Cleveland-based MetroHealth, which has used the Epic EHR system since 1999, meets quarterly with Epic founder and CEO Judy Faulkner.
“We still have quarterly calls with Judy Faulkner,” David Kaelber, MD, PhD, MetroHealth’s vice president and chief health informatics officer, told Becker’s. “That continues to amaze me. Those conversations help ensure alignment at the strategic level.”
During one of those calls a few years ago, MetroHealth leaders raised concerns that Epic’s Hello World tool — a communication platform that sends text messages for appointment reminders, prescription updates and billing alerts — relied solely on texting. For the health system’s safety-net population, they said, that posed a barrier.
According to Dr. Kaelber, Ms. Faulkner immediately brought a senior Epic leader into the conversation, kicking off a multiyear collaboration that led to the addition of voice capabilities. MetroHealth went live with the feature in November.
“To me, that’s what true partnership looks like — having the right interactions with the company so real changes can happen that benefit both sides,” Dr. Kaelber said.
That level of engagement reflects a relationship that stretches back nearly three decades. MetroHealth has been on Epic longer than most health systems and began exploring an EHR for its ambulatory clinics as early as 1995.
“We were a very early adopter — this was before meaningful use, when the EHR landscape was still the Wild West,” Dr. Kaelber said. “So choosing an EHR at all, and then choosing Epic specifically, was a major milestone for MetroHealth.”
MetroHealth’s Epic journey began the day before Thanksgiving in 1997, when the health system sent a small crew to Madison, Wis., where the EHR vendor was located at the time. According to Dr. Kaelber, Epic had essentially paused sales then to focus on improving its software.
“Our team basically knocked on Epic’s door and said, ‘We’re here to talk about an Epic contract,’ and Epic responded, ‘We’re not really selling right now — but you came all the way from Cleveland, so come in and let’s talk,'” he said.
After that visit, MetroHealth went live with Epic in its ambulatory facilities in 1999, becoming one of the vendor’s first 30 customers.
“The analogy I use is that we simply got an earlier start in the race. And we’ve been running hard ever since,” Dr. Kaelber said. “That head start has allowed us to accomplish more than many other health systems — not because we’re inherently special, but because we had visionary leaders who put us on the path early.”
Thirteen years later, in 2012, MetroHealth decided to become an Epic enterprise customer. An enterprise agreement means the health system pursues an Epic-first strategy: if Epic has a product that meets its basic needs — not necessarily the best on the market, but sufficient for its workflows — MetroHealth chooses Epic over a third-party vendor.
“We realized that if we wanted to get the full value out of our Epic investment, we needed to be all in,” Dr. Kaelber said. “That decision also cemented our partnership with Epic. We need to be closely aligned — to understand Epic’s roadmap almost as well as Epic does, and to use its features and functionality at the same level as their own staff. Philosophically and operationally, we committed fully.”
Today, MetroHealth is continuing to evaluate how to optimize its Epic EHR system, moving aggressively into ambient listening, asynchronous communication and Epic-to-Epic interoperability. More than 400,000 MetroHealth patients have signed up for MyChart, the health system’s electronic personal health record.
MetroHealth is also one of only 14 health systems to have been named to Epic’s honor roll six times, placing it among the top 3% of customers of the EHR platform, according to Dr. Kaelber.
