Health Care

UVM Health Network launches $151 million medical records system

The Epic medical records system is fully up and running at the University of Vermont Medical Center in Burlington. Photo by Glenn Russell/VTDigger

When pediatrician Anna Hankins tried this summer to contact all of the families whose kids were overdue for a checkup, it required the work of a data analyst and then personal calls to each family. 

Central Vermont Medical Center, she found, had no more efficient way to do it.

That changed last weekend, when the University of Vermont Health Network launched a $151 million electronic records system, which doctors say will “fundamentally change” the way they provide care to patients. 

The platform, built by the national health care software company Epic, will allow doctors to schedule, bill and view a patient’s history all in one place. Patients can also go online to view their past procedures and lab test results, as well as schedule appointments and refill prescriptions. 

The electronic health records system went live last weekend at UVM Medical Center and three of the network affiliates: Central Vermont Medical Center in Berlin, Porter Medical Center in Middlebury, and Champlain Valley Physicians Hospital in Plattsburgh, New York. Two other New York hospitals in the network will start participating within the next two years. 

UVM Health Network officials say the investment will encourage preventive care and, after they sort out the technical challenges, save time for doctors.

With Epic, Hankins would be able to quickly run a report and notify families electronically that their child is due for an appointment, she said. 

She could also use the system to let patients with asthma know they should get flu shots, or to send a message to parents who had a baby born prematurely within the last year, telling them to make sure to have their infant get the medication to prevent a respiratory virus. 

“I can look at a full population of patients and make an intervention,” she said.

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The rollout hasn’t been without hiccups — thousands of them, in fact. Users have filed 4,500 tickets since Saturday morning reporting issues with the technology, according to Doug Gentile, the health network’s chief medical information officer. Health network staff have resolved roughly 2,500 of those problems.

“That’s pretty much what we expected,” Gentile said. He called Epic “the biggest, most complex project this organization has ever taken on.”

The project has been a long time coming. UVMMC started seeking approval for the project from the Green Mountain Care Board in 2017. Officials called the existing system a “hodgepodge,” with separate programs for billing, programing and scheduling at each hospital. Updating those systems, rather than rolling out a new one, would cost upwards of $200 million, CEO John Brumsted said at the time. 

The Care Board gave UVM Health Network the go-ahead in 2018. The system will be phased in slowly over a six-year period; it’s fully implemented at UVM Medical Center, and partially installed at the other three hospitals.

The remaining hospitals in the UVM Health Network — two New York hospitals and UVM Home Health & Hospice — will join in 2020 and 2021. 

Implementing electronic health records has proven challenging nationwide: A Fortune investigation showed frequent errors and technical issues that led to gaps in communication and lapses in care. 

In Vermont in 2015, Randy Stern sued electronic health records company eClinicalWorks after his wife died of a brain aneurysm when the information wasn’t flagged in the records. The company, whose technology was used by CVMC and some smaller clinics, later settled a class action suit with the U.S. Department of Justice for $155 million. Then in 2019, federal prosecutors reached a settlement with another medical records company, Greenway Health, for $57 million after it was found to have submitted false claims to the government and provided kickbacks to users.

According to doctors and administrators on the ground, access to Epic will make things easier. Gentile previously worked as a doctor in the emergency room, and recalled deciphering handwritten notes or rifling through pages of information for the relevant data. With Epic, no more scrambling to find lost paperwork before a patient comes through the door of the emergency department.

On a basic level, it helps patients understand their own care, according to Hankins. When parents brought their young daughter to Central Vermont Medical Center’s pediatric walk-in clinic over the weekend, Hankins said she used the system to show the parents the young girl’s weight on a growth chart, share medications and immunizations, and type up a plan of care. 

“It really allows me to pull the parents and the patients into this process of working together on their records,” she said. 

The learning curve has been steep for some doctors, but that will change, Hankins said. “In the long run, it will make my job so much easier.”

Disclosure: Reporter Katie Jickling’s brother, Ben Jickling, works for Epic. 

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Katie Jickling

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James Taylor

Fox, enter hen house.

Doug Richmond

$151 million here and there, and it begins to add up to real money. $300 per Vermonter.
With the mega system of hospital take-overs orchestrated by Brumstead, – it may reach
$600? per resident in this mega system.

Only a few patients at a time will accept care, so the cost per actual patient could be – !Good Lord – .!

Add in the cost of each employee having to be trained, and use on the job time to figure the thing out.

Bigger is always better, and more profitable for Ho$pital Management

Leslie A Seifert

Unfortunately, UVM did not wait until the patient interface was fully functional before going live. This transition should have happened years ago, but in their haste to do it now, they have reduced the functionality for patients for who knows how long. Test results which were typically available almost immediately are now somewhere in the ether. My PCP had to log into the “old” system to get my lab results yesterday. I could go on…..

Karen Winchell

Gee, this will be great, if I don’t have a debilitating stroke trying to transfer from my CVH online account.

Jon Parker

These costs will be borne by the users and taxpayers, with a goal of directing more public dollars and private information into the pockets of business. If this particular system is in use in other areas, it would be nice to hear how it has produced better health outcomes.
Will this system give patients will have quick, easy access to the true safety, effectiveness, and side effects data for the treatments their doctor is prescribing?
How about an easy online itemized report of the history of medical errors or fraud on the part of the individual staff and institutions providing treatment?
Salary data for the executives of the ACO that is overseeing their care?
Should be easy to find in that $150M database.
“We take the security and privacy of your data very, very seriously and would never, ever, ever do anything to endanger that for profit (see fine print below for exceptions)”

Aaron Betts

Everyone at the doctor’s office was talking about the failure in educating staff before the roll out this morning. Poorly implemented. Isn’t Al Gobeille the new chief operations guy? Is this what we have to look forward to?

John Shaplin

Is this something like the VA system where you have one ID number with which any physician anywhere can use to access your entire medical record including hard copies of scans not just reports? Does it also mean full access for physicians out of the Hospital network? Does it mean that advances in treatment modalities from research centers such as MA General Hospital will be communicated and put into practice more efficiently than they are now, that bad practices will be eliminated more quickly? Is this going to help with the perennial problem with provider reimbursement rates and the crazy inequities that are a constant challenge to the global budgets of these hospitals that result in virtually unstoppable increases in the cost of medical care? But even if this is only ‘rearranging the deck chairs on the Titanic’ what is Epic’s estimate of ‘updating costs’ and security for its system long term?

Matthew Choate

The negative comments notwithstanding, as a nurse at CVMC I can tell you how much this will help care. When you come into the Emergency Department and your medical information is in 6 or more different systems, things will be missed. This is a massive project for sure, but it will in the end make care much more seamless and complete. I am looking forward to seeing my own records more clearly and completely and having much more complete records for the patients I care for. As to the comments about training – it is a completely different system and we have provided hours of training for each person ahead of our go-live. It will take some time to learn the different work flows and to become efficient with the system – that is natural no matter what system it is and what training you had first. It’s a learning curve and we are doing great so far.

rosemarie jackowski

What a waste. Imagine what that 151 MILLION could do if it was used for direct health care.

Paul Schmied

If there was a direct correlation between the amount of money spent on an IT system project and the quality of the system created, the headline might be impressive.

But there isn’t.

Aside from the very high failure rates for large IT projects (by goals and metric achieved), IT project budgets are as irrelevant to their functionality, security and performance as the salary of a CEO is to the performance of a help desk tech.

EPIC systems are in use by several of my doctors medical organizations and NONE of them or their patients like them.

Laura Stone

The amount of money that a tiny state with only 625K people spends is stunning!

Steve Arrants

It doesn’t look like there is a way to look up your hospital or physician financial balances. It used to be easy to look at your billing history. It is either gone or not there any more. I’ve called and been on hold for more than 20 minutes. I’ve used their form on site to ask — nothing.
Before you go live, you want to test a software or service by doing the things the users typically do. You give users clear direction on what’s changed and how to solve a problem. That’s not here.

Charlie Messing

It might make everything work smoother, if everyone understands how the new system works. And I hope there’s a Plan B. As it is, the system is transparent as mud. I got two identical eye surgeries, and one cost $200 more than the other. No explanation. Any0ne I ask says they do not know anything except their immediate job. I used to have a doctor. Now I have a person who works for a system he doesn’t understand any better than I do. He peers at the screen of his laptop during our brief visits – it’s more important to get the entries coded right than it is for us to communicate as doctor and patient. This will improve?
The new system will tell my doctor and I what all the specialists have found, the complete results of all tests, all future appointments that have been made, and what each item will cost us before we are billed? Sure it will.

Bill Rowe

In six years when the rollout is completed the software and system will be obsolete. What s waste.

David Schwartz

Ask the majority of “providers” and I believe that most of us think EMR have been a nightmare, requiring more time at the keyboard and less time spent with the patient. I agree that data acquisition is helpful for billing purposes, data mining for epidemiologic studies, but I am not convinced it helps with patient care. In the good old days, we actually had to write down medications and past medical history. Now, everything is template driven and I wonder how many “providers” actually really know what meds a person is on. Autofill allows for upcoding and enhanced revenue generation but at the expense of patient care, in my opinion. In my experience, >90% of inpatient notes are the same note as yesterday with a few words changed. I wonder what the charge is for each of those words? And, there is no connectivity with EMR vendors so that independent practices, who can’t afford the monster costs of Epic, can’t communicate with the “mother ship” of UVMMC. Further fragmenting care.

 

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