Overview
WellSpan Health is an integrated health care system headquartered in York, Pennsylvania. WellSpan works to ensure that inpatient, outpatient, home health and physician services are accessible throughout the region by:
- Providing care at six area hospitals
- Offering services at more than 130 outpatient locations
- Operating a regional home care organization
WellSpan launched “Project One,” to consolidate their five legacy EHRs and convert the entire system to the Epic EHR platform. At an estimated cost of $188.7 million over three years, the goal was to create uniformity, better connect providers with patients, and improve care coordination.
WellSpan chose e4health as a partner to support “Project One” by reducing costs, increasing accuracy, improving productivity, ensuring timely project completion, and successfully converting over 250,000 patient records to the Epic EHR platform.
Download our case study to learn how WellSpan overcame the challenges of interfacing 5 legacy EHRs to the Epic platform.
The Challenge
Overcoming the challenges of interfacing WellSpan’s 5 legacy EHRs to the Epic platform
The Epic EHR platform is designed as a true repository for quality historical patient data to be used by physicians and care providers on day one. However, interfacing WellSpan legacy systems into the new Epic EHR platform was not an exact science. The specific Epic format coupled with the limitations of five legacy systems posed significant challenges for an interface match that was all-inclusive. Multiple key clinical data did not interface to Epic including medical, social, family and surgical history. The interfaced data also resulted in duplicate records as well as the inclusion of non-pertinent data. Consequently, Epic was populated with data that called for validation and manual clean-up, and required input of missing key clinical data in order for Epic to function as it was designed.
Integrating a newly acquired cardiology practice onto Epic posed a unique challenge as the practice was not part of the original project plan and added additional legacy records to the mix. There was no data interfaced into Epic and the scanning process was time consuming and tedious. Time and cost constraints necessitated an individualized project plan to handle the practice conversion to EPIC including an innovative approach to scanning records and highly specialized manual clinical data abstraction.
Like most health care organizations, WellSpan was faced with implementing Epic quickly and efficiently with minimal disruption to patient care flow, physician process and without additional work placed on WellSpan staff. The key to success was to ensure physicians and care providers maintained their productivity in terms of patient care and had immediate access to quality and complete patient data on day one.
The Solution
The Intellis implementation team worked with the WellSpan team to determine the timeframe, elucidate the challenges and goals, and develop a comprehensive project plan. These coordination efforts resulted in the decision to preload the Epic EHR for 250,000 patient records.
The criteria determining which records would be preloaded was the anticipation of six months of future patient appointments, along with patients with multiple appointments within the past 18 months. The plan ensured that key patient information was preloaded into Epic prior to the patient visit, supplying the provider with the clinical picture and all information necessary to promote continuity of patient care. The plan took into account how much time and effort was required by physicians and providers if the key clinical data was not preloaded. The excess time involved would have decreased physician productivity, negatively impacted patient care and provided inconsistent EHR across the health system.
A joint staffing approach was used. WellSpan employees worked hours outside of their typical schedules, and Intellis supplied a team of experienced clinical data abstractors. The abstractors precisely reviewed all interfaced data, eliminated duplications, added uninterfaced key clinical data elements, and performed a comprehensive validation. This ensured that each patient record was accurate and ready for use on day one.
The Intellis team began with 24 clinical data abstractors and ramped up to 80 abstractors as needed to maintain the schedule. Understanding that flexibility is key when managing fluid projects, Intellis was able to adjust the abstraction staff — both to increase and decrease — as the workflow dictated.
Further, Intellis provided a customized rollout for the newly acquired cardiology practice. Intellis’ clinical data manager worked with the practice to meet their specialized needs. The issues were twofold. The legacy system and Epic were housed on two different servers. In addition, the legacy system had limited licenses for abstraction use. Intellis’ clinical data manager formulated a plan allowing scanning to be performed off hours. He brought a scanning team onsite, and records were scanned directly into Epic. Then a team of clinical data abstractors accessed the scanned charts and manually input the key clinical findings.
Working in concert, the Intellis clinical data manager, the cardiology practice manager, and the group physicians indentified and tailored key findings that the physicians deemed essential for inclusion in the EHR. The findings differed from those captured in the general project. As a result, 10,000 Cardiology charts were scanned and abstracted in a four-week period. The Intellis team stayed ahead of the patient schedule and satisfied the unique needs of the cardiology practice.
IMPACTS AND RESULTS “PROJECT ONE”
- Successfully integrated 5 legacy EHRs into the Epic platform ensuring all key clinical data was included and eliminating duplicate and non-pertinent data.
- Achieved over 99% accuracy for all data preloaded into Epic EHR from legacy platforms.
- Abstracted and validated 250,000 patient records for readiness on day one.
- Increased efficiency of the project by 53% as the project progressed.
- Added flexibility to abstractor staffing with the ability to ramp up experienced, precise personnel by as much as 233%.
- Developed and executed a customized solution for the cardiology practice by scanning 10,000 records and abstracting directly into Epic.