Electronic Health Records

Adoption & Implementation News

Arizona health system in the red after Epic EHR adoption

By Kyle Murphy, PhD

The University of Arizona Health Network is feeling the effects of its decision to implement an EHR from Epic Systems throughout the large health system.

According to a report in the Arizona Daily Star, UA Health has recorded $28.5 million in debt due in large part to its adoption of the Epic EHR, a decision estimated to have cost the health system $115 million but now includes $32 million in unbudgeted costs during the first two and half quarters of its fiscal year ending June 30.

Emily Bregel and Stephanie are reporting that delays in go-live and the need for additional training and support are responsible for the extra costs with the EHR system launch falling two months behind schedule and not occurring until November 2013. Moreover, disruptions to clinical workflows and patient visits were not remedied until February 2014.

“This is the biggest operational change this organization has ever undertaken,” former consultant and UA Health CIO Dan Critchley told Arizona Daily Star. “We’re in what we call support mode now.”

The decision to go with Epic Systems, however, is apparently not to be to blame for the health system’s plight. Instead, the organization apparently committed itself to an exceedingly aggressive implementation timeline that ended up turning the relatively inexpensive investment into a much bigger one.

Data from Definitive Healthcare, a database comprising intelligence on hospitals, health systems, and other healthcare providers, UA Health’s timeline for its go-live was anticipated to unfold in two phases:

The first phase included an outpatient launch on July 1, 2013 at the Alvernon, South Campus Abrams, and North Hills cites. On Sept. 1, 2013, the rollout was planned for its hospitals, cancer centers, and remaining ambulatory physician offices. This was to be followed in June 2014 by a system-wide upgrade of the Epic EHR.

The second phase targeted Fall 2015 for health plans, cardiology, transplant, and outpatient pharmacy.

The financial situation at UA Health is compounded by Medicaid rate cuts that responsible for generating $33 million for the health system during the first two quarters of its fiscal before coming to an end at the close of December 2013.

So why was there the need to implement a new system? The answer to that question dates back to April 2012 and a lack of interoperability that prevented two of the health system’s campuses from communicating with each other. At the time the decision to go with Epic was made, UA Health was already in the red for $10 million and looked to the success of nearby Tucson Medical Center whose Epic EHR adoption has been successful after its $31-million upgrade in 2010.

Despite the bumps in the road, UA Health leadership is confident that its decision to select Epic will pay off in the end run.

“It was an especially difficult time financially because of Epic, there was no choice in the matter. That period of time has fortunately passed and now we can do much better,” observed Network board chairman Steve Lynn.

Claiming that Epic and its EHR system are to blame for the health system’s losses fails to emphasize how important proper project management and managing expectations are to an EHR adoption of any size. Although UA Health is receiving meaningful use incentives through the EHR Incentive Programs, these funds will hardly offset poor decision-making and execution of a project plan.




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