Symposium at Olympic Medical Center highlights challenges of electronic medical records systems

PORT ANGELES — More than three years after the implementation of a digital patient-records system called Epic at North Olympic Peninsula hospitals, challenges still remain with data sharing.

Epic — a single-database electronic health records system designed by Epic Systems Corp. of Madison, Wis. — is designed to allow doctors throughout the region access to patients’ medical charts in real time, according to health care officials. It is one of several software suites offered by a variety of companies that are generally incompatible.

Such incompatibility issues can prevent doctors at separate hospitals from accessing such data in a timely manner, according to hospital administrators.

Olympic Medical Center, Jefferson Healthcare in Port Townsend and other hospitals associated with Swedish Medical Center and its partner Providence Health &Services use Epic, although in various versions.

Epic was one of several topics, including physician recruitment and TeleHealth updates, discussed at Swedish Health Network’s 2016 annual symposium at OMC on Friday.

OMC began using Epic in May 2013 after a $9 million implementation, with Jefferson Healthcare making the switch in June 2013, according to PDN archives.

While OMC and Jefferson essentially use an identical Epic system, throughout the state, there are 11 “instances” or versions of Epic in use by hospitals, according to Eric Lewis, OMC chief executive officer.

“Instances mean different organizations have different Epic products,” Lewis said after the daylong gathering in Linkletter Hall. “They don’t necessarily talk to each other.”

Epic “is really about getting the right information in the right hands at the right time, and making it very efficient for the patient, because the patient really expects doctors to talk to each other,” even at different facilities, Lewis said.

“If you are on different systems, it is hard. We want to make it easy for the doctor. What we are talking about is having all those different versions of Epic talking to each other.”

But roadblocks preventing seamless data sharing remain, said Rachel Leiber, Providence Health &Services health information exchange and interoperability program manager, on Friday.

Currently, customers using the same electronic medical records (EMR) software “intrinsically believe they can talk to each other,” Leiber told an audience of about 30 medical professionals during the symposium.

“That is why you bought the same product. Is that how it feels? No.”

When it comes to the problems of accessing records across different formats of Epic — or other software entirely — “we haven’t solved it yet,” Leiber said.

System administrators “can’t get the systems to talk to each other, and that is just the situation that we are in,” she said.

“We are in a little bit of Middle Earth right now, where we have the need and the customers demanding it and we don’t have the vendors and technology supporting it completely.”

Currently, third-party providers act as go-betweens for the software suites — allowing hospitals using different programs to communicate with each other, Leiber said.

“These are for-profit vendors or not-for-profit organizations that facilitate as a neutral third party where competitive organizations can neutrally send clinical information,” she said.

“If both providers have a treatment relationship established with that patient, they can now access that patient’s record. It removes the competitive component of information, because that shouldn’t be a competitive part of the relationship. It totally is still.”

This system is contingent upon hospitals making their information available to the third-party providers, Leiber said, adding that some organizations may feel uncomfortable with transmitting all their data and only send portions.

“All of a sudden, my providers on each end are getting these messages … saying sorry, you can’t have those records,” she said.

In-house, Swedish is looking at how to better improve communication between separate instances of Epic in use by its affiliates, Leiber said.

“We are piloting build of what is called [the] Care Everywhere Referrals Management Tool, which allows for referrals information from OMC to fly up to Swedish,” she said.

“Swedish can manage that data and [OMC] will be electronically notified of the status of the referral of the patient you send. This alleviates the need to be on the same instance.”

It is highly doubtful that all providers will someday switch to the same instance of Epic or even the same EMR software, Leiber said.

As such, other solutions will need to be implemented, she said, adding that the various health care providers in the state will need to work together.

“We have to have those partnership conversations with each of these organizations because we are never going to be on the same EMR,” she said.

However, “those vendors should support clinical exchange of information with the same definitions of data,” Leiber said.

There is a long list of organizations that “have to start playing by the same set of rules, so that we all are providing [information] exchange in the same way, [creating] a seamless experience so you don’t even feel it anymore, because right now it is painful,” she said.

The health care community in the state as a whole needs “to think about the partnership with group health, with multi-care … and how we interact as an ecosystem within Washington,” Leiber said.

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Features Editor Chris McDaniel can be reached at 360-452-2345, ext. 56650, or at cmcdaniel@peninsuladailynews.com.

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