Yale to implement new medical records software

Starting next year, the different divisions of the Yale Medical Group will begin sharing their patient records with each other in an attempt to reduce error and increase efficiency.

EPIC, an integrated medical records software created by Epic Systems Corporation, will connect patient records from the School of Medicine, Yale-New Haven Hospital and Yale Health, officials said. Yale’s switch to EPIC will cost approximately $250 million when it is completed in 2013, establishing a significantly more efficient process for patients and doctors alike.

“Using EPIC, doctors are seeing patients, filing charges and sending prescriptions,” said Steven Schlossberg, chief medical information officer at Yale-New Haven. “This process will provide an improved clinical and research foundation for the School of Medicine and Yale New Haven Health System to evolve the model for delivery of health care to meet the challenges facing all of us.”

Daniel Barchi, chief information officer at the medical school, said that the idea to implement integrated medical records arose because the Yale Medical Group, like most health care systems, faced difficulty in sending information back and forth between the different facilities. He added that in most health care systems across the country, each clinic operates a different way, making records prone to errors when patients see other doctors within the same health care system, creating “an unsafe environment.”

“Even with the great amount of work [put into the health care system], it is not guaranteed that the patient will have attention in every respect [without a shared records system],” Barchi said.

He cited a 1999 Institute of Medicine report, which identified thousands of patients who died prematurely because of medical information errors, such as prescribing drugs by mistake or receiving another patient’s medicine. An integrated medical record, he said, allows physicians to keep track of their patients and their individual medical histories, preventing mistakes.

Patients can also access their medical records via a patient portal, through which they can refill their prescriptions, request appointments and review medication lists, Schlossberg said.

One of the challenges of the EPIC records system, Barchi said, is implementing it at a new site, as the program takes time to build and install. It is also important, he said, to verify that the program works well in all environments.

After the contract with Epic Systems was signed in 2010, a team of more than 100 people built and configured the EPIC program at Yale, Schlossberg said. Some sites, including Emergency Services at Yale-New Haven Hospital, began using the program in October 2011, he said.

Robert Alpern, dean of the medical school, said the logistical challenge of programming and teaching doctors to use EPIC leads to delays in its implementation. The program’s cost, he added, is due to the large staff needed to build and program EPIC.

Despite the greater access to patient records, EPIC protects patients’ information, Barchi said. Only authorized physicians and nurses have access to records, and all access is monitored. Schlossberg added that if unauthorized employees are caught accessing patients’ records, they are immediately fired.

Susan Casey, practice coordinator in the Bridgeport office of internal medicine, and pediatrics specialist Dr. Andrew Cutney — one of the Yale clinics using EPIC — commended the program because of its paperless approach. There were a few difficulties in the implementation process, Casey said, but she added that they are “ironing out all those problems.”

Founded in 1979 and located in Verona, Wis., Epic designs software for mid-sized and large medical groups, hospitals, and integrated healthcare organizations. Health care systems using EPIC include Los Angeles’s Cedar-Sinai Medical Center, the Cleveland Clinic and Johns Hopkins Medicine.

Although other companies provide medical records software — such as Cerner, Mckesson and Siemens — Epic has become the dominant software provider in the U.S. market in recent years, according to earnings reports for the company.

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