Focus: Merging disparate medical information systems
The challenge: To merge more than 50 stand-alone electronic systems used by individual physician groups, specialty clinics, hospitals and hospital departments throughout Washington University clinical practices, affiliated hospitals, and within BJC HealthCare, one of the largest nonprofit health care systems in the United States.
The ability to share medical records across hospitals and health-care systems addresses three major health-care issues that have been challenges since the 1990s: patient safety, efficiency and cost. This year, Washington University Physicians joined Barnes-Jewish Hospital, St. Louis Children’s Hospital and Barnes-Jewish West County Hospital in launching a single electronic health record (EHR) system called Epic. The EHR system is now live in all but one of the hospitals, with Belleville Memorial Hospital in Illinois to follow.
The combined BJC and Washington University health-care system is one of the largest in the country to adopt Epic, which claims to hold medical records of 54 percent of patients in the United States. The depth and breadth of Epic means that records can be shared not only between Washington University and BJC HealthCare, but also with other health systems in the region, such as SSM Health and Mercy, as well as many other hospitals across the country.
“This is particularly beneficial since we draw patients from hours and hours away who have complex problems and see multiple physicians,” says Sam Bhayani, MD, chief medical officer of Washington University Physicians and a urologist in the Department of Surgery. “We’re able to have all their information in one place.”
Epic can aid in investigating safety events, allowing the department’s safety officers to do more effective chart reviews. Surgery schedulers also are using the system to communicate surgical plans to system hospitals.
“The Epic record gives you the whole picture of the patient’s health, which is important for surgical planning and optimal outcomes,” says Vicki Peck, RN, BSN, MHS, CURN, the department’s patient safety coordinator. Information Systems Clinical Coordinator Tammy Stotler and Senior Project Manager Hannah Beckmann led the team’s rollout on June 2 and continue to resolve any issues. “With the implementation of Epic, our clinical operations team will focus on efficiency, improving quality of patient care, and creating a successful practice,” says Stotler.
As a step toward improving the scheduling process, a team of medical assistants and scheduling staff in the Section of Colon and Rectal Surgery was the first in the department to obtain 100 percent accuracy in completing surgical plans for three consecutive months, from January to March 2018. The surgical plan is a checklist that notes in part whether a patient is healthy or sick, obese or has adhesions from previous surgeries. A team excellence award was presented to Colon and Rectal Surgery Section Chief Matthew Mutch, MD, on behalf of the schedulers, at the Department of Surgery Fourth Annual Patient Safety and Clinical Effectiveness Symposium and Poster Session.