(Reprinted from the Metro Spirit, 9/15/2011)
To say that the healthcare industry is undergoing significant change is probably an understatement. In the past few years, sweeping changes in federal regulations have prompted changes in virtually every area of healthcare. Of particular interest to IT professionals, the 2009 ARRA-HITECH act provides $19.2 billion to increase the adoption rate of Electronic Health Records (EHR). These incentive payments are available to eligible providers and hospitals that demonstrate “Meaningful Use” of EHR systems. Payment schedules depend on the number of Medicare or Medicaid patients treated, but Eligible Providers could receive up to $63,750 per provider over a 6-year period. Hospitals payments depend on a number of factors, but begin with a $2 million base payment. Needless to say, many Augusta-area healthcare organizations are taking a look at their information systems and developing plans to become meaningful users.
The University Health Care System is one such organization. Late last year, University Health Care announced a $35 million project to replace their current medical information software with an EHR package developed by Epic Systems. Dr. Shannon Stinson, Vice President and Chief Medical Informatics Officer for University Health Care, is leading the implementation effort. The 5-year project began ramping up earlier this year. Physician practices are expected to transition to the new system late 2011/early 2012. Hospital operations will transition during the summer of 2012.
While satisfying the Meaningful Use criteria was a strong consideration, another goal of the project is to create a safer, more efficient and integrated health care experience for University patients. “Epic is built off a single platform. Everything is integrated, and that was very important for us,” stated Dr. Stinson. “Looking at Meaningful Use, you want to put your investment in the system that provides the easiest platform for your providers to use while also allowing them to seamlessly deliver quality patient care. We have a significant investment in our current system, but when we did the analysis with all things considered, for us, Epic came out on top.”
The Epic system provides physicians a number of improvements to patient treatment. In examples described by Dr. Stinson, the current hospital-based system does not integrate outside lab results or any information obtained by a patient’s primary doctor as a structured part of the current electronic health record. In addition, for physicians practicing outside the hospital walls, imaging is not available as an integrated part of the record. “Once Epic is live, it will allow any provider on Epic to easily view any information entered by another provider on University’s Epic platform including a patient’s past medical history, medications, procedures, labs, and imaging results directly in a single, integrated patient chart. Physicians will also be able to order tests from the hospital lab or other outside labs directly from the system. Results will be delivered electronically directly into the patient’s chart.” said Dr. Stinson. Physicians will no longer have to search through multiple sources and different forms of documentation in order to read and interpret a patient’s medical information.
Epic’s centralized patient database will allow the hospital to provide safer and timelier care in emergency situations. “Often, when patients arrive in the emergency room, we have no way of obtaining their chart in a timely manner. If the patient is alone and unconscious or unable to provide a history, we have no way of knowing what their medical history is, whether they have any allergies, or if they’re taking any medications,” said Dr. Stinson. With Epic, the medical records for all patients treated by University physicians will be available. Moreover, emergency room visits and hospital stays are documented directly in the patient’s health record and communicated back to the patient’s primary care physician for follow-up. This capability greatly improves the existing communications process between the primary care physician, the emergency room, and University Hospital.
Patients will directly benefit from the transition to Epic through its online patient portal. The patient portal enables a patient to access their medical history over the internet. Specific content is managed by the physician practices, but patients should be able to view such items as patient demographics, allergies, current medications and summary of care documents. Patients may also, at their physician’s discretion, be able to use the portal to request prescription refills, schedule appointments and complete intake paperwork prior to doctor visits. Notification of health record updates will also be possible. “When lab results are posted, the patient will receive an email saying that new information is available on the portal. They can login and review the results of the lab immediately, and not have to wait for a call from the doctor’s office.”
Data security and continuous operations are critical components of the implementation plan. As Dr. Stinson relates, “We will be locating our disaster recovery systems at an offsite location in order to maintain geographic diversity between our primary site and our disaster recovery site.” In this configuration, the system will continue to be fully operational, even if there were significant damage to the hospital data center. The implementation team considered a read-only disaster recovery alternative, but in the end decided on a read-write strategy. As Dr. Stinson states, “In an emergency, if I don’t have the ability to enter data into the system, it’s going to slow me down. In a disaster situation, that will add to the chaos. Having the stability of using Epic during a disaster situation in a similar fashion as we would for day-to-day operations will have a tremendous calming effect on those providing patient care in these often stressful situations.”
Of course, Epic contains a number of other surprises. “Epic has a bunch of capabilities that make you think, ‘That’s amazing! Who thought of that?’” says Dr. Stinson. For example, Health Information Exchange (HIE) is built into the system. Health records for other Epic sites or other certified systems can be retrieved and uploaded into the local system. Dashboards provide real-time snapshots of clinical performance measures. Measures of productivity, charges, patient volume and many others are possible and can be aggregated by physician, group or specialty.
So, Dr. Stinson, what is the one thing our readers should take away from our discussion of Epic? “Epic is going to be a phenomenal platform for our physicians and clinicians to provide excellent, high quality, safe, and effective patient care. Epic is a robust system that provides a tremendous amount of capability to our physicians. Each physician practices a little bit differently, and the system provides the flexibility to adapt to different styles. We believe that University Health Care patients will be more satisfied with the delivery of health care when their physicians begin using Epic, and they will love the ability to participate in their health care experience by accessing their health information at any time and from anywhere.”
Any physicians interested in implementing Epic in their practice should contact Dr. Stinson at 706-774-7716 or email at firstname.lastname@example.org.
A big Metro Spirit thanks to Dr. Stinson and University Health Care for sharing Epic with us. Until next time, I’ll see you on the Internet…tweet me @gregory_a_baker. L8R.