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MUMPS as a Limiting Factor for Epic; Does the Company Have an Achilles Heel?

Posted Aug 03 2012 12:00am

Mr. HIStalk has responded to a question regarding Epic and its use of the MUMPS programming language. He also discusses the factors that might cause Epic to "hit the wall", which is to say fall away from its current dominant position in signing most new EMR contracts in high-end hospitals (see: News 8/1/12 ). Below is the question and his response:

: “Re: Epic. Could you opine to the extent to which MUMPS is constraining the growth of Epic? Everyone suggests this is a limiting factor, but so far it hasn’t been. How and when would they hit the proverbial wall?”

: It’s armchair quarterbacks, not customers, that keep trying to create a non-existent Epic Achilles’ heel out of MUMPS and Cache’. Most of that hot air comes from competitors Epic is killing, self-proclaimed experts who’ve never worked a day in IT or in a hospital, and cool technology fanboys who can’t stand the idea that Epic doesn’t care what they think. Despite the use of some ancient underpinnings, Epic’s product is apparently almost infinitely scalable, it does everything customers need it to do, and it works reliably. Nobody cares what it’s written in except their programmers – customers just want solutions, and the decision-makers when Epic is purchased are usually end users and operational executives, not IT geeks who salivate over source code.

The only walls Epic could hit would be if InterSystems decided to go out of business (that’s not happening – they were absolutely printing money even before all those thousands of new Epic Cache’ user licenses dropped into their lap); if InterSystems decides to get greedy and either raise their Cache’ licensing fees or stop developing it (doubtful); or if Epic can’t get programmers willing to learn MUMPS (which has never been a problem because they do all of their training in-house and new UW psychology grads aren’t exactly swimming in job offers from Microsoft or Cisco). Anyone who claims Epic is about to hit the technical wall is just trying to plant fear, uncertainty, and doubt in the market.

If there’s an Epic wall to be hit, it will be high costs that hospitals can no longer afford with reduced reimbursement, lack of ability to scale as it tries to extend its dominance outside of the US, some kind of meltdown like Judy stepping down and creating a vacuum of power, or perhaps some major and heretofore unfelt shift toward open systems that would put its rather closed model at risk. You’ll know that’s happening when you see the KLAS scores move from green to yellow. The only opinions that count are those expressed by customers with their dollars.

I have been involved with the LIS world for three decades and have seen a number of companies dominate the market and then fade away. Here's my list of the general factors contributing to the decline of once mighty healthcare software vendors. Many of them are also cited by Mr. HIStalk above:

  • Pricey systems, allowing vendors with comparable systems to soon take away market share.
  • Hubris and complacency on the part of the dominant vendor.
  • Technology shifts with new competitors gaining an edge on this basis.
  • Executive succession problems and current executive incompetence, resulting in lack of focus.
  • Excessive attention to the bottom line, leaving customers adrift because of lack of innovation.
  • Major problems with system installs or with maintenance, tarnishing the company's once mighty reputation.
  • Inflexibility and over reliance on reputation and the status quo.

I would bet that the many of the hospital executives running Epic software have never even heard of InterSystems or perhaps know very little about the company. Any yet, their future success (and job) may be highly dependent on how this "silent company" manages its business in the years to come. Some of these execs may want to review this  company profile  and the rest of the web site to catch up.

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