Data in Epic once felt like it was surrounded by the “walls of Jericho”; a siloed fortress waiting for the trumpets of federal regulation to bring the walls crumbling down.
I can recall the early days of Healthjump, meeting with investors, sharing our vision of providing medical data to all members of the care continuum. Without fail, someone in attendance would respond "sounds great, but how are you going to get data from Epic?" In return, we would share with them our clients that were also large Epic customers and assure them (with some technical detail) that our platform was certainly capable. Still, I noticed we were never asked that question with regard to any other EHR; it was clear that anyone familiar, perceived Epic as unwilling to play nice with others.
However, today those walls should look much less ominous to newcomers entering the space. Honestly, I am not sure if it was:
a) public perception after some unflattering press
b) getting passed over on a massive DoD contract
c) simple product maturity that has brought us to this point. Nevertheless, there are now a few passages for those that need entry beyond the walls.
Healthjump is a registered developer in Epic's App Orchard program, a recent initiative that acts as a marketplace for Epic customers to find integrated apps. Apps that are NOT developed by Epic Systems. Despite this being a young program, it is a clear message they do in fact "play nice with others" and wish to be perceived as an enabler of innovation and interoperability.
Recently we were invited to their headquarters in Verona, WI. On my visit, I met with corporate staff, clients and other participants of the App Orchard program. The subject matter of the meeting included the current state of Epic as a platform, approved methods of interacting with that platform as an app developer as well as the future vision of new and existing products.
THE WHOLE KIT & CABOODLE
Of these products, the one with a majority of the agenda was "Kit and Caboodle". Their latest data warehouse offering (Caboodle) is built with developers like us in mind, by offering a toolkit (Kit) for apps to access aggregated and segmented clinical data. Prior to this, platforms like ours (in most cases) had to rely on the Clarity database which sometimes varied in structure from client to client. With Caboodle, the expectation is that data can be retrieved faster and returned in an identical model from one Epic environment to the next.
Of course, a portion of the time was also spent on the various web service and RESTful APIs available in Epic, some of which are new and noteworthy. However, I won't spent any time on that here since 1) it's pretty technical and 2) all of that is available via open.epic.com if you are so inclined.
I see App Orchard and Kit as steps in the right direction for the EHR giant. Certainly, the path to data ubiquity has many miles that remain untraveled, yet we are seeing obstacles cleared slowly but surely. For a time it seemed like Epic may have seen that path completed with an Epic-only ecosystem. I think this initiative might change those assumptions for some, which in my opinion is a win for all of us digital health.
P.S. If you’re a startup, a seasoned solution or healthcare service provider and you can benefit from accessing discrete data in any EHR via a standardized format and / or RESTful API, give us a shout!