
Epic Tells Customers It Will Stop Google Cloud Integrations - nsriv
https://www.healthcareitnews.com/news/epic-tells-customers-it-will-stop-google-cloud-integrations-says-report
======
leoh
Google is absolutely doing the right thing. Anything that can be done to
enhance the efficacy of EMR software will help lead to better patient
outcomes. As far as I can tell, Google is approaching the problem foremost
from the perspective of "how can we make people healthier by making software
more effective." Epic and Cerner are simply not doing that. Somewhere in the
comments here someone mentioned that most EMR software is a billing system
with record keeping attached. Although implementations vary between hospitals,
the software is always purchased by administrators, typically with little
input from doctors.

In most implementations, neither Cerner not Epic encourage structured data
recording except for billing codes. This means that if a patient comes through
the medical system frequently, doctors have to read pages and pages of
unstructured text to get a sense of what's going on for the patient. The
software is designed to be sold to administrators and, as currently designed
is unquestionably leading to worse outcomes for patients.

Google has made a lot of mistakes. If they build something doctors truly want
to use and that helps properly organize information, however, and if Google
doesn't misuse the data/people aren't unreasonably paranoid about data misuse,
it will be a godsend for the industry and it will save lives.

We haven't even begun to talk about the potential for machine learning and
statistics to understand what treatments are most effective if data are
structured properly. This is unquestionably an interesting and unique case
where collecting massive amounts of data and handing in to a trusted,
competent, creative, research-oriented authority could have incredible benefit
for mankind. I don't trust Cerner or Epic with this mission for a second.

~~~
fauigerzigerk
The problem is that Google has the most obvious conflict of interest of all
cloud and AI providers when it comes to data use.

Many people simply don't believe anything Google says, and even those who do
believe them to some degree know that others won't.

Google has become a reputational hazard in fields that deal with sensitive
data such as healthcare.

Some decisions made by current management don't help at all. Instead of
separating the advertising business from other activities like cloud and AI,
they are moving in the exact opposite direction.

Why? I find this entirely baffling.

~~~
loceng
It's data ownership laws and adequate monitoring (including whistle blower
laws with adequate rewards) and enforcement that is necessary. Replace
"Google" with any unknown or known bad actor that can be taken over by a bad
actor, and we return to the same problem.

~~~
fauigerzigerk
At the end of the day you're right, but look at it from the perspective of a
healthcare decision maker.

What if something questionable happens, even if it's legal, and you're found
to have handed over patient data to Google, the largest ad targeting firm on
the planet?

Pointing at legalities will not save your reputation or your job in the face
of glaring misalignment of interests.

It's like letting your dog guard your employer's sausages after giving it
state of the art training in self control.

~~~
loceng
I understand that monitoring and keeping people in check, and perhaps you're
right that there should be a physical barrier between certain systems, however
there's still nothing stopping bad actors from infiltrating in these systems.
I personally think ads should be obliterated, as they're simply shallow and
cheap methods of manipulating people; Presidential candidate Andrew Yang's
plan is to tax ads higher in his VAT strategy than other things, progressively
increase it over time, basically as a mechanism similar to a carbon tax
countering pollution that's bad for us. Tesla spends no money on advertising,
the word of mouth and media attention they get is all earned - meanwhile other
vehicle manufacturers compete through emotional ads spend money which
increases the cost of the vehicles, perpetuates the ad industrial complex, and
to some degree limits people's depth of critical thinking for their buying
decisions re: the emotional manipulation of ads bombarding them to build a
good, relatable feeling, familiarizing them with specific products to make it
feel like a safe, good choice.

~~~
fauigerzigerk
I don't think ads should be obliterated. People will always try to influence
other people and ads are just one way of doing that. In my opinion, there are
far more nefarious, manipulative and intransparent ways of pursuing the same
goal.

Also, ads are currently indispensible for privacy as weird as that may sound.
There is currently no widespread, privacy preserving form of electronic
payment, and I very much doubt that there will ever be one.

What we should do is regulate/restrict ad targeting and make sure that
advertising is as transparent as possible.

But none of that has anything to do with Google's reputation issues and
conflict of interest. Google should split off its ad business from all other
activities. Otherwise they will always remain an advertising company and
distrust in everything else they do will only grow.

~~~
loceng
How about an "ad system" that people actively engage with when they're wanting
to discover vs. being bombarded everywhere - perhaps not understanding the
implications of manipulation of ads have on them? At minimum it changes the
user experience greatly.

~~~
fauigerzigerk
We can always wish for things to be less annoying, but the difficult question
is how to make it happen without causing more unintended consequences than
intended ones.

You have to ask yourself what advertisers would do if you ban those in-your-
face super annoying ads. Stop spending money on trying to influence our
decisions? I don't think so.

~~~
loceng
Except other methods will certainly cost more, bringing their cost of products
up, and so someone's products who are better and known as such through word of
mouth will have a competitive advantage on price.

~~~
fauigerzigerk
I'm not so sure about that. Ad spending has remained roughly the same as a
share of GDP for over a century.

[https://www.bloomberg.com/news/articles/2014-03-03/advertisi...](https://www.bloomberg.com/news/articles/2014-03-03/advertisings-
century-of-flat-line-growth)

I think transparency is more important than fighting annoyances.

------
kyrra
Googler, opinions are my own.

WSJ has had some good converge about parallel medical record stories that are
going on right now too, as has CNBC:

[https://www.cnbc.com/2020/01/17/epic-systems-warns-
customers...](https://www.cnbc.com/2020/01/17/epic-systems-warns-customers-it-
will-stop-supporting-google-cloud.html)

[https://www.wsj.com/articles/paging-dr-google-how-the-
tech-g...](https://www.wsj.com/articles/paging-dr-google-how-the-tech-giant-
is-laying-claim-to-health-data-11578719700)

WSJ podcast about it: [https://www.wsj.com/podcasts/the-journal/why-google-is-
pushi...](https://www.wsj.com/podcasts/the-journal/why-google-is-pushing-into-
health-data/19d0dbe3-fe29-4c6d-a547-926df9a3ec89)

To quote the end of the WSJ article:

> Existing players in the health-care data market also fear that the tech
> giant will gain too much power in their industry. Some hospital and
> technology executives say they declined deals with Google lest it become a
> future competitor.

> “We could never pin down Google on what their true business model was,” says
> a Cerner executive involved in the discussions.

~~~
platform
Oracle has done the same in the last 25 years. Company I worked for used
Oracle database for an enterprise system.

Oracle over the years, acquired some of our competitors.

Then every time customers would need to renew database licenses with Oracle,
Oracle's sales reps would try to sell them the competing enterprise systems
that they had acquired.

------
semerda
Epic is a cash cow private company. Sutter Health in the Bay Area paid $1B for
its EHR. Epic stays quiet to protect its walled gardens; deeply integrated
into hospital infrastructure. No doubt Google is a threat to them.

Here’s an old article I found that references this juicy revenue opportunity
(the rest have been cleared by Epic, so the story goes):
[https://www.healthcareitnews.com/news/setback-sutter-
after-1...](https://www.healthcareitnews.com/news/setback-sutter-after-1b-ehr-
system%20crashes)

~~~
stygiansonic
I talked to a doctor at Stanford and he mentioned to me one reason why the
main Stanford Health and Stanford Children's Health have separate patient
portals (not unified) that you have to create separate logins for is because
of the huge amount Epic wanted to charge to merge them. (They both run
separate Epic instances as far as I can tell)

~~~
echelon
How are leeches like this tolerated? The sooner they are driven out of
business, the better.

~~~
warent
They're not entirely tolerated fortunately. The US government has been taking
action to tear down EHR walled gardens via the Cures Act[1] which is
manifesting in public access APIs called FHIR.

[1]
[https://en.wikipedia.org/wiki/21st_Century_Cures_Act](https://en.wikipedia.org/wiki/21st_Century_Cures_Act)

~~~
parasubvert
FHIR is nice but doesn’t completely reduce the complexity of integrating the
underlying data itself considering the mess that is HL7 and mess that occurred
with v3.

The situation is sort of like moving from SOAP+XML Schemas to REST/JSON.
Easier to develop, but the underlying data structures are still extremely
complicated and tricky to get right.

This is especially true when dealing with ancient systems written in niche
languages/database hybrids (MUMPS comes to mind):
[https://en.m.wikipedia.org/wiki/MUMPS](https://en.m.wikipedia.org/wiki/MUMPS)

~~~
tomrod
Do you feel OMOP helps to resolve this?

~~~
parasubvert
YES! If only people in healthcare IT would adopt things in years rather than
decades...

------
killjoywashere
This is a head-in-the-sand move by US companies (not just Cerner and Epic, but
the hospital system CIOs). If they really think Google is going after
healthcare data, they should keep in mind Google is already working with NHS
and has a little thing called the Billion Users project focused on India. The
British and Indian populations have the same health problems Americans do.
Proportions might change, but the content is qualitatively the same.

Also, I wonder if AWS is pushing their heads into the sand. Particularly now
that Cerner committed to AWS but DoD gave Jedi to Azure (Defense Health and VA
are migrating their medical records to Cerner). AWS may be pressuring a
customer (Epic) to squeeze _their_ customers. Which absolutely sounds like
something I'd expect from Amazon.

~~~
powowow
Your AWS conspiracy theory is bizarre.

~~~
dang
Would you please stop breaking the site guidelines? You've been doing it a
lot, unfortunately, and we're hoping for more thoughtful conversation here.

[https://news.ycombinator.com/newsguidelines.html](https://news.ycombinator.com/newsguidelines.html)

------
tallgiraffe
Epic is ruthless and takes competition out by any means necessary. They are a
dinosaur that avoided competition for decades, and Google is a massive thread.
This is good news because they are scared, and Google has an infinite runaway
to take them out. Epic should have worked tirelessly to innovate and improve
US healthcare, but instead chose to stay still and to profit. They won’t be
for long.

~~~
ksmsnxn
Is Google going to try to compete in the EHR space? I don’t think of them as
an enterprise software company - at least not in the same way as an Oracle or
MSFT. My impression of their strategy/focus is that they are trying to sell
cloud compute and ML services?

~~~
tallgiraffe
I feel like Google is an everything company. Traditionally EHR has been done
via enterprise and connections, but it doesn’t mean google can’t change it. In
fact, they could open a network of Google hospitals, and run their own
software on them, or buy a big chain. Much like Amazon got WholeFoods, Google
can get into the game if they choose to, and at the end of the day, if they
want to grow, they will have to find more avenues to expand to.

~~~
aguyfromnb
> _In fact, they could open a network of Google hospitals, and run their own
> software on them, or buy a big chain. Much like Amazon got WholeFoods,_

I'm a fan of Google, but what's with people thinking Silicon Valley companies
can easily "get into" everything? What business is Google in that leads you to
believe they could run hospitals? They couldn't even design a decent social
network, which is their _wheelhouse_. At least Amazon was selling groceries
before they bought Whole Foods.

~~~
bagacrap
I thought they designed a perfectly serviceable social network. As a product I
thought it worked better than Facebook. It wasn't enough better to beat the
network effect of the latter, however, and medical records keeping would
likely be an even tougher nut to crack. How are you going to convince a
hospital that just spent $10M on an epic install to switch to your version,
even if it is 15% better?

~~~
fjp
By undercutting the hell out of Epic (at least to start) is what I would
expect.

------
twodave
I really don’t think this has anything to do with competition (if anything
Google is competing with Amazon and Microsoft here, not Epic). The article
muddies the waters somewhat, but all the quotes are telling a story that says
(not untruthfully) they’re dropping it due to its outsized maintenance burden
in relation to the proportion of their clients who use it.

~~~
neandrake
There might be some fear of competition. Google is offering healthcare
solutions some of which seem to be angled at "owning" the healthcare data. I'm
only vaguely familiar with Epic's offerings but a lot of these solutions that
Google offers seem to encroach in that territory:

[https://cloud.google.com/solutions/healthcare-life-
sciences/](https://cloud.google.com/solutions/healthcare-life-sciences/)

[https://cloud.google.com/solutions/modernize-legacy-
apps/](https://cloud.google.com/solutions/modernize-legacy-apps/)

[https://cloud.google.com/healthcare/](https://cloud.google.com/healthcare/)

~~~
avocado4
Google is now building an EHR as direct competition to Epic. It's definitely
related to this move. Fwiw I welcome Google's entrance to this market because
Epic's EHR and business practices are equally aweful.

~~~
bryanrasmussen
Do you mean that Epic's EHR and business practices are equally awful to each
other, or to Google's EHR and business practices (is Google's EHR in the state
that its awfulness can be proclaimed?)

~~~
avocado4
Epic's is significantly worse than Google's.

------
blakesterz
I didn't really understand what this meant until the very end of the actual
MSNBC article. At least I think I get it now.

“We’ve historically seen hospital systems make these decisions independently
of their medical record provider,” said Aneesh Chopra, the president of
health-technology company CareJourney and the former chief technology officer
of the United States. “It will be interesting to see if Epic’s thumb on the
scale moves cloud market share.”

So apparently if I'm a hospital I can run the Epic systems anywhere, or at
least store my records anywhere, well, at least at AWS or Azure, and
apparently not Google now.

~~~
bcrosby95
Sure, but:

> That report notes that "insufficient interest" from Epic customers in Google
> is behind the decision to focus efforts instead with those cloud
> competitors.

It seems like if you run Epic Systems at Google, you were in a minority that
is apparently not worth supporting. This seems less like Epic putting their
thumb on the scale, and more like their customers putting their thumb on the
scale.

~~~
reaperducer
I have only limited experience in the healthcare space when it comes to cloud
selection, but I can tell you that every single healthcare company I work with
uses Azure.

They don't do it because it may or may not be right for their needs. They pick
Azure because somewhere along the line the mid- and upper-level managers,
including director-level IT people, have been made to believe that anything
other than Windows is insecure and not suitable for HIPAA.

If I even mention the word "Linux" or "AWS" to them they immediately curl up
in a little ball mentally and treat me like I'm some kind of evil script
kiddie, or magical wizard. It's truly baffling the responses I get from people
who are supposed to be in charge of these things.

I don't know these people outside of boardroom presentations, so I don't know
how they got this way. My best guess is that it's either Microsoft salesmen,
industry conferences, or simply what they're comfortable with and anything
else is not worth risking their jobs.

~~~
commandar
>They pick Azure because somewhere along the line the mid- and upper-level
managers, including director-level IT people, have been made to believe that
anything other than Windows is insecure and not suitable for HIPAA.

I'd argue it's less because of a belief that a non-Windows environment is
inherently insecure and more that Microsoft very aggressively promotes their
products as being compliant with regulations like HIPAA.

This isn't limited to PaaS. For example, I think that Teams will likely gain a
foothold in healthcare environments over Slack because MS markets Teams as
explicitly HIPAA compliant. (Slack explicitly is not).

Things like that buy them a lot of mindshare when it comes time to choose a
PaaS provider.

~~~
jsperx
“Director-level IT” healthcare person here. We use AWS but are evaluating
Azure because of the way Microsoft includes VDI in the form of Windows 10
Multi-Session licenses available only with Azure+Windows Virtual Desktop.
Classic Microsoft bundle approach.

Oh, and Slack _is_ available with HIPAA compliance —
[https://slack.com/help/articles/360020685594-slack-and-
hipaa](https://slack.com/help/articles/360020685594-slack-and-hipaa)

Also, as someone who actively shops for SaaS offerings for healthcare users, I
can say that AWS and Azure are some of the very, very few organizations who
offer anything with HIPAA compliance that isn’t locked away at the most
expensive “contact us for pricing” tier. It’s so annoying. Never a chance to
try a service with a low cost/stakes pilot/prototype because they hit you with
the full sales pitch and highest price points. Being able to dip our
proverbial toe into AWS with a low time/dollar commitment was a huge win.

~~~
tixocloud
Side note: interesting point on trying services with low cost/stakes
pilot/prototype. How would you expect to try things out? Would it be similar
to online demos that many other SaaS companies employ?

------
1290cc
Google is doing the right thing.

EPIC is a perfect example of the walled garden ecosystem that extracts every
last drop from its clients and keeps anyone trying to innovate out. Healthcare
tech could use the competition to drive down costs related to medical record
management and exchange.

~~~
neuro_image3
Absolutely. | Also EPIC is spectacularly unfit for purpose.

Total garbage software that essentially functions as a billing tool.

~~~
ShirtlessRod
How is it "garbage software"?

~~~
JshWright
It's a billing system with clinical related functionality tacked on. It's
pretty frustrating to use from the perspective of a "boots on the ground"
user.

~~~
ShirtlessRod
That's a pretty pessimistic and quite frankly not accurate assessment of the
software. They have a ton of clinical functionality, and that's what the
majority of the dev/design spends their time on at their users group meeting,
among other places. You might not like it, but many do.

~~~
JshWright
My clinical experience with Epic is limited to emergency care, but I've yet to
meet a clinical user that "likes" Epic.

~~~
ShirtlessRod
I'm not really sure what to say to that, since you seem to be implying that no
one likes it, which is pretty patently false.

A lot of it does depend on the organization you're working with, as some are
more dysfunctional than others when it comes to setting up best practices and
build for their physicians. Others actually listen to their clinical users and
tailor the system for them.

~~~
JshWright
I'm not saying no one likes it, I'm saying none of the several dozen providers
and nurses I know (between two different hospitals in the area using Epic)
like it.

I also don't disagree with the fact that some of the issues arise from the
implementation requirements. But at some point, it's still the system's fault
if it allows its users to be burdened like that. It shouldn't take clicking
across three different pages and who knows how many modals to triage one
patient in an emergency room. It's silly that I've had to learn which order to
provide my transfer of care report so the nurse doesn't have to keep clicking
back and forth between different pages...

~~~
ShirtlessRod
I fundamentally disagree with the idea that the system can somehow overcome
poor implementation; guardrails can only do so much. At the end of the day you
can set up almost any piece of software in a way that hinders rather than
helps a user. At some point the organization needs to take some responsibility
for that.

At any rate, this all started with a glib "garbage software" comment, so I
suppose I should happy that you acknowledge that the implementation
requirements set by the organization have at least something to do with
overall user satisfaction.

~~~
Dylan16807
> I fundamentally disagree with the idea that the system can somehow overcome
> poor implementation

If very large amounts of 'implementation' have to be done _on top_ of the
software, then that's also a sign of bad design. It should be handling more of
the implementation and making it more streamlined.

~~~
oarsinsync
You’ve just described Jira, or really any other heavily customisable tool that
can fit multiple complex workflows.

~~~
killjoywashere
Having used a dozen EMR systems and Jira, I'd say Jira is much better at its
job than most EMRs are at theirs. In fact, now that you mention it: you could
easily model each patient as an epic, assignments to various people on various
teams (ICU, pharmacy, lab, etc), to-do/in-progress/done. Holy cricky, you may
have just cracked the EMR nut.

~~~
TheCoelacanth
Just make sure you don't move the epic to "Done" status.

------
semerda
At Sutter, every machine is Windows and runs Epic integrated. Epic is much
more than EHR. It’s a hospital layer sitting ontop of Windows. Naturally, it
integrates with Active Directory and I can see why Google would have little
dominance.

Saying that, I wonder if Epic has a plan to go after smaller players who might
be using Google Apps and fears google’s dominance.

------
inscrutable
There seems to be major disengenuousness on behalf of EPIC and Cerner, and
some ignorance on behalf of WSJ.

GCP != Google Health, at least for the purposes of patient privacy. If you
hold the encryption keys, google can't do anything, or am I wrong in that
assumption?

It is fine, and expected, to rule out GCP for storing your own records for
competitive reasons (e.g. choosing them would make future Google Health
integrations easier). It is also expected, if not quite fine, to try to
actively prevent your customers from using GCP.

Cerner seemed happy to play a few rounds of golf with Eric Schmidt regarding
using GCP, presumably to try to glean insight into Google Health, while EPIC
flat out refused a meeting. Cerner then helpfully provided a misleading quote
to the WSJ to help spread FUD.

------
metafizikal
everyone has conspiracy theories about what is "really going on here", this is
to stamp out a competitive threat in google, or whatever, but I do think this
story probably is just that hospitals (and "traditional enterprises" broadly)
are not using GCP for their cloud infrastructure and are instead going with
AWS or Azure.

~~~
microcolonel
I still don't see why they have to be tied to a single provider. Seems like a
major weakness of large customers in this space, that they're unwilling to
demand standards or protect themselves from exploitation in this way.
Obviously there will be new APIs for services which are not yet a commodity,
but there are some highly standardized offerings from every major "cloud"
vendor which should be configurable in roughly the same way; many of them even
have similar limitations, like AWS and Azure (last I tried) not having the
option to expose their VPSes directly over IPv6.

------
organsnyder
Epic being concerned about a giant gaining too much power? That's cute.

~~~
karpodiem
Which of the two has a trillion dollar market cap with monopoly like market
share in multiple business to consumer product sectors?

There’s nothing novel about what Epic or any other B2B enterprise software
company does (for the most part), other than total addressable market (and
profits) being far smaller than the B2C FAANG giants - the market caps reflect
this as well.

~~~
manigandham
Microsoft, Amazon, and Google are all trillion dollar companies operating in
multiple sectors. Why is Google special in this regard?

~~~
karpodiem
Right. And while Epic does the heavy lifting of crafting software to support
healthcare provider workflows, integrating dissimilar systems (PACS, etc.),
and storing all that data, the companies you mentioned feel they can create
value by attempting to automate diagnosis and potentially offer some
integration point for genetic counseling.

~~~
killjoywashere
As a physician forced to use Epic, I'm not sure "crafted" is the word I'd use
to describe their software. It's more like they addressed the spec from the C
suite in a way that was equivalent to punching health care providers in the
face. They take Dad's money, and use it to pay thugs to beat up his kids.

~~~
asah
Serious q: are the other systems any better? Have you tried them? Have you
compared notes with physicians using them?

(I'm new to the field and genuinely curious... I haven't heard anybody saying
anything nice about any of them...)

~~~
phren0logy
I have not used all of them, but every one of them I've touched is hot
garbage. Like much enterprise software, the people who decide to buy it are
not the people that use it. It would seem, from the outside looking in, that
the majority of the effort goes into maximizing billing in the byzantine world
of US insurance rather than the work of actually making people well.

What concerns me most about the larger players in the field is their
dedication to minimizing interoperability to lock people into their software.

~~~
wslack
> Like much enterprise software, the people who decide to buy it are not the
> people that use it.

Hard agree. There's also an incentive for hospital systems to "hold onto"
patient data, which is not great.

~~~
JshWright
In many cases those "incentives" are legal requirements.

~~~
killjoywashere
Yeah, for clinical laboratories, for example, data retention requirements can
stretch back 10 years. And yes, the inspectors will inspect that.

------
logfromblammo
> _" This is not us mining somebody’s records to sell ads, to learn from it,
> to do machine learning, to develop products. We developed this on de-
> identified data."_

"De-identified data" _is_ "somebody's records".

Also, for all the PR put behind the patient, Epic (and likely Cerner too)
focus all their bizdev efforts on what the hospital and HMO administrators
want, because they're the ones that sign the checks. Back when I worked there,
they threw huge stacks of employees at customizing every installation, and
significant developer effort at making broad customization possible. If
patient care were the primary issue, every Epic implementation would be
identical at the keyboard shortcut level. Hospital admins would have had to
backdoor their customizations in by forcing their physicians and nurses to
demand them as features. But instead, I saw page after page of customizations,
inserting arbitrary administrator-created workflows on the staff via the
software.

------
berbec
Has it become "nobody got fired for using AWS"?

~~~
organsnyder
In healthcare, absolutely. And it was only a few years ago that it was "on-
prem" instead of "AWS".

~~~
ska
on-prem still is, in a lot of the space. But it's changing.

------
codred
Major part of Google Health team came from Deep Mind. We have a lot of doctors
and people used to work for NHS. Our goal to help doctors, nurses in their
work, save patients lives and revolutionise the industry. We are complient
with privicy regulations and see huge potential in what we do. Majority of
negative comments are driven by fear of Google selling data for targeted adds
but in all our agreements with trust we clearly state our goals and practices.
I'd rather people concentrate on positive side and huge potentials in front of
us instead of FUD.

------
tasssko
To be fair if anyone is going to take on Epic its big tech. What is really
needed is legislation to protect your data. This area seems ready for
disruption.

------
toomuchtodo
Doesn’t bode well for Google’s cloud ambitions, but squares with what the
marketplace looks like (clients absolutely hungry for those with Azure
experience and AWS to a lesser extent). Azure is unpleasant to work with, but
the deals are apparently being made (mostly outside of tech centric firms).
Kudos to MS’ sales teams.

~~~
bfung
^^^ spot on. My thought while reading the article was how poor Google’s sales
and customer support culture is across the entire company that has led to non-
tech firms picking solutions with Azure and AWS who invest heavily on the
support side.

~~~
l33tman
I was operating a fairly large AWS operation, and had the idea to at least
check with G Cloud if they were interested (usually you get a boatload of free
credits to startups).

After 3 emails spread over several months I eventually got a note saying I
should expect to talk with my Google Cloud salesguy, but it can only happen
over a Hangout. And not any hangout - they sent a cheap ass Android "netbook"
that I had to physically go to the post office to get, that the Hangout call
was supposed to happen through.

I did get it from the post office, noted that it took minutes to start up,
then gave it away and never heard from GC again.

~~~
guitarsteve
That’s so strange. Does anyone know why they’d want to chat using special
hardware?

~~~
killjoywashere
Because he's l33tman, man. l33t.

~~~
l33tman
Haha exactly!

No, I'm sure they could have accepted any Hangouts call or being coerced into
accepting a phonecall as well.

But truthfully what they wrote in the sendout was like I described - they
outlined the procedure to go get the netbook and use it and at no point did
they suggest a physical phone number to call or similar. I went along with it
as far as I did just because I was kind of baffled by the suggested procedure
:)

I assume it was part of some marketing scheme to try to market Hangouts and/or
Chromebooks (or whatever it was) at the same time as GCP, but it just confused
the sale and added unnecessary pain-points. The AWS guys just send an email
and let me call them by a normal phone.

------
leshokunin
Might want to specify which Epic. I was left wondering in what way Fortnite
was connected to Google Cloud integrations.

~~~
flounder3
Did you read the article? It begins with "Electronic health record giant Epic
Systems..."

~~~
whiddershins
From the guidelines:

‘ Please don't comment on whether someone read an article. "Did you even read
the article? It mentions that" can be shortened to "The article mentions
that." ‘

------
maxtollenaar
Used to intern at Epic in 2015. I asked my manager why they weren't on cloud.
He said our customer data is too critical to be stored in cloud. Interesting
how things have change in a very short time

------
eschaton
So no running MUMPS code on Google Cloud then?

~~~
killjoywashere
Actually, VMWare supports OpenVMS and VMWare runs in GCP, so MUMPS should be
good to go.

------
zerotolerance
Before I read the article I was guessing that it had to do with the leaked
memo regarding Google cloud growth targets and the popular conclusion that
they'll be shutting it down or pivoting that LoB in 2023.

[https://news.ycombinator.com/item?id=21815260](https://news.ycombinator.com/item?id=21815260)

------
synaesthesisx
I don't blame them - from my understanding there are certain Google Cloud
services that have glaring security holes/are legitimately HIPAA violations.

~~~
dontblink
It's amazing to me how social media is used to spread FUD against some
companies. Please provide sources.

~~~
synaesthesisx
It's amazing to me how social media is used by employees to shill certain
corporations.

[https://www.managedcaremag.com/dailynews/20191113/hhs-
invest...](https://www.managedcaremag.com/dailynews/20191113/hhs-
investigating-google-ascensions-project-nightingale-hipaa-violations)

[https://healthitsecurity.com/news/google-uchicago-
medicine-s...](https://healthitsecurity.com/news/google-uchicago-medicine-
sued-for-sharing-identifiable-patient-data)

I've heard there are a couple Google Ventures - backed healthcare startups
that have questionable HIPAA-compliance as well, directly from clients that
have worked with them. They're not necessarily holes in GCP itself but rather
in integrations with certain services.

~~~
briffle
Neither of those are Google cloud related

------
gsich
Smart choice, considering the shutdown of GCE in 2023.

~~~
metahost
Are you being sarcastic?

~~~
gsich
No. [https://www.cnbc.com/2019/12/17/google-reportedly-wants-
to-b...](https://www.cnbc.com/2019/12/17/google-reportedly-wants-to-be-top-
two-player-in-cloud-by-2023.html)

The dementi was overspecific. "We did not discuss this in 2018". Which could
mean they discussed it in 2019 or 2017.

------
jeanvalmarc
GCP seems culturally a terrible fit for anything compliance-related. Azure and
AWS both offer high-compliance regions (Azure Government / AWS GovCloud) that
are absolutely necessary for many industries (medical, defense, etc). Slightly
salty about this as I am currently migrating a legacy Firebase app because
Google doesn't care...

~~~
xyst
Government Cloud seems to revolve around “access controls” to the cloud
instances. I skimmed over one of specifications (“FedRAMP”) and most of the
requirements seem like the standard requirements for any type of multi-tenant
system (eg, user login expiry).

Doesn’t seem like it offers anything different from the “non-government”
packages.

------
Narkov
> “We could never pin down Google on what their true business model was,” says
> a Cerner executive involved in the discussions.

Imagine being that insecure in what you do. What were they looking for? A non-
compete from Google? Innovate or die.

~~~
briffle
Especially when Amazon is making moves into insurance and pharmacy spaces

~~~
deanCommie
The difference is Amazon won't use confidential AWS data to drive their other
verticals.

Google's very business model is selling their users to their customers.

~~~
daave
Google states unequivocally in its Cloud privacy documentation:

    
    
      3. Know that customer data is not used for advertising.
      
      You own your data. Google Cloud does not process your data for advertising purposes.
    

[https://cloud.google.com/security/privacy/](https://cloud.google.com/security/privacy/)

~~~
meddlepal
But they may process it for non-advertising purposes? That feels... flimsy

~~~
daave
That page links to [https://cloud.google.com/terms/data-processing-
terms](https://cloud.google.com/terms/data-processing-terms), which has a lot
more detail.

I believe usage for ads is highlighted on the non-legalese privacy page
because it's a common question/concern, but the terms specify that data can
only be processed as requested by the customer (IANAL, but that's my read and
understanding as a Googler who works on Cloud infrastructure).

~~~
killjoywashere
I would go further and say you're crazy if you think a Google engineer is
going to run code on your data without a requirement in a signed and funded
agreement.

------
shmerl
Does anyone know, if Epic implemented parallelized Vulkan renderer in their
engine, or they dropped the whole parallelization effort and enabling Vulkan
for high end features? If anyone is using it for development, please comment.

Epic "archived" their TODO item on Trello:
[https://trello.com/c/lzLwtb5P/124-vulkan-for-pc-and-
linux](https://trello.com/c/lzLwtb5P/124-vulkan-for-pc-and-linux)

~~~
grzm
Epic is not Epic

\-
[https://en.wikipedia.org/wiki/Epic_Systems](https://en.wikipedia.org/wiki/Epic_Systems)

\-
[https://en.wikipedia.org/wiki/Epic_Games_Store](https://en.wikipedia.org/wiki/Epic_Games_Store)

~~~
shmerl
Oh, thanks for clarifying, I confused them with different Epic indeed.

~~~
danielbln
You're not alone, I went down a few comment threads in here being more and
more surprised that Epic games has such a strong foothold in the health market
already. Whoops, guess it pays off to actually read the article.

