Epic CEO Judy Faulkner on developing new therapies for COVID-19

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CNBC’s Bertha Coombs interviews Epic Founder and CEO Judy Faulkner from CNBC’s Healthy Returns Summit today

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WHEN: Today, Tuesday, May 12, 2020

Following is the unofficial transcript of a CNBC interview with Epic Founder and CEO Judy Faulkner live from CNBC’s Healthy Returns virtual summit on Tuesday, May 12th.

Interview With Epic System CEO Judy Faulkner

TYLER MATHISEN:  Our next guest is one of the leading women in all of healthcare.  Judy Faulkner cofounded and is the CEO of Epic Systems, the software company that is in practically every hospital, clinic, doctor's office one way or another across the country and as such has unique insights into the immense amount of data that are generated through the healthcare system every single day and probably some insights on what we can learn about treating and developing new therapies for COVID.  Let's find out with Bertha Coombs and Judy Faulkner.  Take it away, Bertha.

BERTHA COOMBS:  Thanks very much, Tyler.  And Judy, thank you so much for joining us.  You were in the forefront of digital health and I can imagine over the last couple of months things have just fast-tracked incredibly, from building field hospitals for New York health systems with hundreds of beds, complete with their Epic charts, to helping some of these same frontline clinicians track and predict what is going to be happening with their patients.  Tell us about what some of that process has been like, particularly what you developed, the deterioration index.

JUDITH FAULKNER:  Okay.  You've covered a bunch of things.  Thank you, Bertha.  Good to see you. Well, we've been, as you said, really, really busy.  And it's been interesting.  I think of our health systems as heros.  They're heros.  And we see our job as being heros helping heros, and we're proud to be that. Some of the things we've done, telehealth has been a big one.  It's been interesting.  On the average, our customers have increased by about a hundredfold.  Some of our customers have said they've gone from 20 telehealth visits a day to 8,000.  That's huge.  We installed over 200 health systems and we trained 5,000 people in telehealth.  We've got a COVID-19 dashboard that I'm told is used a lot.  It is something that keeps test metrics and capacities so that the executives of the organization know what is happening with COVID.  We've, as you mentioned, extended beds.  Normally it takes months to get a EHR system into an organization, and we were told to do it in three days.  And so, you know, after thinking that's impossible, we had to figure out how to do it in three days.  And that's what we've been doing, as you mentioned, in New York, in McCormick Place in Chicago, and in other areas as well.

We've also developed a portal with Cleveland Clinic that we call Care Companion, and that allows our health systems to send patients home with the software on the portal so that the software itself helps educate the patient, helps direct the patients what to do and alerts the health system if the health system needs to step in.

BERTHA COOMBS:  -- is a way for clinicians to share what they've seen.  And that helped you develop the deterioration index.  Can you talk to us about that?

JUDITH FAULKNER:  I missed the first words of what you just said.  What were the first words?  What helps?

BERTHA COOMBS:  You developed a -- you developed a deterioration index that helps predict which patients are going to --


BERTHA COOMBS:  -- become morbid.

JUDITH FAULKNER:  Yes, we did.  That's called the deterioration index.  And what happens is that when patients have a lot going on, they've got machines tied to them all over.  Those machines are spewing out tons of data and the human mind can't process that as quickly as electronic systems can do that. So our systems then evaluate that data, alert the clinicians hours ahead of time, which can be lifesaving in many cases, to the fact that the patient is rapidly deteriorating.  We've been testing this in over a hundred health systems now, -- said it works well.

BERTHA COOMBS:  You've also been working with a number of health systems on monitoring and taking a look at which drugs do and don't work well.  Oftentimes patients are --


BERTHA COOMBS:  -- already on certain drugs, including hydroxychloroquine, which has been talked a lot about.  And you've helped them figure out whether these might help in prevention and might help in treatment.  How -- how difficult was it to get that happening in real time?

JUDITH FAULKNER:  Well, it took -- everything we've been working on seems to take a lot of time to do it, and it's not easy either.  That's part of the trick of it, getting people to continue analyze the data.  Some cases we're looking at over a hundred million patients and trying to figure out what is going on with all of them.  For the medications that we looked at, we looked at about 30 medications to see if any of them were going to be protective of patients if they were taken before the patients were exposed to COVID.  And what we found, unfortunately, was none of them seemed to be protective. We're also looking at what seemed to work best after the patient does get COVID, and that's coming up in the future along with some other things.  Looking at plasma therapy, at Remdesivir.  One of the really interesting things that we're doing now is can you get it twice?  We're looking at patients who had COVID, then got better, then did they have COVID again because clearly we want to see whether your antibodies are protective.

BERTHA COOMBS:  You know, it's one of those things that, you know, I often talk to insurers, and I don't know anyone who loves their health insurer.  When I talk to hospital administrators, they all really have great things to say about your system. But then when you talk to the clinicians, they get frustrated, not just with your electronic records, but with all of them, because it's just unwieldy for them, and I would imagine especially -- and I've seen some of this, the social media -- especially in the middle of a crisis, it becomes unwieldy.  Have you looked at things to make it easier for these clinicians to use them and has watching this pandemic evolve made you think about changes to the -- to the electronic records to make them easier to use?

JUDITH FAULKNER:  Yeah, a few things.  We've constantly been looking at how do you make the system easier to use.  That's one thing that we have multiple people every day working on that, and we have for years.  It's kind of interesting.  I remember once being at a dinner and a man came up to me who was one of our physicians, and he said, "Why couldn't you make the system more like paper?  It should have a spiral around the side of it.  It should have tabs just like paper."  And then that same day another person came to me and said, "Why does the system look so much like paper?  This is the electronic world.  It needs to forget about paper and be creative."  And so it's a challenge.  And every physician uses the system differently than every other physician.  But your question was do we work on it?  We work on it a ton.  It's an important thing to do.  And you always have the challenge of ease of use versus power.  It needs to do all these things, but at the same time, it needs to be easy to use, and how do you do that.

BERTHA COOMBS:  One of the issues that people bring up is the issue of interoperability.  Particularly right now when we have a public health crisis, it would be nice if this data was able to flow across systems more organically and more easily.  You've been seen as someone who has opposed the government's efforts to bring about interoperability.  Have you rethought it during this pandemic as you look at clinicians trying to share data and trying to find the signal in all the noise?

JUDITH FAULKNER:  We were actually the originators of interoperability.  That was in the early 2000s, and it was because my husband, who's a physician, had a patient who was under good care, but she went with her family to another city.  She got sick, she went to the emergency department, and she died.  And he kept saying, "If they had had her record, they would have known what to do.  It was easy."  So I went to HIMSS' board, which take -- is the trade association for EHR vendors and for health system vendors in general. And I asked them when there was going to be standardization of data so that we can interoperate.  And their answer was pretty much "Don't hold your breath."  So we decided we could at least interoperate with those systems that we could manage, which were our Epic Systems, and we created interoperability for all the Epic users, and we went to every single Epic site and we put the interoperability in, and we retrofitted the software so that no matter what version of our software they had, the interoperability worked. So then later on interoperability became a meaningful use standard, and we follow that standard.  Not every vendor has done the same thing.  Some of them are going out and made sure that all the health system users are up to date with it and can do it.  So it's very hard that -- it's like a fax machine.  We can't send a fax to someone who doesn't have a fax machine, so you can't interoperate with someone who doesn't interoperate. Well, we got frustrated with not being able to interoperate with a health system that couldn't interoperate.  So we said, "let's stop thinking of that as an excuse, they can't interoperate, and figure out what we can do to make it -- them interoperate."  And so we created something called Share Everywhere, which basically injects a web viewer into the computer of whoever the patient is seeing who can't interoperate, and that allows them to interoperate with the Epic system that the patient came from. What that allows now is that the patients can be interoperable with any place in the world that has Internet capability.

BERTHA COOMBS:  We've got a question from one of our viewers, who says:  In your opinion, how should AI and clinician learning work ideally? Right now we need learning as well.  We need it to be fast.  Can we do it?

JUDITH FAULKNER:  How should AI and clinician teaming work ideally. AI has been around from the very beginning.  From the very beginning, computers tried to be more than just an electronic device for storing your words.  It tried to be a helper looking up things and telling you -- giving you advice as to what to do.  And that has continued on.  It's been embedded in every EHR system that I'm aware of. How do they team together, the physicians and the AI?  I think the more that we can help the physicians learn what the AI does and the more that the physicians can help learn what the AI does, the better it's going to work together.

BERTHA COOMBS: -- Things that you're looking at is a predictive analysis right now, and I wonder as we look toward next fall, if we've gotten through this first wave of COVID, we could see a second wave coming just as we have the flu coming as well. How can we provide clinicians with some predictive tools to be able to differentiate and figure out what -- which is influenza-like illness and which is actually COVID?

JUDITH FAULKNER:  I don't know.  I wouldn't be surprised if some of our staff know, but I don't know.

BERTHA COOMBS:  Is that one of the things that you're looking at, to try to give them the tools for this next phase of the pandemic?

JUDITH FAULKNER:  That's another thing I don't know.  I know some of the things we're looking at -- because what we're really trying to focus on is what can prevent getting COVID, what can save your life if you do get COVID?  Those are the two things we're focused on right now.  I think what you're asking makes a ton of sense, but I'm not aware that it's something we're working on right now.

BERTHA COOMBS:  All right.  Another viewer question.  I've got to put on my glasses so I can read it correctly. The Epic system -- is the Epic system interoperable with all the NCPDP communication standards?

JUDITH FAULKNER:  We are interoperative with every standard that I know that we should be interoperative with.  But I don't know the list of every standard, so I can't say yes or no.

BERTHA COOMBS:  I know that you all are interoperable and are able to export data via FHIR so that, for example, if I have a hospital record, it can go to my iPhone and I can take that record with me. Are there any protocols you think we need to think about particularly in the pandemic?  There's been so much discussion about being able to track and trace, but eventually also being able potentially to sort of say, "Look, I've been tested and I know I have antibodies."  Is that something that Epic can help with to help public health systems develop a way to be able to say, "Hey, I'm clear"?

JUDITH FAULKNER:  Yes, we're working with a group that is doing that, putting a marker on the phone that will say whether you are tested and you're clear, whether you are currently not safe, whether you have COVID right now, or whether -- so that would be red for if you have COVID now, it would be green if you're clear, and it would be yellow if it's unknown.  And we're working with a group that's doing that, and we said to them we'd like to do it for all our MyChart patients as well.  So we're putting that on MyChart as well so that they too will have that and you could go into a restaurant, show your signal to the people in the restaurant, and they'll know you're clear.

BERTHA COOMBS:  And within MyChart, then it would be HIPAA compliant.  That's one of the issues that you have raised with interoperability, allowing third parties that aren't in healthcare that wouldn't necessarily have to adhere to the same rules as healthcare vendors?

JUDITH FAULKNER:  That is correct.  The health care vendors are HIPAA compliant.  Other third parties don't have to.  And that becomes the choice of the individual, whether they want to extend their date of exposed or whether they don't.

BERTHA COOMBS:  So we have another question which follows on this and you sort of answered a little bit, but will it go any further -- would you go further and have COVID-19 tracking and tracing be folded into Epic's mobile platform?

JUDITH FAULKNER:  There was a poll done recently in one of the healthcare blogs.  And about two-thirds of the people said they wouldn't want that done and one-third said they would.  So we are watching the contact tracing and what people think of it to see about it.  But right now our feeling is that with so many people feeling it isn't the right thing to do, that it becomes too invasive, right now we are not going forward with that.

BERTHA COOMBS:  You know, you've talked a lot about privacy, particularly when it comes to your healthcare records.  We are entering an era where people may have to prove that they've been tested in order to go back to work, and maybe eventually actually prove that they take a vaccine. Do you have worries about what this means in terms of our healthcare records being maintained private?

JUDITH FAULKNER:  I'm not worried about the healthcare records that way.  I think that in fact you're right, that at some point until there is, if such a thing exists, a herd immunity, that we will have to be careful watching, and people will have to take responsibility for that themselves too, that if they are ill, they should not be out. There's a lot going on on that, and we're trying to help on that too.  That's the reason that some of the things that are being done, the telehealth, the Care Companion, are all there trying to help with that.

BERTHA COOMBS:  Judy Faulkner, thank you so much for joining us for Healthy Returns this year, and we hope you will come back in future years.

JUDITH FAULKNER:  Okay.  Thank you, Bertha.  It's an interesting time.

BERTHA COOMBS:  Certainly is. Tyler?

TYLER MATHISEN:  All right, Bertha.  And, Ms. Faulkner, thank you very much for your participation today.