After deploying its new EHR on March 3, United Community & Family Services is now redirecting its full focus from optimizing the Epic system to its response to the coronavirus pandemic.
The Norwich, Conn.-based medical center, which has been preparing for the $1.8 million EHR implementation for the past two and a half years, has been gradually scaling back its focus on EHR optimization and instead is deploying telemedicine services for patients and providers to use to connect and avoid spreading COVID-19.
"By week three of our go-live, I would say that 85 percent of our attention was focused on COVID-19 and a mere 15 percent was really focused on the EHR," UCFS CEO Jennifer Granger told Becker's Hospital Review.
Despite the optimization component of the project being somewhat derailed by the coronavirus pandemic, UCFS employees have adjusted to using the new EHR both remotely and in office. Here, Ms. Granger discusses some of the challenges associated with navigating an EHR implementation mid pandemic as well as how some of the technology benefits that have transpired as a result.
Editor's note: Responses have been lightly edited for clarity and length.
Question: How has the coronavirus pandemic affected your organization's EHR implementation?
Jennifer Granger: We have been pleased to be using Epic as the team had a whole lot of training and were well prepared to launch it, however, the fine tuning and exploring all of the reporting options that we had really hoped to spend more time doing has been diverted to making sure we're prepared for the coronavirus by reorganizing our staff and other measures such as finding protective equipment and tests.
Q: How has patient care been altered during this situation?
JG: We were able to launch telemedicine literally in three days time after having just deployed an EHR. Up until just recently, the state department did not pay for Medicaid patients to use telemedicine in Connecticut. For us, with a new EHR, in order to integrate telemedicine services will take at least three to four weeks. We didn't really have time to spare, so we went ahead on March 16 and purchased licenses for a telemedicine product to use while Epic is still working on the EHR-integrated virtual care solution. We are using two products, Zoom and Doxy.me, which are both HIPAA compliant and can be used outside of our Epic system. The video conferencing platforms allow our providers to virtually visit with patients and then just document the encounters in Epic.
We started on Monday, March 16, by having our first providers begin to use the telemedicine technology. By Wednesday afternoon, we had conducted many visits and we're continuing to roll out these telemedicine solutions to all our behavioral health and medical providers. So, we've been on kind of a roller coaster. It's like really having the perfect storm of this virus and a new EHR implementation. The staff has been amazing but very overwhelmed as you might imagine having to do both at the same time.
Q: Where do you stand now in terms of the status of the EHR implementation?
JG: Our whole organization went live on the new EHR. What has stopped, however, is some of the focus on optimization, including some of the reporting that we'd hoped to fine tune and generate. Right now we're really just running some of the basic reports to monitor the pandemic activity, such as information on how many patients we're seeing, how many are telemedicine visits and how many are in-person visits. Because we're new to Epic, it now takes us a little longer to understand how to write and run reports out of the system, which contributes to part of the optimization delays.
Q: When do you expect you'll be able to pick up again and double down on optimization efforts?
JG: We're taking it day-by-day, need-by-need. We're focusing in on what we need to get our visits that we're conducting paid and out the door. For example, we turned our attention from how to bill for telemedicine. We've never done that before, even in our other system. So, the Epic product that we have purchased and the company network model we're using have had to ramp up their ability to support health centers by including new codes for telemedicine that were not previously in the system. They've had to update their system and we've had to roll that out and train our providers on how to code, where to find the proper codes and the proper steps to code a visit that's conducted via telemedicine. In terms of training, those factors have jumped to the forefront because we had not planned to implement that for another few weeks into the future.
Q: Is there anything else you'd like to add?
JG: For patients to use the EHR-integrated telemedicine service we plan to deploy, they must enroll in Epic's online patient portal. The telemedicine systems we're using now do not require that. We serve 20,000 patients a year. This means that right now, all 20,000 users don't have to be part of the patient portal to access the telemedicine service. We did something quickly that is a much more effective way than trying to get everyone enrolled in the patient portal, so it actually benefited us to have to turn the service around quickly to reach the maximum number of people. While we just launched the EHR, we only had about 120 people enrolled in our patient portal since it was brand new and we hadn't seen that many patients yet to get them enrolled. If we had to wait to enroll everybody it would be taking us a lot longer to enable those people to access our service through telemedicine. Using a system outside of Epic has actually benefited us to get access to the most people through telemedicine.