“This is like the utopian dream of wouldn’t it be cool if we had all this data in one place?” With so many “tech bros” running the federal government, you would think one of them said this. Instead, it is a line from the 180th minute of the latest Acquired podcast episode on the history of Epic Systems, the dominant electronic health records company. I explain how this 4-hour podcast about a uniquely powerful company in the healthcare system provides interesting insight into how health data is collected and analyzed, in the One Thoughtful Paragraph.
This week’s news highlights provide other interesting insights:
- The White House announced an extension of the federal hiring freeze through July 15, 2025. The administration is also making it easier to fire federal employees by removing long-time civil service protections. This Health Affairs Forefront article explains how the recent massive federal HHS staff layoffs are creating waste and inefficiency.
- Rock Health offers takeaways from its digital health survey last month, nicely laid out here by blogger Jane Sarasohn-Kahn, explaining that how consumers use digital health tools depends on their age.
- Surescripts received TEFCA QHIN status, bringing the total number of QHINs to nine and expanding the national health information sharing infrastructure.
“We will see it all. Because knowing is good. But knowing everything is better.” This line from the bad movie The Circle (with Tom Hanks and Emma Watson, best known as Hermione Granger in the Harry Potter movies) came to mind after listening to the Acquired podcast episode about Epic. The Circle is about a creepy big tech company that is trying to gather all the information about everyone, everywhere, purportedly for good purposes, but (spoiler alert) bad things happen. The 4-hour Epic podcast—which you do not have to listen to because someone helpfully summarized it here—comes at a time when our new healthcare leaders in the federal government are trying to gather all of the health data they can into one database. There are lots of examples, but maybe the best one is a NIH slide deck dated April 21, 2025, showing the vision for a real-world data platform. “The opportunities are endless” says Tom Hanks’ character in The Circle. It’s true that having more health data available to researchers and analysts and, yes, AI models, can fast-track our medical breakthroughs and make the system more efficient and work better for clinicians, patients, and every other player in the ecosystem. But: the podcast about Epic makes it clear that this sensitive patient data is kept private for both human privacy and profit reasons. As the podcast guys say, in an explanation for why Epic is notorious for prohibiting other tech vendors from accessing the 20 million patient records that are exchanged daily by the company: “They have been very, very careful about this one over the years … I mean, you don’t want patient data to leak…But [it is] also massively in Epic’s interest for that to be the case.”
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