Frank A. Sonnenberg, MD, FACP, FACMI
Chief Medical Informatics Officer, RWJBarnabas-Rutgers Medical Group
Professor of Medicine, Rutgers Robert Wood Johnson Medical School
I want to tell you a story about Jean.
Jean is 68 years old and lives in New Brunswick. She has breast cancer and is undergoing active treatment. Jean is a widow and lives alone. She’s diligent about her treatment but gets confused between visits to her oncologist, hematologist, surgeon, and primary care physician. Though her doctors work within the same hospital system, she needs to call each office to share her records. Jean wonders why every physician working within the same medical center can’t access her records.
Every time she has a doctor’s appointment, she’s asked to answer the same questions – over and over. She’s often fatigued from the chemotherapy, so her paperwork is inconsistent. Jean would love to bring her daughter to help with the paperwork and listen to what the doctor has to say, but she lives an hour away and is not always available. And Jean’s doctor doesn’t always have time to call and update Jean’s daughter.
Jean’s doctors are rarely in direct communication. Each visit consists of the same probing questions. For the clinicians, each visit requires another round of the same duplicative work.
During a routine visit with her oncologist, Jean’s results showed she had high blood pressure and abnormal blood counts. Her oncologist referred her to two other specialists who, in turn, have questions for her oncologists. The physicians were often unable to reach each other to discuss Jean’s case. They usually had to rely on faxes to exchange information. With this collection of fragmented and disjointed information, it took two weeks to coordinate care. Thank goodness, in this case, Jean was unharmed by her wait. However, she could have suffered a heart attack or stroke from uncontrolled hypertension due to uncoordinated care.
Jean’s Story with Epic
Jean’s story will read very differently after our Epic implementation. Physicians within RWJBH and Rutgers will have immediate access to all of Jean’s records. She won’t have to fill out new forms every time she sees a new provider — because the essential information is already there. Her daughter can participate in her visits through telemedicine without having to take a day off from work. An electronic summary of her visit will be available through MyChart that Jean can share to review the doctors’ recommendations. Should a Best Practice Advisory (BPA) indicate that Jean’s blood pressure is not well-controlled, her oncologist can send a secure message to her primary physician requesting a follow up on the blood pressure as soon as possible. The primary physician can immediately review her blood pressure readings and the medications she takes and resolves the issue the same day.
Jean’s story highlights the benefits of a single unified electronic health record system. By transitioning to one unified platform, stories like Jean’s “before” story will become far less common. That is what we mean when we say that Epic is giving all our patients a voice:
Jean’s unified EHR records and Epic’s patient-engagement tools become her voice.
Epic puts Jean at the center of her care journey. Also, it enhances the expertise of her care providers. With that—the Quadruple aim of better outcomes, improved patient and staff experience, and lower cost of care is achieved.
Enhancing Clinical Efficiency and Helping Providers Thrive
Epic has a comprehensive set of applications that work seamlessly: data is entered once and disseminated throughout the system. Expanded capabilities include:
- MyChart, Epic’s patient portal, lets patients view diagnostic test results, make appointments, request medication renewals, send and receive secure messages, and arrange telemedicine encounters throughout the system. These tools give patients more opportunities to participate in their care and enhanced administrative efficiencies for the practice (e.g., decreased reliance on phone calls, faxes, and postal mail).
- Care Everywhere, Epic’s interoperability solution provides access to electronic medical record data from any Epic provider in the U.S regardless of affiliation, including local systems such as Hackensack-Meridian, Atlantic Health System, and Penn Medicine (including Princeton).
- Analytic Tools and Decision Support Epic’s extensive array of analytics can display care gaps to providers within a patient’s chart and providers’ dashboards to show them how they perform with quality metrics. Users will be able to search Epic to identify their patients with specific characteristics, allowing for more targeted diagnostics. The greatly enhanced clinical decision support that Epic provides will improve patient safety and quality of care through automatic best practice advisories (aka. BPAs) under the organization’s control.
These powerful analytics will help deliver more value-based and accountable care and deliver better outcomes at lower costs.
Care Team and Patient Together: The True Meaning of Epic
Improving Patient Safety
Having all clinical data from all Rutgers & RWJBH practices on a single system will provide immediate availability of critical clinical data, active decision support, and enhanced patient safety. We will also avoid the unnecessary duplication of diagnostic tests, which incur additional costs and increase patient risk. These benefits bring us closer to our RWJBH’s Safety Together goal of zero instances of preventable harm.
The Epic system will also facilitate collaborative research, a cornerstone of RWJBH, and Rutgers’ affiliation agreement. Epic makes it easier to capture data on our entire patient population consistently, which is not currently feasible with our multiple electronic medical records.
Epic raises each of the RWBarnabas Health strategic pillars of Quality, Population Health, Improving Financial Performance, Academics and Research, Consumerism, and Social Impact, allowing us to provide care in a manner consistent with our Safety Together journey.
Without the burden of care coordination and information management, patients like Jean can shift their focus solely onto their health and benefit from a much-improved patient experience.
Epic Together is not just about teamwork at RWJBH. It’s about harmonizing communication between providers and patients, sharing information between providers and patients, and making patients central to the process.