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Katie the Intern 11/13/20

November 13, 2020 Katie the Intern 1 Comment

My learning this week consisted of interviews with readers of HIStalk. These readers also work in healthcare IT and either use HIStalk to some capacity for their job or rely on HIStalk updates to stay in-the-know for work updates. I’ll be summarizing one of those interviews and some of what I have learned about healthcare IT from it as well. 

This interview was with a gentleman I’ll call Steven since he prefers to remain anonymous. Steven works at a hospital as an Epic data architect. As he described to me, his job revolves around how to best make use of the reporting software that is in the hospital’s contract with Epic. Steven says that the hospital’s contract is structured under a strict fee, so the more the hospital uses it, the more benefit the hospital receives. Value is maximized when benefit is increased without a cost increase. All right!

When Steven started at his position, his hospital was just beginning to implement Epic. He had gained experience with Epic from his previous job with a pharma-related company. That is where he was introduced to HIStalk, as he started on the vendor side and moved to the provider side, where he has been for more than five years. 

“That was kind of like a dream of mine, to switch out of the vendor and onto the provider side,” Steven says. “Now I work on the provider side, and it’s kind of a glorious, wonderful thing. It was super meaningful even before the virus hit, and then the virus hit. All of a sudden my job changed dramatically and took on even more meaning.” 

Steven uses HIStalk to understand the general direction of where to take Epic at the hospital. HIStalk helps him understand the direction of the healthcare IT industry in general, allowing his team to make decisions about when to invest in additional effort in Epic or consider using another vendor. 

Before going too much into the interview, I wanted to write about what I learned about Epic and other EHRs (electronic health records, point for me) vendors. I’m sure HIStalk readers understand Epic and EHRs, but for me, this interview revealed a lot about how some of Epic’s programs are used by architects and applied to patients, staff, and hospital data. 

Epic has a software package called Cogito, an analytical database that allows the analysis of patient data as a whole rather than one patient’s data. Steven touched on Epic’s systems known as OLTP (Online Transaction Processing) and OLAP (Online Analytical Processing) and their different uses inside of Epic. The OLTP is useful for looking at one single point for data references, such as a single patient or a provider’s schedule. The OLAP makes it easy to search across an entire population, Steven says. These processes are the analytical tools that he uses to increase the value that his hospital gets from using Epic. 

Steven’s job revolves around understanding certain sets of data to ensure the hospital is able to get the information they need. He uses that information to answer the hospital’s questions, such as which doctor has the most expenses, how financials are doing, or how efficiently the hospital has vaccinated patients.

“I lead a team of 12 and I call the technical shots on how we are going to meet the businesses needs in being able to understand the data across the whole environment,” Steven says. 

This is where HIStalk comes back into play for Steven. He often uses HIStalk to guide his arguments for or against the renewal or discontinuation of programs for his hospital. Understanding the healthcare IT ecosystem allows Steven to see if the products his hospital is using are continuing to meet the needs of providers and patients there. 

“Being aware of what startups are doing or who is buying what helps me make arguments for or against whatever approach people are wanting to talk about in the data space,” Steven says. “Knowing what is happening outside of that, what their competitors are doing, helps me understand, ‘Is this person’s desire for this thing, is that what is best for us?’”

It is this understanding of desire and needs that recently drove Steven to argue for the discontinuation of a software program that many hospitals use. He argued to not renew a contract with a vendor program made by SAP Business Objects, business intelligence software that is not meeting his hospital’s needs. Though it is a partner’s software that Epic recommended, the hospital will be one of the first to turn it off. 

Much of this interview with Steven brought me to a deeper understanding of the crosshairs of analytics, vendors, and running a hospital’s data systems to maximize value. Researching EHRs, talking with Steven, and learning more about the main players in the EHR industry has been eye-opening for me as someone new to the field. I really learned just how important it is to stay connected to the industry, as it helps healthcare IT workers better apply system tools to patients and providers alike.

I do hope this column helped readers gain at least a deeper understanding of the role of a data architect in hospitals. I know that I learned a great deal about Epic, computer software, data analysis, and understanding the importance of keeping up with the industry.

In next week’s column, I’ll be breaking down another interview with another reader who uses HIStalk to stay connected. He is a younger professional in the field and also gave interesting tips on how to learn about the industry as a whole.  

I also plan to begin researching COVID-19 deaths and how hospitals decipher who died strictly from COVID-19 versus from complications it caused. I am hoping to share some interesting information from that research in the coming weeks! 

Thank you for reading. I am enjoying the healthcare IT industry and learning new stuff every day. 

Katie The Intern 

TLDR, as a reader requested – Katie The Intern conducted an interview with an Epic data architect and learned about EHRs, data evaluation, and how an architect makes decisions at work with the help of HIStalk’s industry summary.


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Currently there is "1 comment" on this Article:

  1. Perhaps this will help.

    Cogito is more of an umbrella term for all of Epic reporting. It’s a brand more than a technology.

    Chronicles, which is a component of Cogito, is the piece most like OLTP, because it uses the transaction processing database.

    Farther up the analytical stack, Cogito includes Radar, SlicerDicer, Clarity, Caboodle, Predictive Analytics, and even some AI support. All these items leave the TP database behind in order to do their thing!

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