“The Epic project impacts many different aspects of care in our organization from clinical areas like nursing, to the providers that administer health care, and to the patients themselves. It also involves the revenue cycle operations. There are a lot of areas across SGMC that are impacted—it is not an IT project but an entire organizational project.” — Michael Spence, SGMC Epic Project Director
The method of gathering and storing information is radically growing with the use of digital technology. Computers, smartphones, tablets, etc., have become commonplace in an ever-evolving global society.
The management of healthcare records is a significant part of the electronic phenomenon. The days of endless pages of medical records, which contain physician notes, lab results, and the history of a patient’s medical overview, are becoming obsolete as hospitals and medical offices across the nation are moving toward integrated electronic health record (EHR) systems.
In April 2016, South Georgia Medical Center (SGMC) began implementation of Epic, an EHR system that is fully integrated and includes registration and scheduling, clinical information, lab results, current and past prescriptions, and an overview of a patient’s health history.
Epic, founded in 1979, is one of the leading national companies that develops software for hospitals and medical facilities. According to Epic, more than 190 million patients have current electronic records in hospitals, clinics, and health facilities using the Epic system.
“The move to Epic was based on knowledge that the current EHR system was going to be sunset by its provider,” said Michael Spence, SGMC Epic project director. “We did a market search and identified national leaders in the (EHR) field. We then conducted product demonstrations and selected Epic as the best product to meet the needs of SGMC.”
SGMC is a multi-campus hospital system with facilities in Lowndes, Berrien, and Lanier counties. When Epic is fully operational, it will replace 17 applications currently being used in varying degrees of utilization at SGMC campuses.
“If we have a patient that has been seen at the Berrien County facility, then a month later comes to the main hospital there would be longitudinal data about that first visit,” Spence said. “The provider and clinicians know the patient’s allergies, home medications, and other vital information. That longitudinal data will help provide quality care to the patient.”
According to Spence, the Epic system implementation is a multi-phase process that began in early 2016 with the selection of approximately 65 Epic team members.
“We needed first to find the right team, which is currently 65 employees with a variety of diverse experience, this includes five project managers,” Spence said. “We hired 17 new SGMC employees; however, most transitioned from other areas within the hospital.”
Spence said that getting the right players on the team was a critical start to the project implementation.
“We made sure we have ‘subject matter experts’ who are the nurses, billing and claims analysts, and quality improvement specialists…basically people from departments across the organization,” Spence said. “These are the people that know the workflow and how to best meet the needs of the patients.”
He explains that the experts also understand the regulatory compliance and National Patient Safety Goals.
“The Epic project impacts many different aspects of care in our organization from clinical areas like nursing, to the providers that administer health care, and to the patients themselves. It also involves the revenue cycle operations,” Spence said. “There are a lot of areas across SGMC that are impacted—it is not an IT project but an entire organizational project.”
The next step involved extensive training and certification of the Epic project team, which is comprised of analysts, trainers, business intelligence developers (report writers), and technical staff.
“Epic is very prescriptive about the way their system is implemented,” Spence said. “Each team member had to complete the training and then pass a test to become certified.”
Once the training was completed, team members began the actual design process.
“We held numerous meetings and sessions with SGMC’s operational staff to teach them about Epic and what it can do, as well as get their input on workflow,” Spence said. “We called these direction sessions, and they helped us begin to design SGMC’s Epic system.”
Once the design process is completed, the team will move to the adoption phase.
“During the adoption phase we will have four different phases of build,” Spence explains. “The reason it is divided is that we will begin building the program in sections, then go to the operational people for input…we want to see if we are on the right track and make changes, then go back again and again.”
Testing the application and training the end-users are part of the final phase before full implementation takes place in November 2017.
“The Epic team is a passionate group of people and at the core of their passion is that they understand they are building a better system for our patients,” Spence said. “Many of them have never worked in a hospital before or even in IT, but they are really passionate that what we are doing is innovative.”
Spence admits the process has been difficult at times, but the long-term benefits to the SGMC organization is an important outcome.
“These teams are doing a very hard job, and they are not always the favorite person because we are challenging the culture,” Spence said. “We are challenging the ‘that’s the way we have always done it’ process. It is hard, but we see the positive benefits to the organization and our patients.”
Patients also benefit from the Epic system through the Care Everywhere Network and the My Chart portal.
The Care Everywhere program allows a patient’s Epic EHR to be available when they receive care at any medical facility using the Epic system. The Care Everywhere Network provides valuable insights to physicians including patient allergies, results of recent tests and imaging studies. It also provides information on drug interactions and overprescribing of medications. Another feature of the Care Everywhere application is if the patient moves to an alternate healthcare facility in another town or state, his or her record can be accessed just as easily by their medical professionals.
According to Epic, the Care Everywhere network exchanges more than 5 million patient records a month with affiliated Epic systems and other organization including more than 900 organizations through the eHealth Exchange members (Department of Veterans Affairs, Social Security Administration, and Department of Defense).
The MyChart application will replace the current MyHealth SGMC.
“The patient benefits from Epic because they now have a better input into their care through the patient portal,” Spence said. “The Epic MyChart application allows them to see their lab results and other information so that they can work closely with their providers.”