FORSYTH COUNTY, N.C. — Novant Health Inc. begins at 5 a.m. today an electronic health records transition at its major Forsyth County facilities that represents the most pivotal and expensive system changeover in its history, according to the Winston-Salem Journal.
Novant is spending $600 million over five years on converting facilities in its four-state network.
Officials expressed confidence the switchover will be smooth enough to be a nonevent to patients, as well as more than 6,500 employees and more than 1,000 providers. Forsyth represents the largest of its Epic transition projects.
Their belief is based on more than two years of preparations – featuring an average 16 hours of intensive local training – the forgoing of summer vacation weeks and the successful rollout at its Charlotte-area hospitals in March.
“We have a high level of confidence of a very favorable go live here,” said Dr. Stephen Wallenhaupt, who is serving as Novant’s lead executive for the rollout of its version of Epic, known as Dimensions. “When the patient comes in Monday, their medical information will be waiting on them.”
Wallenhaupt took over the oversight role full time in April after stepping down as chief medical officer after seven years. Although Epic is at the core of the conversion, Wallenhaupt said other software systems are involved.
Wallenhaupt said each team of caregivers and information technology employees have undergone training specifically geared to their duties, including having Charlotte employees share first-hand experiences with the system in what he called “elbow to elbow” learning.
“We recognize it is a hard change, so that’s why we’ve taken this pay-it-forward approach,” Wallenhaupt said. “Employees will demonstrate their proficiency in the system before they are allowed to have their user ID activated when we go live.”
The main push for converting to electronic health records, particularly for Medicaid and Medicare patients, is the potential for federal regulatory penalties for not completing the process by 2015. Federal regulators are offering millions of dollars in incentives for early adopters.
The goal is improving hospital efficiency, particularly preventing duplicate or unnecessary use of drugs and tests, as well as lowering preventable readmission rates – another major emphasis of the Centers for Medicare and Medicaid Services.
“The great thing about the Dimensions product and our implementation of it in Winston-Salem is that all patient information is accessible to our caregivers, no matter where the patient enters our system,” Wallenhaupt said.
Analysts say Epic is considered as the preferred software system for electronic health records, with more than 300 hospitals, health-care systems and physician groups as customers.
There have been several media reports, including by the Journal, of local and national examples of cost overruns and delayed patient billing cycles because of challenges in implementing Epic. In some examples, analysts have said health care systems did not correctly project the amount of time and staffing required for the data transfer.
Epic has not responded to repeated requests for comment about how its system is fairing in the industry.
Novant completed in August 2013 the rollout of Epic for its 350 physician clinics, saying it accomplished the goal three years ahead of schedule and “under budget.”
Novant said the first hospital phase was completed in October “with no significant disruption to operations” at Presbyterian Medical Center. Novant went live at its remaining Charlotte-area facilities in March. In each instance, Novant chose to take several months to monitor and review the rollout before beginning the next phase.
Carl Armato, Novant’s chief executive, has said the conversion already is helping the system’s bottom line in terms of cost savings and a better patient experience.
“We are on our expected financial course in terms of budgeting and spending,” Wallenhaupt said.
According to The News & Observer of Raleigh, the major Triangle hospitals have spent at least $700 million on their versions of Epic. Rex Hospital went live in June, while Duke University Health System did so earlier this year. WakeMed plans to launch Epic in February.
Cone Health has disclosed spending more than $130 million. Wake Forest Baptist Medical Center has disclosed spending at least $60 million directly and indirectly related to Epic through reports to bond rating agencies.
Eric Ford, a visiting health policy and management professor at Johns Hopkins University, said Novant is an interesting case study for Epic’s effectiveness given the deliberate nature of its rollout and the breadth of its market.
“One of the challenges to Epic is that it is not a turnkey solution,” Ford said. “It offers a good template, but each hospital needs to customize it to their specific needs.
“By Novant taking the build-up approach to the rollout, it likely had its share of issues to crop up, but the major ones were discovered and dealt with within the scope of one hospital, not an entire system. The Forsyth facilities are the beneficiaries of that trial-and-learning experience.”
Wallenhaupt said Novant has been aware of the different hospital and health care system experiences with Epic.
“Not every Epic implementation is the same,” Wallenhaupt said. “We have been diligent, cautious and deliberate about our implementation, in large part because of our geography. It wasn’t feasible to go live in every setting.
“We keep learning from our experiences and improving our processes so we’re not making the same mistake twice.”