Why Hospitals Are Choosing Epic Overlooking Other EHR’s?

 Erika Regulsky Tags: , , , , , Billing & Collections, Epic EHR


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U.S. News and World Report after a detailed study have listed 20 Top Hospitals in the US. According to Becker’s Hospital Review, all 20 hospitals are using Epic. The prominent names include Mayo Clinic, John Hopkins Hospital, and Stanford Healthcare.

All of the 20 top-ranked hospitals are either live on Epic or in the midst of a transition to the Verona, Wis.-based company’s software, according to a study by Becker’s Hospital.

  1. Mayo Clinic (Rochester, Minn.)
  2. Cleveland Clinic
  3. The Johns Hopkins Hospital (Baltimore)
  4. Massachusetts General Hospital (Boston)
  5. Michigan Medicine (Ann Arbor)
  6. UCSF Medical Center (San Francisco)
  7. UCLA Medical Center (Los Angeles)
  8. Cedars-Sinai Medical Center (Los Angeles)
  9. Stanford (Calif.) Hospital
  10. NewYork-Presbyterian Hospital (New York City)
  11. Barnes-Jewish Hospital (St. Louis)
  12. Mayo Clinic Hospital (Phoenix)
  13. Northwestern Memorial Hospital (Chicago)
  14. Penn Presbyterian Medical Center (Philadelphia)
  15. NYU Langone Hospital (New York City)
  16. UPMC Presbyterian Shadyside (Pittsburgh)
  17. Vanderbilt University Medical Center (Nashville, Tenn.)
  18. The Mount Sinai Hospital (New York City)
  19. Duke University Hospital (Durham, N.C.)
  20. Brigham and Women’s Hospital (Boston)

A CIO who shares a different view about Epic Health Systems

John Halamka

John Halamka, MD, CIO of Beth Israel Deaconess Medical Center (BIDMC) is amongst the few prominent non-user of Epic Health Systems.

In a recent blog post ‘Life as a Healthcare CIO,’ he’s tried to figure out the potential motivation that most healthcare organizations consider before they choose Epic,  stating that most of his neighboring CIO’s and hospitals too are in the process of considering adopting an EHR from Epic.

He cites five reasons hospitals are choosing Epic over other EHR vendors.

Firstly, Epic has perfected a methodology convincing clinicians to adopt a single configuration for a single product. Except for a few CIO’s, Halamka states most IT management teams have not been able to motivate clinicians to standardize work.

Secondly, observes Halamka, adoption of Epic by hospitals eases the demands on health information managers and IT staff whose capabilities making changes to the system’s functionalities is dependent on the company’s release schedule for updates, upgrades, and the like.

Thirdly he says, the EHR Incentive Programs has facilitated the eligibility of many hospitals to participate in it, this has eliminated the worry over an EHR company’s sustainability or ability to achieve and maintain the meaningful use certification.

Since Epic observed Halamka has a strong track record of providing products and the change management required to help hospitals and professionals achieve meaningful use, it’s a safe bet for Meaningful Use Stage 2.

Fourthly, according to Halamka, the hospitals by adopting Epic, want to be on a safer side, considering its popularity. He observes that no one has got fired for buying Epic, and asserts that it doesn’t mean that the vendor’s EHR is without flaws. However, the healthcare CIO points out that having Epic EHR implemented is considered in some markets as a competitive advantage to attract and retain doctors.

Lastly, says Halamka, the Epic EHR system is streamlined providing a deeply integrated solution, and since some hospitals face interoperability challenges, they prefer taking a best-of-breed approach, besides with one go-to system, the Epic EHR System easily integrates with clinical settings.

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Prominent Users of Epic EHR System

Tanner Health System

Tanner Health System, a non-profit regional health system serving a nine-county area of west Georgia and east Alabama have chosen Epic has their new platform to advance healthcare.

Being the world’s leading comprehensive electronic health record network, the integrated Epic EHR system will cover five hospitals and more than 30 outpatient clinics and urgent care facilities.

The Tanner Health System on its website states that Epic Health System has been at the forefront of using technology to improve patient care. The health system, according to the website, was among the first in the nation to attest meaningful use of electronic medical records.

Further on the website states, Epic has implemented new technologies through the years, making health information more readily available for providers throughout the continuum of care.

Another aspect of the Epic Health System that’s been featured on the website states that the population health and patient portal tools that come with Epic may prove invaluable in capturing data and empowering patients to become more active participants in their health.

Tanner Health officials decided to implement the Epic EHR early in March 2018. As part of the EHR selection process, physicians and staff members had evaluated systems from different EHR vendors.

Tanner Had Relied on Multiple EHR Systems Earlier

The health organization relied on multiple health systems, the hospital relied on one system, while Tanner Medical Group practices were tied to a different system, and the emergency departments were supported by a third system.

According to hospital sources, there were no functionality issues using multiple systems, but gathering patient’s health information and piecing them together took a lot of effort and time.

The health organization is being assisted by over 100 IT professionals and clinicians to facilitate the EHR implementation and to ensure the workflow runs smoothly. The Epic coordination team includes nurses, physicians, pharmacists, and other professionals.

Another prominent hospital, Johns Hopkins Medicine has found Epic as the preferred electronic medical record system. According to hospital sources, the health system is used by more than 250 health care organizations nationwide, and as per statistics, 45 percent of the US population has their medical records in an Epic system.

The hospital’s institution-wide implementation having been completed, the Epic System allows one chart to follow patients throughout the hospital’s network in multiple areas where they can receive care. Patients can access their health records through the ‘MyChart’ function of the health system.

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Epic’s Edge over Other EHR Systems

Epic’s interoperability feature for coordinated patient care

Dave Fuhrmann, Vice President of interoperability at Epic Systems, explained to Healthcare IT News that their systems support interoperability in four different ways.

  • Since the patient’s record is on one shared database, Community Connect enables an organization using Epic to share the information with other providers in the community.
  • The EpicCare Link which is web-enabled allows community providers’ access patient chart on a web portal, facilitating patient care follow-up across the health system, scheduling appointments, placing orders, sending notes and more.
  • Epic’s C-CDA Push/Pull Interoperability – Care Everywhere attribute sends out requests to other health systems when a patient walks in for care at a health system using Epic, it sends an automated request to send the summary of the patient’s record, and receives the standardized summary (C-CDA) and incorporates the new data within the patient’s record.
  • The Push/Pull interoperability attribute has a subset named Direct Messaging; it enables an organization that is currently seeing the patient to send the standardized C-CDA summary to another organization. This is for the benefit of referrals.

The Epic System has an included feature called Happy Together, it enables patients and providers to see data from multiple sources in a merged portal view, on a single window.  Another attribute called, Working Together, enables health systems to check duplicate lab order, retrieve reference-quality images, scheduling, messaging, and searching other health system networks, within the same Epic platform.

The Epic Health System includes a second basic type of interoperability, which is patient-directed interoperability, the feature Epic’s ‘Share Everywhere’, using the patient portal ‘MyChart’ allows patients to view their own record, facilitating a temporary web view of their own record to any other entity with an internet connection.

According to Dave, Epic’s vice president of interoperability, there’s a third type of interoperability included in the system, it integrates other software products used by healthcare organizations. This support is extended through APIs, interfaces, incorporating other technologies, enabling billions of interface messages and API calls monthly.

 Interoperability Attributes cannot be ignored by Healthcare CIO’s

While considering an EHR purchase, healthcare CIO’s while reviewing the features of the system should specifically be looking at interoperability attributes available in the system.

Dave recommends asking EHR vendor’s the definition of interoperability, to determine if it matches their needs. The CIOs, according to Dave should ask vendor’s these questions:

  • How many records do their health system exchange every day? Does it support C-CDA exchange?
  • What is the percentage of their customers that are able to interoperate?
  • Will a patient portal be available, allowing patients to access their own records, and share their health records with their family members, or direct them to other providers?
  • How does the system integrate outside information at the point of care, would there be a separate screen available to view outside data, or would it be intermingled with the physicians own system’s data?
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Survey Determines the Physicians EHR Preferences

As part of a survey conducted by Reaction Data, the research firm asked 889 physicians to discuss their EHR’s, off them 43 percent respondents belonged to acute care facilities, and 57 percent from ambulatory facilities.

Almost 33 percent of respondents stated they would renew their contracts with Epic, while 18 percent opted to renew their contract with Cerner, and only 7 percent decided to have their contracts renewed with Athena Health.

On a scale of 0 to 10, the respondents were asked to rank their satisfaction:

Allscripts EHR
  • Only 16 percent of Allscripts’ users ranked the vendor a seven or above.
  • The average bed count for Allscripts’ happiest customers is 207 with 239 physicians.
  • The majority of Allscripts’ happiest customers are ambulatory facilities.
Athena health EHR
  • Nearly 39 percent of athenahealth’s users ranked the vendor a seven or above.
  • The average bed count for athenahealth’s happiest customers is 246, with 135 physicians.
  • The majority of athenahealth’s happiest customers are ambulatory facilities.
Cerner EHR
  • Twenty-two percent of Cerner’s users ranked the vendor a seven or above.
  • The average bed count for Cerner’s happiest customers is 562, with 586 physicians.
  • The majority of Cerner’s happiest customers are acute care facilities.
eClinicalWorks EHR
  • Roughly 53 percent of eClinicalWorks’ users ranked the vendor a seven or above.
  • The average bed count for eClinicalWorks’ happiest customers is 568, with 291 physicians.
  • All of eClinicalWorks’ customers come from ambulatory facilities.
Epic
  • About 45 percent of Epic’s users ranked the vendor a seven or above.
  • The average bed count for Epic’s happiest customers is 421, with 1,343 physicians.
  • The majority of Epic’s happiest customers are acute care facilities.
GE Healthcare
  • Roughly 47 percent of GE Healthcare’s users ranked the vendor a seven or above.
  • The average bed count for GE Healthcare’s happiest customers is 611, with 1,141 physicians.
  • All of GE Healthcare’s customers come from ambulatory facilities.
Greenway Health
  • Sixteen percent of Greenway’s users ranked the vendor a seven or above.
  • The average bed count for Greenway’s happiest customers is 51, with 17 physicians.
  • All of Greenway’s customers come from ambulatory facilities.
Meditech
  • About 15 percent of Meditech’s users ranked the vendor a seven or above.
  • The average bed count for Meditech’s happiest customers is 114, with 177 physicians.
  • The majority of Meditech’s happiest customers are ambulatory facilities.
  • Nearly 25 percent of NextGen’s users ranked the vendor a seven or above.
  • The average bed count for NextGen’s happiest customers is 183, with 1,020 physicians.
  • All of NextGen’s customers come from ambulatory facilities.
Practice Fusion
  • Nearly 70 percent of Practice Fusion’s users ranked the vendor a seven or above.
  • The average bed count for Practice Fusion’s happiest customers is 362, with 498 physicians.
  • All Practice Fusion’s customers come from ambulatory facilities

According to hospital sources, having an integrated system enables continuity and quality of care. The patient information can be shared and duplication of investigations can be avoided. Besides, communication is enhanced among providers, and between provider and patient.

Many hospitals have initiated the process of Epic EHR implementation in 2019. The University of Health System in April this year spent $170 million on implementing the Epic system, the health organization sources state that they want to cut down hospital cost, and improve quality of patient care in the next few years.

Likewise, Catholic Health System would be spending $135 million on an Epic EHR replacement in February, and intend completing the implementation by the end of 2020.

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I’m a multi-certified revenue cycle management professional and compliance officer with 20+ years of experience. I contribute articles to leading healthcare publications and journals. I am currently working as Senior Transition Manager, in BillingParadise headquartered at Diamond bar, California. BillingParadise offers Medical Billing Services that intersect perfectly with the EMR/Practice management system you use.BillingParadise has offices in New Jersey, New York, Florida, Georgia, Minnesota, and Texas.


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