October 15, 2018
Focus on information technology

A year after launching Epic, UMass Memorial will update its electronic records

Photo | File
Nurses train on the Epic system before its 2017 launch.

A year ago, UMass Memorial Health Care made a belated leap into using electronic patient records, capping off a four-year planning period and a $650-million investment.

"It took years of planning just to get to the point of last October," Mark Sugrue, associate chief nursing officer for the Worcester-based health network.

More than a year after its Oct. 1, 2017 rollout, however, UMass officials says they have seen the benefit of such a wide-scale investment at its hospitals and in physicians' offices.

Now, nurses or doctors can instantly see, for example, an emergency room patient has an important allergy or had recently seen a doctor about a relevant medical issue. Before, a provider might have to call the patient's primary care physician or even have records faxed.

After an intial adjustment period by nonprofit's 12,000 medical providers, the electronic records system – known as Epic – has brought clear benefits, said Tim Tarnowski, the chief information officer for UMass Memorial.

"We've settled in nicely," he said.

An entirely new system

Epic replaced what had been 120 different records systems – some electronic, some still on paper – from across UMass Medical Center and other medical offices in the system. Combing through an uncountable number of patient records to digitize them was a herculean effort spurring UMass to hire 125 new employees to handle the upgrade.

UMass appeared to be late to adopt an electronic system across its whole operation. A 2015 survey by the National Center for Health Statistics found 95 percent of office-based physicians in Massachusetts used an electronic health or medical records system.

But many went digital only fairly recently. A report last year from industry trade publication Medical Economics found 38 percent of physicians had adopted electronic records within the past four years, and the average time since making the switch was six years.

For UMass, going digital meant a long planning process and a major financial commitment at a time when hospitals are as pressed as ever to balance rising costs for care with patient needs. Roughly 1,200 doctors, nurses and other providers helped choose Epic as a vendor and then helped design what the program would look like when tailored for UMass.

"For an organization like ours, it takes a lot of courage, right up to the board of directors, to sign off on something like that because it's such a huge investment," Sugrue said.

Those entering old patient records into the system – with everything from allergies and medications to records of visits – had to ensure every detail was right. Tests like X-rays were scanned.

"We don't have the wiggle room of a high failure rate with this," Sugrue said.

Keeping records safe

With all patient records now computerized, problems with accessibility are solved. But another potential problem arises: theft or other malicious acts.

A 2017 Office of the National Coordinator for Health Information Technology found 10 percent of patients still withhold giving some information to health care providers because of privacy or security concerns. Two out of three patients said they were concerned about unauthorized viewing of their records when the records are exchanged between parties.

UMass Memorial itself has had issues.

In September, UMass was ordered to pay the state $230,000 after complaints of two data breaches exposing personal and health records of more than 15,000 patients. Attorney General Maura Healey's office said two former employees of the hospital accessed patients' personal and health information for fraudulent purposes, including opening cell phone accounts and new credit cards.

UMass said the incidents took place four years ago and since then, it has implemented more safeguards.

The Epic system comes with its own safeguards. Information is kept not in Worcester but in Wisconsin at Epic's offices. A redundant records-keeping system is in Minnesota, Sugrue said.

Work is never done

For UMass, the transition has gone well enough the network received stage-7 certification by the industry group HIMSS Analytics. Only 2 percent of hospitals receive such a designation for its medical records system capabilities for both the acute and outpatient settings, UMass said.

But the job isn't done. Technology upgrades weren't finished last October when Epic went online. Staff has spent much of the time since then responding to any issues and gauging its ease-of-use with providers.

An employee survey of inpatient physicians on the new records system found a 60-percent satisfaction rate, said Tarnowski, who was hired as UMass' first chief information officer as part of the Epic rollout.

Because upgrading to Epic took so long, UMass isn't running on the latest operating system. The network's system is the 2015 version.

By Nov. 3, UMass is slated to upgrade to Epic's 2018 version, bringing another effort to the staff just as upgrading to the initial system was becoming habit.

"It doesn't end, and the investment continues," Sugrue said.

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