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Fall 2011

An epic journey

Date: October 3, 2011

The Epic software system will provide a single portal through which Hopkins doctors and patients can track care records, schedule appointments, and review billing statements.
The Epic software system will provide a single portal through which Hopkins doctors and patients can track care records, schedule appointments, and review billing statements.

Johns Hopkins Medicine leaps into the electronic future of health care.

With the 2013 launch of Epic, a software system that will integrate medical records across Johns Hopkins Medicine into a central database, all of the health system’s 1,700 specialists and primary care physicians will soon be able to keep track of their patients’ progress as they move through different clinical sites.

“Not only will I be looking at the records of patients who have come into Johns Hopkins Community Physicians, I will be able to track them across Hopkins,” says internist Gene E. Green, JHCP’s vice president of medical affairs. “The number of places where caregivers touch our patients that I can see will increase by an order of magnitude.”

Epic will provide a single system for registration, appointment scheduling, patient accounting, and billing. With its rich store of real-time patient information, it will also give providers a complete picture of all admissions and discharges, expediting bed management. Through their own electronic portals, patients will be able to see their online charts, request appointments, and review billing statements.

“Right now, patients across the health system are on multiple scheduling systems, which are complex because they have expanded over the years in different clinical specialties. Now, we can create a new scheduling system as a baseline to improve simplicity and function for all specialties,” says Wayne Smith, the former senior director of information services for the Clinical Practice Association and now the project director for the Epic implementation.

The Hopkins Medicine trustees recently approved a $100 million investment to activate Epic, starting with the health system’s ambulatory care centers. The endeavor comes at a pivotal point in the health system’s history, when rapid growth, financial challenges, regulatory obligations, and health care reform demand a fundamental shift in medical and administrative practices.

“We can’t continue to grow and be efficient, safe, and patient-centered unless we make this investment,” says Stephanie Reel, the university’s chief information officer and vice provost for information technology. Reel also sees the new system as a boon for Hopkins researchers and educators. “Epic can be a foundation for their work because patient data is the baseline for translational research and for the School of Medicine’s new curriculum,”  she notes.

Selected in part for its seamless integration of ambulatory and inpatient records, the Epic system will be phased in across all care settings over a five- to six-year period, pending the approval of the Johns Hopkins Medicine and Johns Hopkins Health System boards of trustees. When complete, Epic will have eliminated more than a dozen patient record systems across the Hopkins institutions and transformed work routines for thousands of employees.

Along with executives, scores of administrators and clinicians have prepared a comprehensive plan and timeline for the Epic rollout. Pending board approval, leaders are eyeing an almost simultaneous launch of Epic on the inpatient units of Sibley Memorial and Howard County General hospitals because their electronic health record systems are outdated and in need of a more immediate upgrade.

Because the current clinical information system for inpatients at Hopkins Hospital—known as Sunrise—is robust enough to meet pending federal regulatory requirements, it will be among the last to migrate to Epic, most likely in five years, Smith says. For the time being, Johns Hopkins Bayview Medical Center and Suburban Hospital also will rely on their respective electronic record systems. At present, All Children’s Hospital in St. Petersburg is not part of the initiative.

As he prepares for JHCP’s migration to EpicCare as part of the Ambulatory First rollout, internist Gene Green sees even greater benefits ahead. “I’m really excited that it will be easy to find electronic patient information from specialists that I used to have to search for outside the JHCP system,” Green says. “This system is truly patient-centric.”

Stephanie Shapiro