They testified in front of the Green Mountain Care Board, which will decide in the coming months whether the network’s flagship hospital can spend more than $150 million on a new electronic health record system.
The project would upgrade systems at all of the network’s doctors’ offices and four hospitals within the network: the UVM Medical Center in Burlington, Central Vermont Medical Center in Berlin, Porter Medical Center in Middlebury, and Champlain Valley Physicians Hospital in Plattsburgh, New York.
Alice Hyde Medical Center in Malone, New York, is not included in the project because it was not part of the UVM Health Network when the network started planning the project. Elizabethtown Community Hospital in Elizabethtown, New York, was included in the original proposal, but Porter later took its place.
Network officials testified that replacing the dozens of different IT systems at each hospital would cost up to $200 million — and would need to happen in the near future because many of those systems are reaching the end of their useful life.
However, installing the new software from Epic Systems Corp. in those locations would cost $151.7 million over six years, network officials said. Much of the predicted savings are from Epic offsetting existing system and staffing costs.
The network’s flagship hospital, the UVM Medical Center, would foot the majority of the bill. Over six years, the hospital would pay $137.3 million for the system. That includes $109.3 million in capital costs and $85.9 million in operating costs, minus anticipated revenue and savings.
The UVM Medical Center would receive $30.7 million in revenue from Epic in the form of subscription fees that the smaller hospitals pay to use the Epic system. The UVM Medical Center is also anticipating $27.1 million in system and staffing savings from the project. The smaller hospitals are predicting smaller savings.
Dr. John Brumsted, the CEO of the network, framed the project as a significant step forward for health care across the state. He said the biggest risk he can foresee is not proceeding with the project.
Dr. Adam Buckley, the chief information officer for the network, said patients and doctors alike would be happier with the Epic system because everything would be in one place.
Currently, doctors go from system to system to get information, he said, and patients don’t have easy access to their records. With the Epic system, Buckley said, patients would be able to access their health records from their cellphones.
Dr. Fred Kniffin, the CEO of Porter Medical Center, gave an example in the emergency medicine department at his hospital, which he said transfers about 300 of the sickest patients each year to the UVM Medical Center.
When a patient needs to be transferred to Burlington, Kniffin said, doctors will often print out the person’s information and put it in a folder between the cushion and the metal part of the stretcher so it travels with the patient.
Dr. Anna Hankins, a pediatrician at a Central Vermont Medical Center practice in Barre, said she has had trouble adjusting to her job with the hospital, where she started in August, because it does not have a unified electronic health record system.
Hankins used the example of treating a newborn and needing to see the medical record from the mother. At a hospital in Wisconsin, she was able to simply log in to Epic and see the mother’s lab results. In Barre, she said, nurses log in to one system, print out records and put them on a clipboard.
When she needs a copy, Hankins said, she doesn’t borrow the clipboard. Instead, she gets another clipboard and hand writes the information on another piece of paper. She said she often just uses a paper towel.
Hankins called the situation “alarming.”
Marc Stanislas, the vice president of finance for the UVM Health Network, said the network used the same financial principles to project costs and savings for Epic as it did for calculating the cost of the new inpatient wing currently under construction.
“Our approach to this was to build fair and reasonable assumptions,” Stanislas said. “There’s going to be pluses. There’s going to be minuses. But at the end of the day the hope is that they balance.”
Buckley said the UVM Medical Center is paying for the capital costs of the project because it will hold the license. “If CVMC or CVPH were trying to do another project … the capital expense would be dramatically more,” he said.
Buckley said Epic is a good choice because academic medical centers and hospital systems across the Northeast are starting to adopt it. Additionally, he said about 95 percent of patients in the Midwest are served through Epic.
Epic has an 87 percent success rate for completing implementations on time and on budget, according to Buckley. He said the network has also brought on Cumberland Consulting Group for project management services and that the company has a 100 percent success rate.
Jessica Holmes, an economist who sits on the Green Mountain Care Board, questioned whether Epic has such “tremendous market share” that it is not the right choice for the UVM Health Network’s software upgrades.
Buckley countered that patients are very happy with Epic. He said the company is planning, in the future, to implement a price transparency tool that would make it easier for patients to shop for health care.
The board has 120 days from closing the case on Oct. 3 to issue a decision.
Public comments can be submitted here for the next 10 days.
