lot of patients going to OHSU for their specialty care, and return home for the rest, no more faxing/Fed Ex'ing records back and forth.

Aside from the price tag I really can't see why anyone would be implementing anything but Epic right now.