Health-care systems expect savings from Epic Systems Corp.

Improving the portability and usability of electronic health records have been national goals for more than a decade, and Boulder Community Health’s move to the Epic Systems Corp. in October puts the medical system near the front of the pack.

“Epic gives our physicians and clinical staff the latest tools for providing optimal medical care, and our patients get access to a user-friendly patient portal that makes it easier and more convenient to connect with BCH,” said Michael Jefferies, vice president and chief information officer.  “By far, rated by staff and patients, the best product was Epic. The biggest question was could we afford to implement it.”

Steve Hess, the chief information officer for UCHealth, said his organization first adopted the Epic system in 2011 at the UCHealth University of Colorado Hospital in Aurora, and has been gradually extending it to the other 12 hospitals and numerous clinics as the UCHealth system grows. Both he and Jeffries noted the 20 top hospitals in U.S. News & World Report’s Best Hospitals rankings for use Epic.

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“Pretty much everyone, other than HealthONE and Banner (Health in Colorado) is on Epic,” Hess said. “I think Colorado is far ahead of almost all the states (in adopting EHR technologies),” Hess said. “There is collaboration on health care; we’re not competing on technology.”

BCH replaced two EHR systems used for hospital services and physician clinics, and was able to complete the transfer of systems for what was actually a relatively inexpensive $18 million.

“Our (BCH) team has been working crazy hours, and it didn’t get paid an extra dime,” Jeffries said. “And we had access to very talented people here; 100 percent of the people we hired (temporarily) were local.”

By contrast UCHealth’s initial implementation was about $60 million, though that was replacing several existing EHR systems and early technology adoption is always more expensive. Extending it to other hospitals and clinics, most recently Yampa Valley and Pikes Peak hospitals, resulted in instant savings, Hess said.

Initially, “you are building the house,” Hess said. Meanwhile, the system has provided not only savings in dealing with record keeping, but also extended UCHealth’s ability to conduct virtual health visits and thus extend the availability of specialists and super sub specialists (such as oncologists who specialize in particular cancers).

Hess said that extending virtual patient visits saves rural patients about 110,000 miles of travel annually, but the hospitals can create other savings in IT staff and record keeping. Both CIOs said they expect the system to save both the health systems and their patients money in the long term.

“We can create vast savings in utilizing virtual health care,” Hess said. “For instance, if a patient is deemed a fall risk, in the old days you would put a (staff) person in that room to watch that person. Now a nurse can wheel the cart in the room and a tech can watch 12 people at one time.”

Jeffries said the system not only creates a continuity of care for patients within the BCH system, it helps create a continuity of care when patients go outside the system for specialized care. In the first weeks of operating the Epic system, the system exchanged records with 290 organizations across the United States, with the Mayo Clinic in the top 10 of the number of records exchanged.

During the last decade, the federal government encouraged creating programs to more fully use EHR through legislation that increased payments, for instance, for Medicare reimbursement, and then later on by penalizing health systems that were not using EHR. However, neither Jeffries nor Hess said those were great considerations with their respective organizations.

Both said that creating future savings within their IT budgets, while increasing communication with patients, were of greater concern. Again they both extolled the merits of Epic, which also has an app by which patients can book visits and access their own health records in a very secure environment.

Epic, a privately held company, also has another aspect that both Jeffries and Hess noted. The system is not unlike open source communities, in that if one organization makes improvements, those improvements are available to all the other Epic clients.

UCHealth has already created such a program, which allows doctors to see what their patients will pay for drugs at the moment they are prescribed, regardless of what insurance or pharmacy is used. The program actually required changes in the base Epic system, but now it is available to BCH, as well.

“It’s one of those things you might think, why couldn’t we already do this?”