Dozens of anonymous physicians at Partners are complaining about inefficiencies caused by an Epic implementation.
The $1.2-billion Epic implementation at Partners HealthCare remains on schedule, but some of the early adopters of the health system’s new EHR technology are reporting frustrations in learning and adapting to the new platform
The report appearing earlier this week included numerous anonymous sources voicing their dissatisfaction with the Epic EHR at Brigham and Woman’s Hospital, one of the first Partners sites to undergo the Epic implementation in May 2015.
“It usurps the physician-patient relationship,” one doctor told the Globe. “It was very difficult for me. It factored into my retirement.”
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This and other comments focused on the multitude of clicks, keystrokes, and other information entry-related tasks and the time it takes to complete documenting patient encounters.
“They say it has an insatiable demand for information that, keystroke by keystroke, click by click, overwhelms the already tightly wrapped day inside a hospital, eats away at time with patients, and sometimes forces them to work longer shifts,” reported Priyanka Dayal McCluskey. “Simple tasks like ordering medications and tests can take several minutes longer, forcing patients to wait around while staff navigate the system.”
According to the report, the volume of data stored in the Partners EHR system required a significant hardware refresh of computer monitors in order to probably display this information.
Leadership from Partners admitted that complexity necessarily follows an Epic implementation of this size and scope.
“Any implementation of something this large is going to be rocky at times, and I am actually pretty satisfied with the way it went,” Chief Clinical Officer Gregg S. Meyer, MD, MSc, maintained. “I’m not sure I agree that doctors are feeling demoralized. I’m sure some of them do. There are others who very quickly say wonderful things about it.”
While the Epic implementation has represented a burden for some, others reported reaping benefits in the form of improved efficiency, such as neurologist Marie Pasinski, MD, of Massachusetts General Hospital who spent upwards of 18 hours in EHR training to prepare for the switch to the Epic EHR.
“It is a very complex system with lots of bells and whistles,” Pasinski opined. “It’s probably easier as a specialist because you’re just dealing with one organ system.”
A major source of the EHR-related frustration at Partners stems from the use of a notification system criticized for overwhelming doctors with hundreds of messages daily. According to McClusky, Brigham officials took it upon themselves to convene a task force to address this pain point head on, and that work continues to this day.
“We’ve made tremendous progress,” Brigham COO Ron Walls, MD, said. “There are still some frustrated clinicians out there. There were many more.”
A previous Globe report shone negative light on the financial implications Partners is facing in part because of its EHR vendor selection of Epic Systems.
The health system reported a $60-million drop in operating income between 2014 and 2015. Investment losses accounted for $37.5 million. The total cost of ownership for going with Epic Systems is reported to approach $200 million over three years — software, hardware, training, etc.
All the “losses” aside, Partners still netted $3 billion in revenue, a 6-percent improvement over the quarter.
The same report references Brigham EHR implementation and the financial losses resulting from a loss in productivity and a reduced number patient visits. However, the most recent report indicated that subsequent Partners EHR go-lives at MGH, Newton-Wellesley Hospital, and Massachusetts Eye & Ear went more smoothly (and reading between the lines likely resulted in less frustration and fewer interruptions to care delivery).
Spaulding Rehabilitation Network in Massachusetts is awaiting its Epic implementation in 2017 and its CIO John Campbell, CHCIO, is excited for the transformation that the EHR system will enable at the post-acute care organization.
“Epic will be transformational for us because we have a lot of challenges in our current IT footprint,” he told EHRIntelligence.com last month. “A patient gets transferred to us from one of our acute hospitals and they are on a different EMR, and even in this world of technology very often the patient arrives in the bed with a stack of paper. We might be able to go to some portal and get a snapshot of the patient, but it is really not the full medical record.”
Health system EHR implementations are costly endeavors, but there’s more to these implementations than large capital outlays. Industry leaders do not choose health IT infrastructure by chance. Evaluating long-term success of the Partners Epic implementation will have to wait until the dust settles.
Date: May 19, 2016