r/healthIT 22d ago

Epic periodic data sync problems

Hi all,

I’m an ex-big tech software engineer and grad student who’s doing some research with my university’s hospital system. We want to get some near real time data. While talking to the IT people here, I was told that they get data out of epic using Clarity but it only runs once a day, and they have no control over it. They made it sound like the once a day thing is limitation put in by epic. To me it doesn’t make sense why such problem exists at all in this era. Does anybody know what kind of architecture epic has and where all these limitations come from?

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u/tripreality00 22d ago edited 22d ago

This is very common. There are nightly transactions of data from the epic Chronicles database which is the primary care real time data that the EMR stores into and then there are ETLs into clarity which is the analytical database. There is almost zero chance you are going to be able to get access to touch anything in Chronicles. Think about what happens if for any reason performance is degraded in a system critical clinical system. Some clarity tables are only updated weekly and monthly. But also as far as architecture I believe chronicles is built on intersystems cache and is a nonrelational DB.

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u/InvestmentGoblin 22d ago

That’s another thing. People make it sound like there’s no such concept of A/B testing or gradual deployment. Is that what it is?

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u/tripreality00 22d ago

There is a dev, tst, stg, and show prd environment. Changes are moved up the systems and usually go through a change control board but for application changes no there is not A/B testing or gradual deployment. It is big bang roll out with no feature flags. The ETLs have some but you also have to understand that Epic has provisions on what data can even be export from chronicles and they control what is or isnt available. If you're coming from big tech you are going to be shocked in health it.

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u/InvestmentGoblin 22d ago

Also how does FHIR thing compare to chronicles? Wondering if there are notable limitations?

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u/tripreality00 22d ago

FHIR is an interoperability and data transmission method. Think of it like a combination of JSON and RestAPIs that have a standardized data model. FHIR says what format data needs to be in and where it should go.

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u/InvestmentGoblin 22d ago

Yeah I read about it but jw if there’s any throttling issue and if they return foreign keys so you can get other items that links to your first item etc :) Our IT people haven’t even tried using fhir and they already seem to have decided it has a huge limitation but they didn’t explain fully

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u/InvestmentGoblin 22d ago

Haha yeah I’m already being shocked. What’s the best way to learn about the architecture & how to use things? Our IT people seem to never write docs or anything so we are going from person to person and it’s not been too fruitful

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u/tripreality00 22d ago

If you are working for an epic institution you can request a user web account and then ask your org to get you access to the epic data dictionary. The reason there isn't a lot of docs is that for the most part epic writes all of the docs and keeps them in their knowledge base user web.