Middle Park Medical feels pressure for new electronic records system
If you saw an employee sobbing alone outside a hospital, you might assume the worst.
That person lost a patient, you might think. That person is overwhelmed by the ebb and flow of life and death that doctors, nurses and other medical professionals are adrift in each day.
You probably wouldn’t chalk the outburst up to frustration with a buggy, poorly functioning computer system, but maybe you should.
During an Aug. 27 Middle Park Medical Center board meeting, Dr. Thomas Coburn described such a scene at a MPMC facility as an example of the toll that the organization’s dysfunctional electronic medical records system is taking on its employees.
Dr. Mark Paulsen, MPMC’s chief of staff, described how doctors are scanning and faxing patient records to other facilities for lack of a functioning EMR system.
One doctor present remarked that, in some instances, MPMC couldn’t send records electronically between facilities within its own system.
MPMC’s executives and board members are currently shopping for a new EMR system.
EMR systems are big investments for hospitals, but Coburn and Paulsen say the situation is dire, and MPMC leadership must grapple with finding a solution that is both a good long-term investment and expedient.
“I think our people from docs through all the departments would much rather say, ‘we’re going to implement this; It’s going to be hard; We’re going to be implemented in three months; We’re going to be done in three months,’ versus saying, ‘we’re going to look at some more vendors; We’re going to talk about this and, you know, we’ve got some kind of soft deadlines,” Paulsen said. “I mean, we’ve had a lot of soft deadlines.”
MPMC undertook a major overhaul of its IT infrastructure last year and is ready to accommodate a cutting edge EMR system, but its current system Healthland hasn’t been updated since 2008, making it the “’71 Pinto” of EMR software, said MPMC Chief Operating Officer and Chief Information Officer Trampas Hutches.
Bills out the door
The system’s lack of functionality is taking a toll on staff, but it’s also hitting MPMC financially by affecting billing, Hutches said.
“We have trouble getting bills out the door,” Hutches said.
Billing time has been a recurring issue in MPMC’s financial reports.
MPMC is considering a number of options for upgrading its system, from building a system from the ground up to purchasing a hosted system from another organization like Centura Health, which manages MPMC under contract.
Judging from the current situation at MPMC, the former option is out of the question, said Russ Johnson, Centura’s Vice President of Network Development.
“It’s not realistic to think you can do it in a couple or three months, to build and customize, because an IT system as you know is not like getting a house,” Russ said. “It’s like getting a bunch of bricks and nails and hammers and all that stuff and then building it and making it yours.”
Joining Centura’s hosted Epic software system, ostensibly the most favorable choice, is expensive – possibly as high as $1.5 million for implementation without software, though Russ called the figure “way too heavy.”
But there’s a more substantive problem – Centura hasn’t yet implemented its own system.
Centura will bring its own 16 hospitals onto Epic in three waves, Russ said. The first will be in May 2016 and the second will be in November 2016.
Hutches said Centura is MPMC’s best choice, and MPMC hopes to make one of the first two waves.
Otherwise MPMC would have to wait until 2017, which Board Member Kelly Johnson said MPMC “simply will not survive.”
“I think if we tell our people 2017, there’s going to be despair,” he said.
But Centura’s IT department is hesitant to include an affiliate organization in those first waves, Russ said.
“We know we’re going to mess up in some things,” Russ said. “We’re not going to subject somebody else to that learning curve.”
But MPMC CEO David Ross said he’s willing to take chances.
“One thing I will say that Dr. Paulsen just said to me – there is no way it can be worse than it is right now,” Ross said, “so we’re ready to volunteer, and we could not be worse.”
MPMC could also buy into a hosted Epic system that’s already been established by another health system, Hutches said.
Epic currently has around 53 percent of the market share nationally, and joining the software system would mean being able to share records easily with any Epic hospital in the world, Hutches said.
Another system could be implemented quickly and possibly cheaper than Centura’s, but the different hosts mean staff would lose some interoperability with other Centura facilities, Russ said.
EMR software generally runs from $500,000 to $800,000 for software alone, Hutches said. Implementation costs between $400,000 and $1 million.
If MPMC chooses to join Centura’s Epic system later, it can be done, Russ said.
“It’s just a new build, and it’s a lot of work,” Russ said. “It’s not simple to do. It’s not, ‘Oh, they’re both Epic systems, so click.’”
MPMC is also looking at other systems like cloud-based Prognosis, but Hutches said such programs don’t have the record sharing ability that Epic does.
Given the direction that healthcare is moving, electronic medical record sharing is becoming increasingly important in improving the quality of care that physicians can provide to patients, Hutches said.
MPMC executives are using input from doctors, clinical department and other staff to formulate a recommendation, which the board will consider in October, Hutches said.
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