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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