Waukon, Iowa-based Veterans Memorial Hospital went live with an Epic EHR on June 14 — all for the relatively low price of $3.88 million.
As a 25-bed critical access hospital, the organization typically wouldn’t have access to Epic, which usually only works with larger hospitals and health systems, said Veterans Memorial CEO Michael Coyle. Providers had been asking for a new EHR for improved patient safety.
In 2021, he sought out a partner through the EHR vendor’s Community Connect program, in which large health systems link smaller hospitals to their Epic EHRs.
The first two health systems he tried didn’t have the capacity to add a new partner. “So then I made one of the best phone calls I’ve ever made in my life,” Mr. Coyle told Becker’s.
He cold-called Iowa City-based University of Iowa Health Care. They set up a meeting for the next day.
“We just instantly had a bond between our two facilities,” Mr. Coyle recalled. “Everything that they could offer to us was exactly what we were looking for, and they challenged us a little bit in some of our workflows and some of the things we do here.”
Three years later, Mr. Coyle convinced his board to switch to Epic. Veterans Memorial started its implementation last summer, becoming the ninth hospital to be connected to UI Health Care’s Epic EHR. The county-owned hospital had previously used CPSI (now known as TruBridge) for its EHR.
UI Health Care supported Veterans Memorial through each of the implementation’s phases, from planning and discovery to the build to legacy data conversion to training to go-live. They used a “train-the-trainer” model, where UI staff taught about 40 Veterans Memorial EHR super users who then taught their colleagues how to use Epic. Mr. Coyle hosted a weekly podcast with a staff informacist to update Veterans Memorial employees on the rollout.
“We’ve had multiple comments from UIHC staff going, ‘We’ve done nine of these … and this has been by far the best implementation we’ve done,'” Mr. Coyle said. “And that really says a lot for how eager both staffs were to work together.”
Mr. Coyle said he expects to recoup the $3.88 million cost of the implementation (and then some) through improved revenue capture and population health. Veterans Memorial financed the purchase through bank-backed revenue bonds.
“Obviously it’s all about patient safety,” Mr. Coyle said. “But secondly, when you have a system that automatically drops charges for you, it takes the human error out of it. All of a sudden, we’re seeing more revenue because we’re dropping charges immediately, so it’s clean claims coming back faster, more money in the bank.”
He said patients will benefit from MyChart features like viewing test results, messaging providers and paying bills online.
To support the new EHR, Veterans Memorial brought on a CIO and increased its IT staff from two to six, planning to grow that number to 10 with the addition of informatics and financial analysis experts.
“The coolest thing about Epic is the amount of data you can get out of it,” Mr. Coyle said. “Data means nothing if you can’t use it. One of the things that rural hospitals have not done well in the past is get data, study the data, utilize the data to do predictive modeling, look at market share, market growth, how different service lines are operating.”
Since the switch, Veterans Memorial has decreased the average new patient registration time from 12 to 17 minutes to less than four. Processes in the OB department have been reduced from hours of paperwork to minutes. The hospital has only dealt with minor challenges so far, like printers printing at the wrong campus.
“I walked around, did some rounding, and staff was like, ‘You almost feel like you’ve been using it for years,'” Mr. Coyle said. “It’s pretty intuitive.”
Veterans Memorial hopes to use some of the AI features Epic is developing.
“I’m very curious to see what AI does on the billing side,” Mr. Coyle said. “So if I enter some notes, is AI smart enough to know that note equals this CPT code?”
The hospital hasn’t been able to afford all the features Epic has to offer, like linking blood pressure machines to the EHR, but hopes to eventually be able to.
“As we get better with Epic, and as we understand workflows, and we’re able to take some of those lost charges, and now that’s money in the bank, so I can afford some of these things,” Mr. Coyle said. “When you see everything they’re working on, my mouth waters.”
He said rural hospitals like his don’t have a lot of “bench strength,” so implementation leaders had to work on Epic while doing their regular jobs.
“Just kudos to the staff, because as the managers or the selected people were working Epic, there were people who were picking up a lot of additional shifts, taking on more duties, because they knew that at the end, this is exactly where we wanted to be as an organization,” he said.
