The key to an affordable Epic install

Hospital executives told Becker's that the key to a successful and affordable EHR implementation is creating a thorough plan, utilizing all your resources and looking to the future. 

"It's important to get the implementation right the first time," Cleveland-based University Hospitals CIO Robert Eardley told Becker's. "The most important step in the process is developing a solid, comprehensive cost model. This way you can gain confidence with senior leadership and the board that varied costs are accounted for in the budget plan." 

Hospital leaders are caught between the tension of needing to digitize their operations and the rising cost of software. With EHRs being perhaps the most expensive software investment a hospital will make, an over-budget installation can be disastrous.

In October, Gardner, Mass.-based Heywood Healthcare cited a "lengthy electronic medical record transition" as part of its decision to file for Chapter 11 bankruptcy. Fort Lauderdale, Fla.-based Broward Health announced its transition to Epic will cost $250 million.

CIOs are working closely with their finance departments to ensure there is room for a new EHR on the balance sheet. Pittsburgh-based UPMC is switching from nine EHRs to Epic. UPMC CIO Ed McCallister said he is working to make the health system's transfer of 6 million patient records "as cost-effective as possible."

"We align with finance and are intentional to validate that together we have a common understanding that these initiatives are necessary to drive UPMC forward, while not losing sight of the costs associated with these activities," said Mr. McCallister. "To accomplish this, together we leverage common tools and methodologies to plan and deploy technology investments across the organization. More specifically, we utilize a cost transparency budgeting tool to have data-driven discussions with our customers to meet their needs in the most valuable and cost-effective way."

To keep costs down during the installation and make sure that care isn't affected, some CIOs have had success turning to outside help. Mr. McCallister has created a "three-legged stool" that brings together Epic's expertise, internal UPMC talent and external workers. Methodist Le Bonheur has also brought in external workers to help keep the costs of its Epic installation down.

"We wanted to ensure that we had an experienced implementation partner who would work with other large health systems similar to ours, who were used to coming in on time, on budget and on benefit," said Methodist Le Bonheur COO Monica Wharton. "Deloitte has been a tremendous partner, as well as Epic, and we've set up the appropriate governance models to really help ensure we are moving in the right direction for this initiative."

Despite the lofty installation costs, hospital executives said it is important to view a new EHR as a long-term financial investment. 

"We see it as 'no margin, no mission.' We don't drive ourselves to deliver care based on revenue, but it is an important piece of the business," said New Hyde Park, N.Y.-based Northwell Health CIO Sophy Lu. "The investment is significant, but the outcomes that you get out of it are also significant. It leaps you into the future and allows you to do different things because now your building blocks are set to integrate on top."

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