- University of Illinois (UI) is set to sign off on a $62-million EHR replacement contract to upgrade its best-of-breed, 20-year old EHR technology to a single Epic system.
Implementing the Epic system at UI hospitals in Chicago should simplify billing processes, allow doctors, nurses, and other hospital staff more efficient access to patient EHRs, and improve overall patient care through better-informed clinical decision making.
While the price tag is daunting to some UI trustees, the investment should save money over time by enabling more focused, accurate patient care that cuts down on redundant test ordering, readmissions, and other unnecessary treatments. Additionally, UI hospital officials hope to improve patient satisfaction by streamlining operational processes and allowing providers to spend more time interacting with patients.
The current health IT system in place at UI dates back to 1997. The system lacks analytics capabilities needed to improve quality of care and engage in burgeoning areas of care management, including population health.
UI Hospital CEO Avijit Ghosh told The News-Gazette that the system is also inefficient and prone to cause problems when billing patient accounts.
"This is not simply an IT project, it is a project to improve our work flow — the way we work, the way we code, the way we document things," he said.
To upgrade UI hospitals and improve patient health outcomes, hundreds of hospital employees participated in a year-long study of current health IT infrastructure and concluded that a new, integrated EHR system would be necessary to improve UI daily clinical processes.
UI subsequently formed a workgroup titled the 3i project team, representing the need for integrated information infrastructure. The group recommended implementing an Epic EHR system. UI will pay off the $62 million contract over the course of seven years. The investment will include EHR software, technical support, and remote hosting. Technical support and remote hosting in particular will result in significant savings for UI down the road in both hardware and labor costs.
However, implementation and operating costs are likely to reach $101 million over 15 years, according to UI officials. Some UI trustees were shocked by the hefty price tag. Estimates regarding the 15-year financial impact of the project show net savings in operating costs of around $21.6 million.
Trustee Edward McMillan worried the system could be “obsolete before we ever get it paid back.”
But Ghosh argued the system would have a longer shelf life than some trustees expect.
"The typical lifetime here is 20 years," Ghosh said. "Our system is so fragile now. If you asked me in the past what kept me up at night as the hospital CEO, it is the IT system."
Other trustees warned against likely cost overruns and delays that could set the project back even further.
"I think that there is significant risk to this financial plan," said Trustee Don Edwards. "We don't know what's going to happen to health care over that period of time."
The implementation project will be completed over two years, according to UI officials.
"It feels like a staggering number, but it’s what’s required of hospitals today," said UI Trustee Stuart King of Champaign, “The electronic medical record has become as important as the stethoscope."
Trustees arguing $100 million investments are the norm for EHR replacements can point to recent similarly-priced projects to back up this claim. Meritus Health in northwestern Maryland signed an Epic EHR implementation contract for $100 million last month.
The full Meritus implementation and modernization project is slated to take five years. Among the top priorities during the Meritus selection process were patient and provider satisfaction.
“From a provider standpoint, they looked at what the workflow looked like within the actual computer system and software,” Chief Transformation Officer Carrie Adams told EHRIntelligence.com. “How many times do they have to go in and out of pages to find notes or lab data or look at medication lists? Flipping through all those screens decreases efficiency and adds redundant work to finding and documenting information. They also looked at the availability of information following patient discharge, the ability to look at labs and progress notes, and the ability to follow up easily and quickly.”