Iowa City-based University of Iowa Health Care has been extending Epic to other hospitals across the state to increase access to the EHR.
Through Epic’s Community Connect program, UI Health Care has helped nine critical access hospitals in Iowa get on its EHR over the past decade-plus.
“Not only would Epic be pretty unattainable from a contracting perspective for each site individually, but the technical support that’s needed to run Epic easily overwhelms what a small rural hospital is able to do, so we’re able to support them with our own internal technical staff,” Lee Carmen, associate vice president for information systems and CIO of UI Health Care, told Becker’s. “That ensures these small rural hospitals are running the latest and greatest electronic medical record tools, revenue cycle management tools … and we’re able to keep them up and current on all the latest technology by using our own internal resources.”
Waukon, Iowa-based Veterans Memorial Hospital was the latest facility to join UI Health Care’s Epic EHR through the program, in June, with plans to extend it next to Waverly (Iowa) Health Center. Implementations typically take 11 to 14 months.
The hospitals that UI Health Care works with are independent, and the health system doesn’t require any kind of business relationship. UI Health Care doesn’t have any referral expectation from the participating hospitals, though if the facilities do make referrals having Epic makes it easier for UI providers to see the patients’ past care. The health system also offers clinical research opportunities to member hospitals.
Mr. Carmen said the arrangements boost healthcare delivery across the state.
“We actually have sites coming to us now wanting to sign up because they’re struggling to recruit new staff because they are not on a tool like Epic,” he said. “We believe it really does improve quality and outcomes, and it’s a better revenue cycle management tool. We also believe there’s great value clinically to making data available to providers at the point of care.”
Hospitals pay for the service, with the cost depending on their size and reach. Veterans Memorial Hospital, for instance, paid $3.88 million for the implementation.
“We don’t run it in the red, but we’re not doing it to make a margin and create new revenue streams for us,” Mr. Carmen said. “We’re just covering our costs. And keeping the cost low is helpful to the rural sites.”
Participating hospitals initially had challenges switching to a new revenue cycle system but UI Health Care has since put extra resources into advising them on accounts receivable strategy and billing-and-coding staff and training needs during the transitions.
UI Health Care now only has the capacity to complete one implementation at a time but is growing staff and redesigning processes to do two concurrently. The health system has five hospitals on the waiting list to join.
The program has also created a collaborative approach among the member hospitals.
“If there’s a site, for example, that’s looking to buy new anesthesia machines, they realize that we’ll interface Epic to any medical device that can take an interface. But if they’re interfacing it to a device that we’ve already developed an interface for, because another customer has it, we only charge them time and materials to do that, so it’s a much lower cost for them and much faster time to production if they acquire a new device that already is in use in the network,” Mr. Carmen said. “Or if they’re struggling with prior auth with a particular payer, or they’re struggling with having an optimized revenue cycle process, they will talk amongst themselves as to ‘Well, what did you do and what reports are you using to manage daily activity, or what reports are you using to manage your KPIs?'”
Mr. Carmen said the program has been a “big success” and “mutually beneficial” to UI Health Care and the rural hospitals alike.
“As long as there’s demand, we’ll continue to grow it, and it really is a result of a strong partnership with the other hospitals,” he said. “They benefit because they see how a large academic practices. We offer them if they want our order sets, our clinical protocols. That intellectual property is available to them if they choose to adopt it into their clinical practice. But we also learn things from the rural healthcare setting that bring value to our organization.”
