Providence set to launch Epic system

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After two years of planning and tens of thousands of hours of employee training, Providence Health Care Eastern Washington plans to go live with an Epic health records system in its four Inland Northwest hospitals at 2 a.m.Oct. 26.

The launch comes seven months after many of Providence's physician practices and other ambulatory-care operations in Eastern Washington started using the system.

"It's sort of like going from DOS to Windows," says Dr. Jeff Collins, chief medical officer at Providence Health Care. "It's much more automated and much more complete."

The Eastern Washington facilities are coming on line as part of an $800 million installation throughout Providence Health & Services, which includes 29 hospitals and more than 400 clinics in Washington, Oregon, Montana, California, and Alaska. Collin says the system already is in place in Western Washington, Oregon, Montana, and Alaska, with only Eastern Washington and California left to go live.

Collins says the system's purchase price was negotiated for Providence Health & Services as a whole, and he doesn't know the breakout cost for implementation in Eastern Washington alone.

Epic Systems Corp., of Madison, Wisc., developed the records system being implemented across the Providence network. Collins says the system typically is used in large, multisite health care networks, and the Providence implementation is the second largest Epic has handled.

Providence Health Care Eastern Washington spokesman Joe Robb says, "We've benefited. We have been able to learn from the other Providence systems."

The launch here comes almost a full year after Providence originally had planned to have the system up and running. Initially, Providence planned to have its ambulatory clinics using the Epic system by August 2012 and its two rural hospitals - Mount Carmel Hospital, in Colville, and Providence St. Joseph's Hospital, in Chewelah - live on the system last October. Providence Sacred Heart Medical Center & Children's Hospital and Providence Holy Family Hospital were to be on the system by Dec. 1, 2012.

However, Collins says, as Providence began rolling out the system in other areas, it encountered some problems with the system.

"We found enough glitches that we had to take a pause," he says. "We took a pause for six months."

During that re-evaluation, Collins says, the organization decided to go live with all four hospitals simultaneously.

Since then, Providence staff involved in patient care or patient billing has been undergoing extensive training on the system. Providence spokeswoman Anne McKeon says that of the 6,900 Providence employees in Eastern Washington, all but about 350 were required to receive training.

To accommodate this massive undertaking, Providence dedicated a handful of classrooms on its Sacred Heart campus to Epic training and subleased some space from Alpine College, in Spokane Valley, to set up classrooms there.

Collins says a person involved in billing required as few as four hours of training, while a pharmacist had to have 36 hours of training. Physicians typically need eight hours of coursework, as well as specialty-specific training.

Once the system is launched, Providence hospital staff will have access to records from physicians' practices, allowing staff to get up to speed on a patient's condition more quickly. For a referring physician, the system incorporates scheduling that can be tracked to ensure that a patient's follow-up care doesn't slip through the cracks.

Collins points out that Providence has acquired a number of physician practices in recent years, and many of them had different electronic records systems that weren't compatible with the one Providence operated. Having all of them on one system should increase efficiencies, he says. Specifically, he says, the organization hopes to reduce the number of times patients are asked the same basic questions, such as whether they have allergies or whether they take certain medications.

Importantly, he says, the system should enable caregivers to find test results quickly, "so we don't have to do another test because we can't find the one you just had."

Patients themselves will have access to their records through Epic.

At first, Robb says, information will be available online, but a mobile application is being developed as well so patients eventually will be able to access their information through smartphones and tablets.

Robb adds, "We all realize medicine has to be focused on providing greater value, and this represents an investment by Providence for that."

Group Health Cooperative, of Seattle, has been using an Epic system at its facilities statewide, including in Spokane, since 2005.

Collins says the two systems are somewhat different but can be enabled as "trusted partners" with one another so that data can be exchanged.

"It does facilitate integrated management of patients and allow us to standardize care better," he says.

While the launch of the new system comes as health-insurance exchanges come online and just two months before other major components of the Affordable Care Act go into effect, Collins says the timing is coincidental. The ACA has a provision that calls on health care organizations to have what it calls "meaningful use" of electronic records, but Providence already was using electronic records before it started implementing the Epic system.