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BusINess » Business Health Care Technology » Epic transition in health care

Epic transition in health care

Epic's sprawling, eco-friendly campus is located in Verona, Wisconsin. (Photograph courtesy of JJR architecture firm.)

Epic's sprawling, eco-friendly campus is located in Verona, Wisconsin.
(Photograph courtesy of JJR architecture firm.)

At a time when jobs are scarce, businesses are dying and not having enough money to pay the bills is a common theme, there’s one company that’s thriving. The Epic Healthcare system isn’t just thriving. It’s snowballing around the world, and taking every major health care organization—including all of the big hospitals near and in Northwest Indiana—with it.

It’s rare that a company can boast having $650 million in revenue, no debt and a customer base that includes 30 percent of the United States and 1 percent of the world. But the Verona, Wisconsin-based technology focused health care company does that—and more.

Epic is able to be so successful because it brings technology to hospitals and doctors, which is necessary and soon-to-be required by federal law. Its software includes applications such as MyChart, which gives each patient access of their own clinical information. Through MyChart, patients can also send secure messages of their doctors, schedule their own appointments and print their children’s growth charts.

The software can speak multiple languages and do easy translations.

Epic’s applications are designed to be used in the ambulance, in the emergency room, in the in-patient hospital units and even at home.

Another popular application is the computer system that prompts doctors to ask specific questions about different symptoms or illnesses. Once the doctor types in the answers, the electronic database will travel with him wherever he is in the hospital so that the patient never has to repeat his answers.

Patients also appreciate being able to have complete online access to their medical records and lab results.

“We’ve used Epic for patient registration and billing, and the clinical components which went live in August, which include nursing documentation, bedside scanning of medications and the components for the emergency room,” says Ed Duryee, CIO of Methodist hospitals. Duryee loves the fact that patients can have one electronic chart that follows them everywhere in the hospital and throughout their doctor’s visits, providing each doctor with the correct information and making sure that the patient’s medicine doesn’t overlap, and that his treatments complement each other.

Patients also benefit from the new applications. Sister M. Aline Shultz, corporate vice president of development, marketing and public relations for Sisters of St. Francis Health Services, Inc., says SSFHS system is rolling out Epic for their entire healthcare group, which includes 12 hospitals. She says that while the new applications will help the doctors and administrators, the patients will also be able to access their information.

“We’re going to be building a patient portal so they can make physician appointments and look at their lab and test results,” she says. “Patients are excited.”

ProHealth Care, which operates a host of hospitals and healthcare organizations in Wisconsin, uses Epic’s software to link its different systems together. “ProHealth Care is transforming its current clinical and business information systems into one integrated system across the entire organization,” says Rodney Dykehouse, ProHealth Care’s vice-president and CIO of information services. “The initiative is essential to our ability to work with our doctors and provide the highest quality of patient care while meeting the challenges of the changing health care environment. The Epic system will allow us to serve patients with a common experience across all ProHealth Care and affiliated sites, regardless of point of entry, provide high quality patient care and maximize efficiency across the health care continuum through an integrated electronic health record.”

In short, Dykehouse is pleased that Epic is able to electronically connect and maximize efficiency throughout ProHealth Care. Doctors, patients and administrators can even get Epic on their phones. They’re creating new products featuring cell phone applications that can be used on the iPhone, iPad and Verizon’s Android. Those apps will allow the doctors and patients to access records and lab results, in addition to refilling their prescriptions and see their lab results with a touch of the button wherever they are.

Projects in the works include intensive care interactive touch screens, an application that allows nurses to watch and monitor patients from a single screen, and technology for electronic learning systems to help with customer training.

It’s very important that the hospitals are happy with Epic’s service. After all, the health-care company charges upwards of $20-30 million per client. But what Epic’s learned over its 30-year career is that customer service must be a primary goal.

“They’ve been successful because they have a relentless pursuit of customer service,” says Shahid Shah, CEO of Netspective Communications, a health care strategy consulting firm focusing on technology; and health IT blogger at Healthcareguy.com. “It’s not an overnight success. It’s one they’ve been working on for a very long time.”

Epic was founded in 1979 in Madison, Wisconsin, and had three half-time employees. Now, they have a 500-acre rural campus in Verona, in addition to an office in The Netherlands. Epic isn’t just expanding. They’re also incredibly environmentally conscious. All of their buildings rely on geothermal energy to heat and cool, and the company is planning on adding a 15-acre solar farm, complete with a biomass digester and wind turbines so that their consumption comes from alternative sources.

Epic currently has 225 customers and 4,000 employees and serves nearly 95 million patients and clients who are based in hospitals, academic facilities, group practices and safety net organizations. Once rollouts are complete, Epic will be serving 200,000 physicians, according to Barb Hernandez, Epic’s spokeswoman.

In the past year, Epic has added nearly 600 new employees to its staff this year—and it continues to grow. They had just 396 people in 2000, but have added 2,000 people over the past decade, and now have a payroll that tops $300 million.

The systems company opened four new office buildings to its $500 million campus to house 3,600 of its employees. Other people work in the older offices in Madison or in its small Netherlands outpost. The growth appears to be happening at exactly the right time for the company. Epic is projected to end the year with $780 million in revenue, which is up from $650 million last year and just $47 million in 2000.

Still, Epic is very picky and private. They will only accept clients who are large or major health care providers. In fact, they won’t even take hospitals if they have fewer than 400 beds, Shah explains.

“What happens in most implementations for their competitors is that they will sign up as many people as possible as quickly as possible,” Shah says. “If you look at Epic, they will let go of just as many customers as they accept if they don’t believe that they’ll benefit from the software.”

Epic is also inflexible about modifying its software to fit the needs of the customers. Unlike competitors, who let their customers go in and change the software, Epic stands behind each application and won’t let anyone alter it in any way, Shah says.

Epic also rarely advertises and doesn’t encourage media articles. In fact, after numerous calls and e-mails to the company, the spokeswoman said that there was no one available to answer any basic questions. When asked how they are able to grab so many more clients than their competitors, Hernandez says that Epic doesn’t comment about competitors. She added that the company’s managers and leaders were too busy to speak with newspaper reporters, even if the reporter in question was writing a major feature story about them.

The privacy and lack of advertising doesn’t appear to be working against Epic. They’ve grown from their initial $70,000 investment in 1979 to its estimated market value today of $2.6 billion. A large part of Epic’s success is owed to federal government mandates. An April 2009 survey published in the New England Journal of Medicine found that only 1.5 percent of hospitals in the United States had comprehensive electronic record systems. Plus, only 8 percent of hospitals had basic systems covering at least one clinical unit.

President Obama wants that to change. He created an economic stimulus package which provides billions of dollars for hospitals and health care facilities to buy and start using digital patient records. In addition, the Health Information Technology for Economic Clinical Health earmarked $19 billion for Medicaid and Medicare technology over the next five years.

By creating electronic health records, hospitals and doctors could earn up to $27 billion over the next decade, and each doctor can receive up to $63,750 for using technology for Medicaid, and up to $44,000 for Medicare.

Hospitals and doctors who are interested in the incentive programs must demonstrate that they are making meaningful use of their systems and are able to track their success and quality of the applications. While the incentives are nothing to frown at, the hospitals are motivated to move quickly too. Part of the administration’s plan stipulates that health care providers could face financial penalties if they don’t start using electronic health systems within the next five years.

It’s about time that the medical field entered the modern age, Shah says. “There are two primary reasons for electronic health records: Patient safety and improved clinical outcomes, But it’ll take a decade or two to gain the kinds of efficiency that we’ll need in order to get the big benefits that we’re hoping to get.”

Right now, what takes a doctor a few minutes to scribble into his notes will take about 10 minutes to do electronically through Epic’s systems. Some of the doctors have a hard time using computers and others don’t see the necessity since they can just write their prescriptions by hand and use shorthand to jot down their notes.

And while the electronic health records provided by companies like Epic strive to make the administrative aspect of medical care easier, it’s hard to say how much they really help with safety. According to Shah, 90,000-100,000 deaths that occur annually can be traced to record-keeping mistakes and unless doctors see themselves making mistakes, you can’t prove that it’s happening.

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