University Hospitals, based in Cleveland, is taking a strategic approach to digital transformation by embracing an "Epic first" philosophy.
This guiding principle ensures the health system prioritizes tools and innovations available within its Epic electronic health record platform whenever feasible, according to Robert Eardley, CIO of University Hospitals, who spoke with Becker's.
The decision to focus on Epic solutions stems from the health system's emphasis on streamlining workflows and maximizing its $400 million investment in the EHR system, completed in 2023.
"Our CEO has communicated twice this year to all leadership that we need to be Epic first," Mr. Eardley said. "If you are identifying a clinical or business need, start by exploring how we can expand the use of Epic to address it."
This philosophy aims to enhance efficiency and optimize clinical operations by leveraging Epic's built-in features, particularly its expanding suite of AI tools. These include predictive models and generative AI capabilities, which are pre-tested by Epic and integrated seamlessly into workflows.
"Epic has been investing in AI for over a decade and offers more than 30 pre-packaged predictive models, with new features introduced regularly," Craig Schwabl, vice president of enterprise analytics and digital solutions at University Hospitals, told Becker's. "This allows us to deploy tested models more quickly and reduce time to value."
A key advantage of the "Epic first" approach is the ability to maintain consistent workflows.
"We can interface data, but interfacing workflows is much harder," Mr. Eardley said. "By staying within Epic, workflows remain consistent and efficient, reducing the burden on end users."
For example, University Hospitals uses Epic's predictive models for tasks such as census forecasting, patient discharge predictions and clinical risk assessments. These models provide actionable insights while integrating into existing workflows, minimizing disruptions for clinicians.
Mr. Schwabl emphasized the importance of avoiding redundant features when evaluating external AI solutions.
"We are diligent in ensuring that external tools are only considered if they fill gaps that Epic cannot address or won't deliver in the near future," he said.
Balancing Epic and external tools
While Epic offers many capabilities, there are instances where third-party solutions or internal custom development are necessary. For example, University Hospitals uses non-Epic tools for radiology workflows, including AI-driven fracture analysis and image prioritization based on acuity. Similarly, the system employs external vendors for ambient listening technologies, which support clinical documentation.
However, introducing external tools can pose integration challenges.
"External AI tools must integrate back into Epic workflows to maintain efficiency," Mr. Schwabl said. "Asking clinicians to toggle between systems adds inefficiencies, which we aim to avoid."
As a relatively new Epic client, University Hospitals is focused on fully utilizing the platform's existing capabilities before adopting untested innovations. The health system has adopted a "cautiously optimistic" approach to generative AI, recognizing its potential while awaiting more proven applications.
"Epic's generative AI tools are still in their early stages, so we are evaluating their use thoughtfully while remaining focused on traditional AI models that are tried and tested," Mr. Schwabl said.
By taking an "Epic first" approach, University Hospitals is positioning itself to innovate responsibly while ensuring technology enhances, rather than complicates, clinician workflows.
"Our philosophy is not about limiting innovation but about prioritizing solutions that integrate seamlessly into our ecosystem," Mr. Eardley said.