Game Review: EPIC EHR

When entering orders, various red exclamation points appear to hinder your progress. Exciting!

UPDATE (2/20/13): EPIC has banned my use of the screenshots.  The original post follows, considerably damaged by the lack of screenshots.  Thanks a lot, EPIC!
Here at EP Studios we don’t often venture into the entertainment realm of computing, but alas here we’ll make an exception, given the medical subject of this game.  EPIC EHR (for Electronic Health Record) asks the player to envision an alternative universe ruled from behind the scenes by a group known only as “The Digerati” (a conglomerate of government, business, and alien forces) whose motive is to take every human task and “digitize” it, no matter how ill-suited for this kind of treatment.  The scope of this conspiracy includes the field of Medicine.  The world of paper medical charts, unit secretaries transcribing written orders, and doctors giving verbal orders over the phone has been deemed too dangerous to continue, because of the unwieldiness of the records, the risk of transcription errors, and illegibility of doctors’ handwriting.  Showing a modicum of humor in an otherwise humorless game, the solution to all this is to completely throw out this admittedly flawed but tried and true system and substitute an electronic health record (EHR) system, so that every medical practitioner must log onto a computer (which must be profligate to make this work) for every action taken.  Medical records are now entrusted not to paper, which has a half-life of thousands of years (remember Egyptian papyri are still around) but to silicon and hard disks, fragile and changeable digital formats that are easily hackable and suspect to attacks from computer viruses.  Order entry is not by experienced unit secretaries who have spent years interpreting doctors’ handwritten orders, backed by nurses who can recognize what the doctor was trying to actually order, but by the doctors themselves on the computer!  Reports are no longer written by experienced medical transcriptionists, but are directly typed into the computer by these same hapless doctors or via a computerized dictation program that randomly substitutes words (such as “rectum” for “recognize”) to liven up these reports.  Of course this is just science fiction.  No society would actually believe that this would help reduce medical errors.  But nevertheless this alternate reality is the basis of this game, and if the player can get past the implausibility of this premise, a challenging game playing experience is ahead of them.

Typical game screen. Note the insane layout of nested tabs and toolbars. Two of the "Meaningful Use" Mark as Reviewed buttons are shown.
Typical game screen. Note the insane layout of nested tabs and toolbars. Two of the “Meaningful Use” Mark as Reviewed buttons are shown.

EPIC is the name of the computer program that you interact with during the game.  You play as a physician in a busy medical practice.  Your practice has shifted over to this new EPIC program.  Unlike traditional medical games though, you are not scored on patient outcomes.  Instead you are rated on what is called “Meaningful Use” (I am tempted to rename it “Meaningless Use”).  Essentially what this consists of is the following.  During the course of each patient visit, while you are desperately clicking around in the program to locate information (I should note that the program provides screen after screen of decoy information — i.e. screens that look important but don’t actually contain any useful information), various buttons appear that look unimportant, but which are critical for you to click.  These buttons don’t actually do anything other than record that you have clicked them.  Nevertheless if you fail to click these buttons you incur a financial penalty, and this is the whole basis of the game.  Sound easy?  Well, not really.  Remember you are also a doctor, seeing patients at a good clip and these patients have real medical problems that you also have to address.  It turns out to be very easy to forget to click some button when under time pressure and when dealing with complex medical problems.  Fortunately the game does have different modes: Easy, Hard, and Insane.  Hard is the default mode, and consists of seeing 80% of the patient volume you used to see before switching to EPIC.  I have not tried the Insane mode, which is 100% of your prior patient volume, but I am told it is virtually unplayable.

An example of a hidden Mark as Reviewed button. Click on the Vital Signs link and this hidden button appears. Cha-Ching!
An example of a hidden Mark as Reviewed button. Click on the Vital Signs link and this hidden button appears. Cha-Ching!

One criticism of the game is that it is not very realistic.  If a system such as EPIC was ever devised for the real world, it would not be the caricature of computer user interfaces that is contained in the game.  No real computer program would contain the multiple layers of tabs and toolbars that the game has.  In a real program that requires a secure login there would not be buttons to push to confirm that you are looking at a screen that you could only be looking at if you had not already logged in.  In other words, if someone did want to track your usage of the program it could be done very easily without the idiotic “Meaningful Use” buttons scattered through this program.  Since the buttons are there only to enhance reimbursement, I think it would add to the game play if they stuck a dollar sign icon on the buttons and added a “cha-ching” cash register sound every time you pressed one of the buttons.

Failure to click the "Make Me Author" button while writing your progress note costs you points.
Failure to click the “Make Me Author” button while writing your progress note costs you points.

Overall I rate the game 2 stars out of 5.  Playing certainly gets the adrenaline going, but overall frustration with the game mechanics and unrealistic game premises lowered my score.  Also the game may be a bit pricey for the average gamer.

Rating: 2/5 stars

Price: $700,000,000

By mannd

I am a retired cardiac electrophysiologist who has worked both in private practice in Louisville, Kentucky and as a Professor of Medicine at the University of Colorado in Denver. I am interested not only in medicine, but also in computer programming, music, science fiction, fantasy, 30s pulp literature, and a whole lot more.


  1. Excellent! I also heard through the grapevine that there were many more interesting posts submitted in response to your original post, where are they?

  2. Put the screenshots back up, it is clearly fair use if no PHI. Don’t have to the empty threat from Epic.

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