Tim Tarnowski has a big deadline looming.
In a little more than a year, the team of coders, hardware experts and project managers he oversees is due to flip the switch on a new electronic medical records system for the sprawling UMass Memorial Health Care network of hospitals, clinics and doctors’ offices.
It’s a project estimated to cost $650 million to $700 million in hardware, software and labor over 10 years. About 300 people are working on it, focused on bringing to UMass Memorial a medical records system developed by Epic Corp. of Verona, Wisconsin.
With all those workers toiling away, Mr. Tarnowski, chief information officer for UMass Memorial, said his biggest worry is making sure the correct people are on teams to make decisions, and that those teams are functioning.
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“If a team gets off the rails, you’ve got to get them right back on,” Mr. Tarnowski said.
It’s no small worry. UMass Memorial’s decision to implement Epic’s medical records system is the nonprofit health organization’s largest capital investment to date, according to Dr. Eric Dickson, UMass Memorial president and chief executive.
About 1,288 U.S. hospitals have Epic electronic medical records in use. Once installed, the software should replace about 120 different software programs at UMass Memorial and allow doctors, nurses and other professionals to call up information about a patient from any connected computer.
Patients’ information should flow into the system even if they show up at different UMass Memorial sites.
In addition, patients should be able to access their patient information, send a message to a doctor and book appointments through a smartphone app.
And UMass Memorial may find it simpler to exchange patient data with other systems that also use Epic records, such as Worcester’s Reliant Medical Group.
“This is an important investment, but I think it’s critical,” Dr. Dickson said. “I can’t imagine working the new health care paradigm without a fully integrated electronic health record.”
Electronic medical records, also known as electronic health records, are the digital replacements for paper records.
They aim to make patient information available to doctors, nurses and others wherever and whenever a patient needs care. The programs can prod physicians to cover certain subjects every time a patient visits or display recent test results so that duplicate testing need not occur.
They can also provide health systems with information about general trends in the populations they serve, a critical function as organizations increasingly get paid to keep people healthy.
Epic is not the first electronic records system for UMass Memorial, which operates four hospitals, multiple clinics and a doctors’ group in Central Massachusetts.
In 2008 and 2009, the system launched a six-year, $100 million “Cornerstone” project to integrate dozens of software systems, including a Soarian system by Cerner Corp. for hospital patients and a separate system by Allscripts Healthcare Solutions Inc. of Chicago for doctors’ office practices. A writer for Healthcare Informatics described it in 2010 as building a “Frankenstein IT system.”
Cornerstone took place as federal authorities were hammering out plans to provide economic stimulus money to doctors and hospitals that converted to electronic medical records and put them to use to improve patient care and operations.
Between 2011 and 2016, the government provided nearly $32 billion to providers for electronic medical records. UMass Memorial hospitals snagged about $8.6 million that went toward their old systems.
Dr. Dickson, appointed CEO of UMass Memorial in 2013, hired Mr. Tarnowski in 2014 and said he told him that if he could bring together the health system’s records so that all could sit at a computer, log on once and obtain patient information from any UMass Memorial entity in a dependable, easy-to-use way, “we would be erecting a statue of him by the time he was done.”
UMass Memorial’s system had been cutting edge at one time, said Judy Hanover, research director for IDC Health Insights of Framingham. But the health system had evolved.
“They’ve clearly got a need to have a record that serves the different types of clinical systems they serve,” she said.
The first phase of Epic is due to “go live” July 1, 2017, according to UMass Memorial plans. It will start with UMass Memorial Medical Center in Worcester, Clinton Hospital and Marlboro Hospital. HealthAlliance hospitals in Leominster and Fitchburg and other affiliated UMass Memorial organizations, such as Community HealthLink, will go live later.
Mr. Tarnowski said doctors, nurses and other professionals who use electronic records at UMass Memorial helped choose Epic to provide the next system, and they’re still providing input.
“A really important factor of this implementation is this will be designed by the people using the system,” Mr. Tarnowski said. “In our design sessions, we had 1,400 people participate.”
Reliant Medical Group of Worcester, an independent group of physicians, installed an Epic system in phases between 2005 and 2007. Doctors like it, said Dr. Lawrence Garber, Reliant medical director for informatics, and even use it to monitor the blood pressure of about 100 patients from their homes.
“We’re looking to turn on video visits so we can do visits with patients without them having to come out of their house,” he said.
Electronic medical records do not solve all issues for hospitals, however. Dr. Garber said that while Reliant doctors and staff were getting used to Epic, patient satisfaction temporarily dipped.
Ms. Hanover of IDC also said only about 20 percent to 30 percent of hospitals she’s surveyed say they make fewer errors with electronic medical records.
“The change in how staff communicate when they move to an EHR (electronic health record) and the way they think actually tends to cause new kinds of errors,” she said.
Date: April 3, 2016