Epi Software Systems

  

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Epi Info
Developer(s)Centers for Disease Control and Prevention
Stable release
7.2.2.6 / February 2, 2018; 20 months ago
Repository
Written inMicrosoft Visual C# 4.0
Operating systemWindows
Android
iOS
TypeStatistical software, epidemiology
LicenseApache License 2.0[1]
Websitewww.cdc.gov/epiinfo/

Epi Info is statistical software for epidemiology developed by Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia (US).

Epi Info has been in existence for over 20 years and is currently available for Microsoft Windows, Android and iOS, along with a web and cloud version. The program allows for electronic survey creation, data entry, and analysis. Within the analysis module, analytic routines include t-tests, ANOVA, nonparametric statistics, cross tabulations and stratification with estimates of odds ratios, risk ratios, and risk differences, logistic regression (conditional and unconditional), survival analysis (Kaplan Meier and Cox proportional hazard), and analysis of complex survey data. The software is an open-source project with limited support.

An analysis conducted in 2003 documented over 1,000,000 downloads of Epi Info from 180 countries.[2]

History[edit]

Epi Info has been in development for over 20 years. The first version, Epi Info 1, was originally implemented by Jeff Dean as an unpaid intern in high school[citation needed]. It was an MS-DOSbatch file on 5.25' floppy disks and released in 1985.[3] MS-DOS continued to be the only supported operating system until the release of Epi Info 2000, which was written in Microsoft's Visual Basic and became the first Windows-compatible version. The last MS-DOS version was Epi Info 6.04d released in January 2001.

Epi Info 2000 changed the way data was stored by adopting the Microsoft Access database format, rather than continuing to use the plain-text file format from the MS-DOS versions. Following the release of Epi Info 2000 was Epi Info 2002, then Epi Info version 3.0, and finally the open-source Epi Info 7. Epi Info 7 was made open source on November 13, 2008 when its source code was uploaded to Codeplex for the first time. The 7 series is the presently maintained Epi Info product line. Note that Epi Info 3 for Windows is different from Epi Info 3 for MS-DOS even though they share the same version number.

After Microsoft shut down Codeplex in December 2017, the repository of Epi Info migrated to GitHub.

Features[edit]

From a user's perspective, the most important functions of Epi Info are the ability to rapidly develop a questionnaire, customize the data entry process, quickly enter data into that questionnaire, and then analyze the data. For epidemiological uses, such as outbreak investigations, being able to rapidly create an electronic data entry screen and then do immediate analysis on the collected data can save considerable amounts of time versus using paper surveys.

Epi Info uses three distinct modules to accomplish these tasks: Form Designer, Enter, and Analysis. Other modules include the Dashboard module, a mapping module, and various utilities such as StatCalc.

Electronic questionnaires are created in the Form Designer module. Individual questions can be placed anywhere on a page and each form may contain multiple pages. The user is given a high degree of control over the form's appearance and function. The user defines both the question's prompt and the format of the data that is to be collected. Data types include numbers, text strings, dates, times, and Boolean. Users can also create drop-down lists, code tables, and comment legal fields. One of the more powerful features of Form Designer is the ability to program intelligence into a form through a feature called 'check code'. Check code allows for certain events to occur depending on what action a data entry person has taken. For example, if the data entry person types 'Male' into a question on gender, any questions relating to pregnancy might then be hidden or disabled. Skip patterns, message boxes, and math operations are also available. Relational database modeling is supported, as users may link their form to any number of other forms in their database.

The 'Classic Analysis' module is where users analyze their data. Import and export functions exist that allow for data to be converted between plain-text, CSV, Microsoft Excel, Microsoft Access, MySQL, Microsoft SQL Server, and other formats. Many advanced statistical routines are provided, such as t-tests, ANOVA, nonparametric statistics, cross tabulations and stratification with estimates of odds ratios, risk ratios, and risk differences, logistic regression (conditional and unconditional), survival analysis (Kaplan Meier and Cox proportional hazard), and analysis of complex survey data.

The 'Visual Dashboard' module is a lighter-weight Analysis component that is designed to be easy to use, but does not contain the full set of data management features that the 'Classic Analysis' module does.

Using the Map module, data can be displayed either by geographic reference or by GPS coordinates.

Older versions of Epi Info contained a Report module and a Menu module. The Report module allowed the user to edit and format the raw output from other Epi Info modules into presentable documents. The menu module allowed for the editing and re-arranging of the basic Epi Info menu structure. This module was powerful enough that several applications have been built off of it (in versions of Epi Info prior to version 7), including the National Electronic Telecommunications System for Surveillance (NETSS) for Epi Info 6. Unlike the other modules, the menu module does not have a design-mode user interface, but instead resides in a .mnu file whose scripts must be edited manually. In Epi Info 7, the Visual Dashboard assumes some of the basic functions of the report module.

Epi Info 7 includes a number of nutritional anthropometric functions that can assist in recording and evaluating measurements of length, stature, weight, head circumference, and arm circumference for children and adolescents. They can be used to calculate percentiles and number of standard deviations from the mean (Z-scores) using the CDC/WHO 1978 growth reference, CDC 2000 growth reference, the WHO Child Growth Reference, or the WHO Reference 2007. It replaces the NutStat and EpiNut modules found in prior versions of Epi Info.

Open Epi[edit]

OPenEpi is an online version of the software and has inbuilt statistical calculators. For more information, see the article OpenEpi.

Future developments[edit]

Version 7 is in continuing development as an open source project. Web-based data entry, web-based analysis, and mobile data collection tools are currently available and will see continued improvement in 2014 and beyond.

Release history[edit]

SeriesVersionOperating System SupportSupport statusRelease dateSignificant changes
Epi Info for DOS1MS-DOSN1 Sep 1985
2MS-DOSN20 Aug 1986
3MS-DOSN1988
4.1MS-DOSN15 Nov 1988
5.01MS-DOSNOct 1990Allowed European date formats and non-English characters in data fields.[4]
6.0MS-DOSN1992Added programmable menu system
6.02MS-DOSNOct 1994
6.04cMS-DOSN1998Year 2000 compatibility upgrade
6.04dMS-DOSJan 2001
Epi Info 20002000 1.1.2Windows 9x, NT 4.0, 2000N2 Nov 2001First Windows-compatible version of Epi Info.
2002 R2Windows 9x, NT 4.0, 2000, XPN30 Jan 2003
Epi Info 33.0Windows 9x, NT 4.0, 2000, XPNn/a
3.01Windows 9x, NT 4.0, 2000, XPN3 Nov 2003
3.2Windows 9x, NT 4.0, 2000, XPN4 Feb 2004
3.2.2Windows 9x, NT 4.0, 2000, XPN14 Apr 2004
3.3Windows 98, NT 4.0, 2000, XPN5 Oct 2004Windows 95 no longer supported, case-based mapping functionality added to the Analysis MAP command.[5]
3.3.2Windows 98, NT 4.0, 2000, XPN9 Feb 2005
3.4Windows 98, NT 4.0, 2000, XPN30 Apr 2007Ability to use standard ISO date formats, disallowed multiple instances of the Analysis module, added ability to run reports from Analysis, and CDC flags added to the Nutrition module.[5]
3.4.1Windows 98, NT 4.0, 2000, XPN9 Jul 2007Added a right-to-left language controller in Analysis[5]
3.4.2Windows 98, NT 4.0, 2000, XPN20 Sep 2007
3.4.3Windows 98, NT 4.0, 2000, XPN17 Oct 2007
3.5Windows 98, NT 4.0, 2000, XP SP3N9 Jun 2008Added feature to use standardized vocabularies.[5] First version to require Service Pack 3 if running Epi Info on a computer with Windows XP.[5]
3.5.1Windows 98, NT 4.0, 2000, XP SP3, Vista13 Aug 2008First version compatible with Windows Vista. This version also fixed compatibility for languages that are read right-to-left.[5]
3.5.2Windows 98, NT 4.0, 2000, XP SP3, Vista, 717 Dec 2010First version compatible with Windows 7. Also included a preview of the new Epi Info 7 MakeView and Enter tools.
3.5.3Windows 98, NT 4.0, 2000, XP SP3, Vista, 726 Jan 2011Minor update to the Epi Info Enter tool released with 3.5.2.
3.5.4Windows 98, NT 4.0, 2000, XP SP3, Vista, 710 Aug 2012Modified installation packaging.
Epi Info 77.0.5 (Alpha)Windows XP, Vista, 7, UbuntuN5 Jan 2009Programming language changed to Visual C# .NET; MySQL and SQL Server database support added; XML meta-data support added; Linux compatibility added; first Windows version of Epi Info to be open source.
7.0.7.0Windows XP, Vista, 7N27 Sep 2011Upgraded framework to .NET version 3.5; Added ability to run Epi Info 7 from a flash drive without administrator rights; Added ability for Epi Info 7 forms to work with essentially unlimited number of fields; Mapping module added; Geocoding added; Visual Dashboard module added; plugin-based data driver model added; Linux and MySQL support removed; Growth charting added.
7.0.8.0Windows XP, Vista, 728 Oct 2011Release build. Added ability to install Epi Info 7 using a traditional setup file; Added new check code commands; Added ability to calculate z-scores for the WHO Child Growth Standards and WHO Reference 2007.
7.1.0.6Windows XP, Vista, 79 Aug 2012Major updates to Dashboard module; Added web-based data entry capability; Added features to allow compatibility with the Epi Info for Android app.
7.1.4.0Windows XP, Vista, 7, 811 Jul 2014Increased precision for some statistical results and other improvements to Analysis. Added ability to decrypt and import data collected on iOS devices and other improvements to Import/Export. Included other minor updates to Form Designer, Enter, and Dashboard.
7.1.5.0Windows XP, Vista, 7, 819 Mar 2015Added SQRT, POISSONLCL, and POISSONUCL functions to Analysis. Fixed regional number formatting issues in Enter. Added small cell size and sparse data warnings to 2x2 and MxN analyses. Included various changes to support the VHF application and to support the Android Companion. Included other minor updates to Form Designer, Enter, Analysis, and Dashboard.
7.2.0.1Requires Microsoft Windows XP or higher with Microsoft .NET 4.0.27 Jun 2016
SeriesVersionOperating System SupportSupport statusRelease dateSignificant changes

See also[edit]

References[edit]

  1. ^'Epi-Info-Community-Edition/license.md'. Github. Retrieved 18 January 2019.
  2. ^'CDC Epi Info - About Epi Info'. CDC. Retrieved 2009-02-02.
  3. ^'CDC Epi Info - Museam Version 1'. CDC. Retrieved 2009-02-02.
  4. ^'CDC Epi Info - Museam Version 5'. CDC. Retrieved 2009-02-02.
  5. ^ abcdef'EPI INFO VERSION 3.5.1 READ ME FILE'. CDC. Retrieved 2009-02-02.

External links[edit]

Retrieved from 'https://en.wikipedia.org/w/index.php?title=Epi_Info&oldid=887673853'
Epic Systems Corporation
Private
IndustryInformation Technology
Health Informatics
FoundedMadison, Wisconsin, United States (1979)[1]
FounderJudith Faulkner
Headquarters
Verona, Wisconsin
,
Key people
Judith Faulkner, Founder & CEO
Carl Dvorak, President
Revenue$2.5 billion (2016)[2]
9,000+ (2015)[3]
Websiteepic.com

Epic Systems Corporation, or Epic, is a privately held healthcare software company. According to the company, hospitals that use its software held medical records of 64% of patients in the United States and 2.5% of patients worldwide in 2015.[4]

  • 3Concerns

History[edit]

Epic Systems Campus in October 2010

Epic was founded in 1979 by Judith R. Faulkner[5] with a $70,000 investment[6] (equivalent to $240,000 in 2018). Originally headquartered in Madison, Wisconsin, Epic moved its headquarters to a large campus in the suburb of Verona, Wisconsin in 2005,[7] where it employs 9,800 people as of 2019.[8]

As of 2015, the company was in the fifth phase of campus expansion with five new buildings each planned to be around 100,000 square feet.[4] The company also has offices in Bristol, UK; 's-Hertogenbosch, Netherlands; Dubai, United Arab Emirates; Helsinki, Finland; Melbourne, Australia; Singapore; and Søborg, Denmark.[9]

Product and market[edit]

Epic primarily develops, manufactures, licenses, supports, and sells a proprietary electronic medical record software application, known in whole as 'Epic' or an Epic EMR. The company offers an integrated suite of healthcare software centered on its Chronicles database management system. Epic's applications support functions related to patient care, including registration and scheduling; clinical systems for doctors, nurses, emergency personnel, and other care providers; systems for lab technologists, pharmacists, and radiologists; and billing systems for insurers.

Epic also offers hosted solutions for customers that do not wish to maintain their own servers; and short-term optimization and implementation consultants through their wholly owned subsidiary Boost Services.

Epic Systems was voted top overall software suite in the 2018 Best in KLAS awards; the company has received this award 8 years in a row. Epic Systems also took the top spot for overall physician practice vendor in 2018, receiving Best in KLAS awards in 7 segments.[10]

The company's competitors include Cerner, MEDITECH, Allscripts, athenahealth, and units of IBM, McKesson, Siemens and GE Healthcare.[11] In 2003, Kaiser Permanente, the largest managed care organization in the United States,[12] chose Epic for its electronic records system.[11] Among many others, Epic provides electronic record systems for Cedars-Sinai Medical Center in Los Angeles, the Cleveland Clinic, Johns Hopkins Hospital, The Mount Sinai Hospital,[11][13]UC Davis Medical Center in Sacramento, multiple campuses of the Mayo Clinic,[14] and Yale–New Haven Hospital. Partners HealthCare began adopting Epic systems in 2015 in a project initially reported to cost $1.2 billion, which critics decried and which is greater than the cost of any of its buildings.[15] By 2018, the total expenses for the project were $1.6 billion, with payments for the software itself amounting to less than $100 million and the majority of the costs caused by lost patient revenues, tech support and other implementation work.[16]

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Concerns[edit]

Data sharing[edit]

Care Everywhere is Epic's health information exchange software, which comes with its EHR system.[17] A 2014 article in The New York Times interviews two doctors who say that their Epic systems won't allow them to share data with users of competitors' software in a way that will satisfy the Meaningful Use requirements of the HITECH Act. At first, Epic charged a fee to send data to some non-Epic systems.[18] Epic says the yearly cost for an average-sized hospital is around $5,000 a year.[17] However, after Congressional hearings, Epic and other major software vendors announced that they would suspend per-transaction sharing fees.[19] Epic customers must still pay for one-time costs of linking Epic systems to each individual non-Epic system with which they wish to exchange data; in contrast, Epic's competitors have formed the CommonWell Health Alliance which set a common interoperability standard for electronic health records.[19] A 2014 report by the RAND Corporation described Epic as a 'closed' platform that made it 'challenging and costly for hospitals' to interconnect with the clinical or billing software of other companies.[20] The report also cited other research showing that Epic's implementation in the Kaiser Permanente system led to efficiency losses. Implementation in the Hennepin Health system did not change outcomes for critically ill patients; however, physicians complained of workflow interruptions and slower processes of care.[citation needed]

In September 2017, Epic announced Share Everywhere, which allows patients to authorize any provider who has internet access to view their record in Epic and to send progress notes back.[21]

UK experience[edit]

An Epic electronic health record system costing £200 million was installed at Cambridge University Hospitals NHS Foundation Trust in October 2014, the first installation of an Epic system in the UK.[22][23]

After 2.1 million records were transferred to it, it developed serious problems and the system became unstable.[24] Ambulances were diverted to other hospitals for five hours and hospital consultants noted issues with blood transfusion and pathology services.[25] Other problems included delays to emergency care and appointments, and problems with discharge letters, clinical letters and pathology test results.[23] Chief information officer, Afzal Chaudhry, said 'well over 90% of implementation proceeded successfully'.[22]

In July 2015, the BBC reported that the hospital's finances were being investigated.[26] In September 2015, both the CEO and CFO of the hospital resigned.[27] Problems with the clinical-records system, which were said to have compromised the 'ability to report, highlight and take action on data' and to prescribe medication properly, were held to be contributory factors in the organization's sudden failure.[28] In February 2016, digitalhealth.net reported that Clare Marx, president of the Royal College of Surgeons of England and member of the NHS National Information Board, found that at the time of implementation, 'staff, patients and management rapidly and catastrophically lost confidence in the system. That took months and a huge amount of effort to rebuild.'[29]

Danish experience[edit]

Danish health authorities spent 2.8 billion DKK on the implementation of an Epic system for the two largest health regions in Denmark. An audit of the implementation that voiced concerns was published in June 2018.[30] At the end of 2018, 62% of physicians expressed they were not satisfied with the system.[31]

See also[edit]

References[edit]

  1. ^Eisen, Mark (June 20, 2008). 'Epic Systems: Epic Tale'. Isthmus. Archived from the original on December 19, 2013. Retrieved December 18, 2013.
  2. ^Conn, Joseph (March 10, 2015). 'As Epic Systems has soared, Madison has become a center for health information technology'. Modern Healthcare. Archived from the original on May 22, 2018. Retrieved December 8, 2017.
  3. ^Jeff Glaze - Wisconsin State Journal. 'Epic Systems draws on literature greats for its next expansion'. madison.com. Archived from the original on January 9, 2015. Retrieved January 23, 2015.
  4. ^ abGlaze, Jeff (January 6, 2015). 'Epic Systems draws on literature greats for its next expansion'. Wisconsin State Journal. Archived from the original on January 9, 2015. Retrieved January 23, 2015.
  5. ^Eisen, Marc (June 20, 2008). 'Epic Systems Corporation: An Epic timeline'. Isthmus. Archived from the original on May 22, 2011. Retrieved February 20, 2009.
  6. ^'Epic Systems soars with transition to electronic health records'. Archived from the original on November 16, 2016. Retrieved November 15, 2016.
  7. ^Boulton, Guy (August 24, 2008). 'Epic Systems' $300 million expansion tangible sign of success'. Milwaukee Journal Sentinel. Archived from the original on February 4, 2016. Retrieved January 28, 2016.
  8. ^Newman, Judy (April 8, 2019). 'Electronic health records giant Epic Systems turns 40'. Wisconsin State Journal. Retrieved June 5, 2019.
  9. ^Glad, Jack. 'Epic EMR – EHR Review'. EHRSoftware.US. Archived from the original on August 2, 2016. Retrieved August 2, 2016.
  10. ^'Epic Systems lands Best in KLAS award 8th year in a row'. Healthcare IT News. Archived from the original on June 29, 2018. Retrieved June 29, 2018.
  11. ^ abcFreudenheim, Milt (January 14, 2012). 'Digitizing Health Records, Before It Was Cool'. The New York Times. Archived from the original on December 25, 2016. Retrieved September 26, 2014.
  12. ^'Kaiser Permanente CEO on saving lives, money'. USA Today. October 23, 2012. Archived from the original on January 26, 2015. Retrieved December 21, 2014.
  13. ^'Electronic Medical Records at The Mount Sinai Medical Center Shown to Greatly Improve Quality of Care'. Archived from the original on April 15, 2015. Retrieved April 9, 2015.
  14. ^Reilly, Mark (July 14, 2017). 'Mayo Clinic begins shift to $1.5B digital records system from Epic Systems'. Milwaukee Business Journal. Retrieved November 26, 2018.
  15. ^'Partners HealthCare's new computer system challenges some doctors, nurses - The Boston Globe'. BostonGlobe.com. May 16, 2016. Archived from the original on April 15, 2017. Retrieved May 17, 2017.
  16. ^Gawande, Atul. 'Why Doctors Hate Their Computers'. The New Yorker. Retrieved November 7, 2018.
  17. ^ abSullivan, Mark (December 8, 2014). 'Saying Epic is a Closed System is an Oversimplification'. Venture Beat. Archived from the original on January 25, 2015. Retrieved January 23, 2015.
  18. ^Creswell, Julie (September 30, 2014). 'Doctors Find Barriers to Sharing Digital Medical Records'. The New York Times. Archived from the original on January 23, 2015. Retrieved January 23, 2015.
  19. ^ abCaldwell, Patrick (October 2015). 'EPIC FAIL. Digitizing America's medical records was supposed to help patients and save money. Why hasn't that happened?'. Mother Jones. Archived from the original on September 7, 2017. Retrieved September 6, 2017.
  20. ^Kobb, Enesha; Sauser, Kori (2014). Electronic Health Records(PDF). RAND. Archived(PDF) from the original on March 22, 2016. Retrieved March 7, 2016.
  21. ^Boulton, Guy (November 10, 2017). 'Epic Systems lets patients share medical records with doctors around the world'. Milwaukee Journal Sentinel. Retrieved November 16, 2017.
  22. ^ ab'Addenbrooke's Hospital paperless system's 'significant problems' reported'. BBC News. November 24, 2014. Archived from the original on November 27, 2014. Retrieved December 21, 2014.
  23. ^ ab''Major incident' declared for flagship IT project'. Health Service Journal. November 25, 2014. Archived from the original on December 23, 2014. Retrieved December 23, 2014.
  24. ^'The NHS's chaotic IT systems show no sign of recovery'. The Guardian. December 21, 2014. Archived from the original on December 21, 2014. Retrieved December 21, 2014.
  25. ^'Addenbrooke's consultants reveal eHospital concerns in letter to management'. Cambridge News. December 11, 2014. Archived from the original on January 3, 2015. Retrieved December 21, 2014.
  26. ^'Addenbrooke's Hospital's e-hospital finances investigated'. July 31, 2015. Archived from the original on December 3, 2016. Retrieved May 17, 2017 – via www.BBC.co.uk.
  27. ^'Addenbrooke's Hospital chief executive Keith McNeil resigns'. September 14, 2015. Archived from the original on August 17, 2017. Retrieved May 17, 2017 – via www.BBC.co.uk.
  28. ^'Addenbrooke's and Rosie hospitals' patients 'put at risk''. BBC News. September 22, 2015. Archived from the original on September 24, 2015. Retrieved October 3, 2015.
  29. ^McBeth, Rebecca (February 25, 2016). 'EPR implementation led to 'catastrophic loss of confidence''. Digital Health Intelligence Limited. Archived from the original on February 28, 2016. Retrieved March 7, 2016.
  30. ^'Har brukt 2,8 milliarder på ny plattform: – Ikke mulig å tro at profesjonelle aktører er i stand til å lage et så elendig produkt'. Digi.no (in Norwegian). Archived from the original on June 25, 2018. Retrieved June 25, 2018.
  31. ^Christensen, Mikkel Fyhn; Sturlason, Astrid Sofie (January 23, 2019). 'Blå blok vil droppe Sundhedsplatformen: »Har gjort det værre for sundhedspersonale og patienter i stedet for at gøre det bedre«'. Berlingske.dk.

External links[edit]

Epi Software Systems Free

  • Epic, state's largest solar producer, to build own wind farm - Milwaukee Journal Sentinel article
  • Epic Systems feeling heat over interoperability - Modern healthcare article
  • Epic Systems, Leading Defense EHR Bidder, Slammed for Lack of Interoperability - Nextgov article
  • Patient records giant Epic Systems will take a big step into the cloud in 2015 - VentureBeat article
  • Cancer moonshot head recounts exchange with Epic’s Faulkner - Politico article

Epi Information Software

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