UMass Goes Big on Health Records Tech

This summer, UMass Memorial Health Care made a big statement about its commitment to health care information technology when the Worcester-based health care system, the dominant provider in Central Massachusetts, revealed it would spend $700 million upgrading its electronic health records system.

Suddenly, a system that had been shedding services in the previous couple of years in order to shore up its finances was detailing plans to purchase one of the most expensive electronic health records systems on the market from Epic Systems Corp. Along with the software, the process of building out the necessary IT infrastructure would contribute to the total investment of $700 million throughout the multi-year project. The system’s Worcester hospitals are expected to go live with Epic in July 2017 before it is extended to UMass Memorial’s community hospitals and physician practices throughout the region.

Having an electronic health records system that allows doctors to share information across all UMass Memorial sites is the goal, and Dickson said at the time of the announcement that improving efficiency by two or three percent through the project will make the $700 million back several times over in a short period of time. That’s because time spent trying to obtain records at different sites costs money and also impacts the quality of care patients receive.

But this opportunity isn’t just for UMass Memorial hospitals and doctors. Dickson said in an interview last month that hospital executives are in the process of enticing affiliated hospitals outside the UMass Memorial system that provide care in Central Massachusetts to adopt the same system. UMass Memorial can help them do it at a bargain, so that it would be cheaper than adopting any other solution, according to Dickson. This would set the stage for a health care system that is completely, electronically integrated throughout Central Massachusetts for optimal efficiency and health care quality, Dickson said.

Dickson said UMass Memorial already plays a “very unique role” as the connector of all Central Massachusetts health care players. The system has formal affiliations with Heywood Hospital with campuses in Athol and Gardner, Harrington HealthCare with hospitals in Southbridge and Webster, and Milford Regional Hospital. It also either owns or is affiliated with about 75 percent of physicians practicing in the region, Dickson said.

“We connect almost all of the care that occurs in Central Massachusetts,” Dickson said.

Still, doctors frequently struggle with sharing information, both with providers within the system and outside. By negotiating a price with Epic for affiliated doctor groups outside the UMass System as well as the community hospitals, Dickson said the potential for records sharing to become seamless is real. But it will take some work to get there. Doctors’ groups on the whole, which generally have smaller IT budgets but are under the same pressure to have robust EHR systems as hospitals, are excited by the Epic option, Dickson said. Community hospitals are a little more reserved, though Dickson said there is some interest.

“For the hospitals, we’ve got some work to do to convince them at that this is actually going to be worth the change,” Dickson said.

He recognized that transitioning to a new EHR system is a massive undertaking, more so for hospitals than for physician practices.

The U.S. EHR systems market has been growing at about 7 percent a year and is expected to hit $9.3 billion by the end of this year, according to a 2014 report from research firm Accenture. Epic is by far the largest vendor for doctors’ offices, serving more than twice as many providers as its nearest competitors, Allscripts and eClinicalWorks LLC, according to data from the Centers for Medicare and Medicaid Services. Meanwhile, for hospitals, the top EHR vendors are Cerner Corp., followed closely by MEDITECH and then Epic, with the three companies making up almost 60 percent of the market.

Edward Kelly, president and CEO of Milford Regional Medical Center, said an IT system upgrade is definitely in the independent hospital’s future, but the administration is waiting until a $54 million building expansion project is complete this fall. He said that UMass Memorial’s proposition may be attractive, but it’s not the only system that has approached Milford Regional about signing on to its EHR system. Other providers in Boston with which Milford Regional works closely have considered doing the same.

“We need to make sure that whatever we do we can communicate with all the organizations that we do business with,” Kelly said, noting that Milford Regional straddles the line between Boston and Worcester.

Kelly also pointed out that UMass Memorial is first rolling the Epic system out at its Worcester campuses. Epic won’t be live at its community hospitals for another few years. He said Milford Regional will be watching that process closely.

Larry Garber, medical director for informatics at Reliant Medical Group in Worcester, said he thinks UMass made a smart choice in selecting the Epic system.

“Realistically I told them they should have gotten Epic years ago,” he said. “There’s no question that Epic is the best system in the country.”

Reliant chose Epic for its own EHR system back in 2004, Garber said. He said he’s been impressed with the technology itself as well as the support the company provided in implementing it and training doctors and other staff in its use.

Still, Garber said it’s not necessary for everyone in Central Massachusetts to use the same vendor for their records. He said Reliant already has an interface to share records with the current UMass system—and with Milford Regional, Harrington, and Saint Vincent Hospital in Worcester—even though none of them use Epic at the moment.

“It’s not crucial for interoperability,” he said.

For some medical practices, the notion of making any change at all in their EHR system is unappealing. Blaine Christopher, practice administrator at Child Health Associates in Auburn, said the office has been using General Electric’s Centricity records system for seven years and has no plans to switch.

“We invested a significant amount of time and resources to implement this system,” she said. “It’s a huge undertaking for human resources, as well as financial resources.”

Christopher said the process of getting the practice’s staff used to the system involved a “huge learning curve.” The practice also put a lot of time and energy into customizing the system’s forms to fit its needs, she said, and switching to another system would probably involve a similar amount of work.

“It’s definitely not something that we want to look at doing anytime soon,” she said.

Still, Christopher said there are some downsides to the practice’s current setup. For example, if one of their patients is seen at the UMass emergency room, the EHR system can receive notifications about the visit, but the communication doesn’t go the other way, so it can’t share the patient’s records with the ER staff.

But even switching to Epic wouldn’t fully solve that problem, Christopher said. For one thing, the practice wants to be careful about the security questions involved in letting an outside party access patient records. For another, UMass isn’t the only hospital where Child Health patients receive care.

“UMass’s system won’t necessarily benefit us in communicating with Saint V’s or the Boston systems,” she said. “Everybody’s doing their own thing. It’s challenging.”

Heywood Hospital and Harrington Healthcare System officials declined to be interviewed for this story.