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May 15, 2013 Headlines 5 Comments

House Spending Panel Backs Joint Defense-VA Electronic Health Record

The House Appropriations Committee approves the VA’s requested 2014 budget line item of $252 million for an integrated electronic health record, then adds another $92 million, but mandates that no money be released except for an open architecture system that will serve as the sole EHR for the VA and DoD.

Physician adoption of health information technology: Implications for medical practice leaders and business partners

A Deloitte survey of US physicians finds that 75 percent believe that Meaningful Use holds promise for improved efficiency but that reduced costs resulting from the use of EHRs is inflated and that ultimately care will cost more, not less.

Wake Forest Baptist Medical Center reports gain in excess revenue

Wake Forest Baptist Medical Center reports operational income losses attributed to problems with its Epic implementation after spending $13 million directly on Epic and $8 million on implementation expenses. The hospital also reports $26 million in lost margin due to volume disruptions during initial go-live and post go-live optimization. Baptist was already scheduled to complete a staff reduction of 950 employees by June 30, but will now implement additional immediate cost-cutting measures. Moody’s has downgraded its long-term debt rating.

Expert predicts ‘meaningful use fatigue’ in 2015

Laura Kreofsky, principal at Impact Advisors and director of Sutter Health’s Meaningful Use program, discusses the need for organizations to operationalize Meaningful Use-related projects by moving them from small project teams to increasingly stretched IT departments. Due to this shift, she predicts widespread organizational "MU fatigue" by 2015.

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Currently there are "5 comments" on this Article:

  1. Failures of EPIC proportion: New York City Hospitals/Epic/Allscripts–in 2 years Mr. H will be posting about the financial shackles Epic put the city’s healthcare arm in and how Allscripts’ estimate of Epic costing 400 M more than what the city was estimating was true.

    If I was a resident of New York I would have backed the lawsuit Allscripts filed–it will be a waste of citizen tax money.

    How many more failures of Epic and Cerner before admins catch on, off the top of my head at 6am in the morning:

    UCSF Epic fail
    Maine Epic fail
    Contra Costa Epic fail
    Wake Med Epic fail
    UK several Cerner fails
    Not even going to start on Meditech

  2. UCSF Epic fail – local politics and poor leadership.
    Maine Epic fail – Poor leadership
    Contra Costa Epic fail – local county politics! Unions and county rules forced their hand…had to move the go live date up by over 6 months…
    Wake Med Epic fail – Poor leadership
    UK several Cerner fails: UK is a horrible environment to conduct business, can’t really blame Cerner for the Trusts that haven’t gone “as planned.”
    Not even going to start on Meditech – MEDITECH…It’s a acronym.

    Epic is a business. Selling it’s buddle packages to industry executives that have little to no experience in IT especially as it pertains to system wide EHR’s. It will be interesting to see what happens by 2015. This space is very hot right now, attracting a lot of attention from outside executives that are sure to bring value to the game. I’ll be surprised if Epic or Cerner are not still the two biggest fish in the pond by 2015. Weather their different clients force change is really up to the clients…haven’t seen much of that yet. Hoping…

  3. Sounds like a typical Epic response – it’s not us, our customers are just dumb. Let’s be really honest here. The larger Epic gets and the farther away it gets from hand-picked customers, the more it’s just like every other system before it – Cerner, Eclipsys, Meditech, and HBOC have all been industry darlings at one time that grew unwieldy as their businesses scaled and couldn’t deliver on promises. Epic may have the benefit both of coming last before the MU wave hit and limited competition, and being so expensive it’s not easy to replace. Give it time, though, Epic will fade. Nothing in health care happens quickly, but don’t take that to mean your customers are satisfied. Your customers are smarter than you think they are.

  4. Breaking News: EHRs cost money!

    Epic is one of the few vendors that drive clients to develop a total cost of ownership. The amount of funds that they collect for licensing, maintenance and installation professional services is a small portion of the total cost of a project. The resources are the largest part of the costs if you place a price on each hour spent on the installation. Some organizations choke on the amount of staffing required by Epic but this is what it takes to be successful.

    Few organizations have experience implementing a major system with a broad impact. They have little to no accurate reference point. For an EHR implementation to be successful, all the niche technology players in an organization, outside of the IS/IT are needed. Call them shadows, rogues, or whatever, it requires a “village” and when everyone sees how many people are in the village and the costs, most are astounded. Few organizations have had live round-the-clock clinical applications with a wide deployment requiring real-time support. To support the system in a way that the users expect you can’t use your run of the mill service desk staffer. It requires a more experienced resource that costs more money and may require some incentives to work off-shift. Another surprise to some but not if they have developed realistic total costs.

    If organizations just install a system to meet Meaningful Use, they miss the boat. If they just look at the costs short-term while they have the Meaningful Use incentives, they miss the boat. If they just slam a system in to get it live, they miss the boat. With the pressures faced by health care, finding efficiency, cost savings, lost revenue, better communication, and better information for decision-making is required.

    If people want to try to compare costs from vendor to vendor, they need to normalize the information as you would in any sound data analysis. I have been exposed or hands-on with the big vendors like Cerner, Eclipsys (Allscripts), Siemens, McKesson, and Epic. The cost differences when the project is done right, to the same scope and to the same level of completion are small.

    Its unfortunate that so many waited so long to install these systems. Now with multiple mounting pressures like ICD10, payment changes, and CMS penalties, the amount of change, amount of coordination and the alignment required is daunting for most organizations.

  5. I was at UCLA last week–the integration btwn departments is a mess…the project at a whole is a mess even with their sister campus, another Epic fail at UCSF, trying to help.

    They were suppose to have a blog about their Epic go-live and cant find enough physicians who are wiling to participate.

    We can add:

    UCLA Epic fail–docs hate it, lab and other department integration is clunky at beast
    AHMC in CA–Paragon fail, they bought Paragon and failed to achieve MU and are back looking for a better option
    Marin General hospital–Paragon fail, Mr. H has reported a good deal on this

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