A Story of Epic Proportions

Hawaii Pacific Health’s agreement with Epic Systems Corp. may signal a trend toward statewide, community-based healthcare

April, 2004

Hawaii’s two largest health care providers are going with the same technology vendor to integrate patient records, care and administration, and a third may be hopping onboard the same digital bandwagon.

Last year, Kaiser Permanente Medical Care Program of Oakland, Calif., announced a three-year, $1.8 billion partnership with Epic Systems Corp. of Madison, Wis. “Marriage between nation’s largest health care group and most advanced technology to revolutionize health care,” trumpeted the press release. Kaiser Permamente Medical Care Program in Hawaii, which is ranked no.1 on Hawaii Business’ list of healthcare providers, with $632 million in 2002 gross sales (see pg. 45), will be part of that nationwide integration of Kaiser’s systems.

Hawaii Pacific Health (HPH), which had $550 million in 2002 gross sales, announced in January that it had also entered into a multiyear agreement with Epic Systems Corp. This one is worth $35 million over five years. Dr. Lee Evslin, president and chief executive officer of HPH’s Wilcox Memorial Hospital and the Kauai Medical Group, says, “I’m pushing them to go as fast as possible. I think it’s a very good thing and it’s way overdue. It’s amazing, with the amount of data we work with in medicine, that we are as paper-bound as we are at this time.”

Improvements to HPH’s system will include: The ability for a nurse and doctor to click a mouse a couple of times, rather than pass papers through four sets of hands, to fill a prescription; patients having access to their medical information via the Web; and each patient in the four-hospital HPH system will have an integrated, paperless medical record.

HPH’s vice president for IT and revenue cycle management, Richard Robel, says, “It allows us to continue to move forward to a community-based patient medical record in essence, so we provide better care.”

Evslin adds, “Particularly intriguing to us is that Kaiser is definitely going in this direction and Queen’s [Health Systems] might be. If all the big players in the state are all on the same system, that would be pretty remarkable.”

According to Robel, if there were some sort of agreement among medical care providers to share information from a master patient index it would benefit, for example, a Kaiser patient who goes to another hospital’s emergency room. “Imagine that. In terms of treating the patient, they are going to have right up-to-the-minute, instant access to data for proper treatment,” he says.

Robel headed the selection process for an integrated system for HPH’s 6,000 employees and affiliates. He says, “This is going to be one of the few in the country that has this top to bottom integrated system governing hospitals, emergency rooms, clinics and physicians’ offices.” It also will integrate radiology and pharmacy operations. Robel is projecting that HPH will realize a return on its $35 million investment in five years.

Epic will increase efficiency for HPH by eliminating the need for seven different computer systems. Robel says, “A lot of them have been in place for some time. They’re legacy systems and some of them are main-frame, if you can imagine.”

Evslin says the bells and whistles of the new Epic system are phenomenal. “Say you went over [to Oahu from Kauai] and had a cardiac catheterization, and you came back to me, the primary physician. I could actually show you the cardiac catheterization on the computer screen, because those will be collected in digital format.”

Even if the system’s data remains confined to HPH and affiliates for now, Evslin says, “What it allows is a seamless transfer of patients around the state, with all of the records that we have now in electronic format, which is always extremely good for medical care.”

Patients aren’t the only ones who should experience increased effectiveness and efficiency. Evslin says, “What’s also very good is, you can, with a few clicks of the query system, tell how your physicians are doing against each other in chronic disease management. …If you think how hard that is with a paper chart where you are pulling one paper chart after another, it’s amazing.”

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Kelli Abe-Trifonovich