St. Charles Health System says it will hire roughly 100 permanent “Epic analysts” as it heads into the massive process of switching its electronic patient records system, an undertaking that will take years and cost several million dollars.
The new positions will be filled largely by people who already work for the organization and understand its operations, but hires could come from outside as well. Technical knowledge, such as an IT degree, is not necessary, but it’s a plus.
The analysts, all of whom will be hired by Sept. 1, could be people like office managers, nurses, medical assistants or even doctors, said Chad Cagnolatti, St. Charles’ Epic project director. Their main focus will be helping tailor the Epic system to specific areas within the health system ahead of its anticipated launch in early 2018.
“They would be successful because those folks really know the workflow that goes into caring for the patients,” he said.
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St. Charles announced last week it plans to switch from Paragon, its current electronic health records vendor, to Epic, one of the most widely used EHR vendors nationwide.
The move represents a 180-degree shift from the health system’s stance in late 2014, when Mary Dallas, St. Charles’ chief medical information officer, told The Bulletin that despite problems with Paragon, the health system was not considering changing EHRs. This will be the fourth EHR platform to be implemented in the Bend and Redmond hospitals, although one of those transitions was from one McKesson product to another when the company phased out an older version.
“We’ve just gone through that process and we really have no desire to start that over again,” Dallas said in December 2014.
The change of heart is really just the result of a change in leadership, said Jeremiah Brickhouse, who became St. Charles’ chief information officer in February 2015, just two months after Joe Sluka took the helm of St. Charles as its chief executive officer. Brickhouse used to work at Rapid City, South Dakota-based Regional Health, the same health system Sluka was hired from.
“The CEO likes making decisions based on data,” Brickhouse said. “Having good information, good analytics is key to that. So one of the first things he wanted to look at was our information systems, which kind of drove this discussion.”
Brickhouse said St. Charles’ board approved contract negotiations with Epic, which are ongoing, in February after 100 percent of doctors involved in a selection group voted to go with Epic. The board will vote on a five-year implementation budget in June. Brickhouse’s team is still developing the budget, and he said he can’t yet provide a cost estimate.
“Budgets like this are so large, we have to go through it with a fine-toothed comb,” he said.
The cost of implementing Epic depends on the size of the health system, and has surpassed $100 million in some large health systems.
Lahey Hospital & Medical Center in Burlington, Massachusetts, for example, spent $160 million implementing Epic, a two-year process that wrapped up last year, according to the health system’s spokesman. That hospital’s revenues were about $828 million in 2013, surpassing St. Charles’ $632 million that year, according to tax documents. Lahey had 31,000 patient admissions that year compared with about 17,300 at St. Charles Bend and Redmond.
The switch will require training most of St. Charles’ roughly 3,800 employees to use the Epic system over a period of up to 12 weeks, Cagnolatti said. How long people train depends on their job functions. A pharmacist, for example, may need a total of 16 hours, both online and in a classroom, whereas someone in environmental services may need only four hours of online instruction, he said. People who work in billing, business processes, specialists and providers who work in acute areas like the emergency room or intensive care unit will need the most training, he said.
“For any hospital system, putting in a new EMR whether it’s Epic or another one is usually the largest endeavor that they’re ever going to take on,” said Michael Sinno, chief operating officer of the HCI Group, a Jacksonville, Florida-based health care IT consulting firm.
Currently, St. Charles’ hospitals and outpatient clinics rely on separate EHR platforms, making sharing patient information difficult, Brickhouse said. He said patients will only receive one bill for visits after the Epic switch as opposed to multiple bills. They’ll only call one phone number to schedule an appointment, regardless of what specialty it’s for, Brickhouse said.
“It’s going to be a single, unified database,” he said. “It’s going to improve efficiencies.”
Patients will also have access to Epic’s MyChart Internet application, which allows them to view patient records, pay bills and schedule appointments using their smartphones, Brickhouse said.
A driving force for choosing Epic was the fact that it’s the same system used by both Bend Memorial Clinic and Mosaic Medical, two major primary and specialty care providers in Central Oregon. Sharing patient records across Epic providers is simple, Brickhouse said.
Currently, if patients want their BMC providers to see their records from St. Charles, they need to fill out a medical release form, have the relevant records printed out, bring them to BMC and someone at BMC will scan the document and re-upload it into their EHR system, said Christy McLeod, BMC’s chief business development officer.
“It’s a very clunky process,” she said. “One of the real benefits of Epic is that it does offer the ability to have a more seamless transfer of information on behalf of patient care.”
Epic and Cerner ranked highest among EHR platforms for usability, according to a 2015 report based on interviews with 110 health care providers by the research firm KLAS. Epic and Cerner are currently dominant forces in the EHR market, Sinno said. Epic tends to be a favorite among providers, he said.
“The ease of use compared to some other and the fact that it’s designed from a physician satisfaction point of view is a big differentiator,” Sinno said.
Brickhouse doesn’t shy from admitting it’ll be a lot of work over the next two years, but leaders from Legacy and Asante two other Oregon health systems that also implemented Epic have assured their counterparts at St. Charles it’s worth it in the end.
“They really encourage you to tough it through, because at the end of it, there is a ray of hope,” Brickhouse said, “and it will make St. Charles a better organization.”
Date: May 8, 2016