Electronic Health Records

Adoption & Implementation News

New York City Hospitals Epic EHR Implementation Hits Snags

By Kyle Murphy, PhD

- Probes of alleged inappropriate billing and other misconduct associated with the New York City Health and Hospitals Corporation Epic EHR implementation have already led to the sacking of four high-ranking officials at the health system, according to multiple New York Post reports.

Epic EHR implementation in NYC is beset with problems

The latest executive to depart the organization is Chief Technology Officer Paul Contino, Yaov Gonen reported earlier this week.*

*Editor's note: A representative for HHC refutes any claim that the depature is any tied to the Epic EHR implementation.

HHC officials confirmed that Contino left his post close to three weeks ago. However, these officials indicated that Contino's departure was unrelated to the implementation of the Epic Systems EHR that is now 18 months behind schedule.**

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READ MORE: El Camino Epic EHR Implementation Officially Up and Running

**Editor's note: A representative for HHC reports that the project is on schedule and budget. The completion date is December 2018 according to HHC once the project included the integration of a laboratory system.

The most recent report includes a revelation that a consulting firm has been largely tasked with managing the project over the past year. Allegations of inappropriate billing and other misconduct began surfacing last summer and are currently under investigation by HHC Inspector General Norman Dion.

The Epic EHR implementation project already costed Bert Robles his post as HHC CIO in February, the Post reported Monday:

Chief Information Officer Bert Robles was forced to resign from his $296,000-a-year job in February while investigators were looking into allegations, including claims that his domestic partner received taxpayer-funded training on the new electronic medical records — even though she doesn’t even work for HHC.

Joining Robles were his interim deputy, the project's head of training, and the consulting firm tasked with helping bring the EHR implementation project to fruition.

READ MORE: Epic EHR Implementation Cited in Denver Health CEO's Departure

Along with the sackings, the total cost of the Epic EHR implementation project has also undergone changes, reportedly likely to increase to $1.4 billion. This is far cry from the projected cost of the EHR implementation HHC announced back in 2013.***

***Editor's note: As for the current estimate, it is $764 million over 6 years for the Epic EHR implementation. The $1.4 billion was a previously used estimate for comparing EHR vendors vying for the contract. The Epic contract is for $303 million over 15 years.

At that time, HHC President put the price tag of the Epic EHR vendor contract at $302 million and anticipated a project end date of 2017 for its 22,000 end-users. Robles was on record as a champion of EHR vendor selection of Epic:

With the new Epic system, doctors and staff in any part of HHC will be able to access accurate patient records at any time, and patients themselves will be able to view their medical records online. The records will also be more secure from damage from hazards such as fire and replicated at a back-up to ensure business continuity. Epic is generally recognized as the leading provider of EMR systems. HHC's implementation of Epic will be scalable and flexible enough to conform to evolving health IT standards and allow for future interoperability with external systems, health information exchanges, and other providers.

HHC selected Epic from five finalists, one of which moved to sue the health system. Chicago-based EHR vendor Allscripts alleged in the suit, which it eventually dropped, that HHC did not properly take into account the total cost of ownership of the various bidders:

READ MORE: NYCHCC Epic Implementation Will Not Hit 2018 Deadline

HHC failed to follow the evaluation criteria which required that award be based, in part, on the comparative Total Cost of Ownership (“TCO”) of offerors. Properly calculated, the TCO of Allscripts’ proposal represents savings of up to $535 million in comparison to Epic’s proposal. For example, HHC awarded point scores to offerors under the undisclosed evaluation criterion of “overall cost.” Although Allscripts’ proposed cost was indisputably lower, Epic’s point score under this criterion was 27% higher than Allscripts’.

Prior to Allscripts dropping its complaint, HHC officials denied its merits:

The New York City Health and Hospitals Corporation (HHC) conducted an extensive four-year evaluation process to determine the best vendor for a new electronic medical records system. At the end of the process, the selection committee clearly preferred Epic Systems Corporation, a company widely acknowledged as providing outstanding electronic medical record systems throughout the U.S. Epic was chosen for its functional superiority, outstanding level of integration, its strong corporate foundation, and for being more able to service the diverse needs of HHC. Allscripts’ allegation that its proposal is significantly less expensive than Epic’s is false and fails to acknowledge all of the costs HHC considered to support its integrated, patient-centered model of care. HHC anticipates that the Allscripts complaint will be found to be without merit.

Nowhere in these recent reports is Epic Systems implicated in the EHR implementation project's setbacks, which likely serves to more squarely lay the blame at the foot of HHC managers.

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