West Burlington, Iowa-based Great River Health said Dec. 3 it would transition its EHR from Oracle Health, formerly known as Cerner, to Epic over the next 18 months. The $35 million investment will be the second-largest the health system has ever made, trailing only its new flagship hospital in 2001.
“It was difficult, yes, but it was also kind of easy at the same time, because they’ve got a proven track record,” Great River Health CFO Jeremy Alexander told Becker’s. “Their support model is wildly talented. They’ve got a really good reputation; they don’t let clients fail. They support the heck out of you as you work toward planning and implementation and post.”
It also wasn’t a hard sell to his colleagues in the C-suite. They understood that although the project would temporarily drain the health system’s finances, the ultimate return on investment would be worth it.
“You have to be a bit more long-term oriented,” Mr. Alexander said. “When we look at relative cost of ownership, it’s over a 10-year period. What you find is that for the first two, three years, you’re probably going to be operating in a bit worse financial environment as you work through preimplementation, implementation cost, your one-time opex [operating expenses], your capex [capital expenditures].”
For one, patients have been pining for Epic, Mr. Alexander said. They often ask why they can’t use MyChart like they do when they get specialty care at nearby Iowa City-based University of Iowa Health Care. Most of the surrounding hospitals have been switching to Epic as well.
Uncertainty with Oracle Health was also a factor, Mr. Alexander said. The company is building a new EHR, which is both “very exciting” and a “very scary prospect” for legacy customers that have spent so much time and money customizing their platforms, he said. The health system also lost a lot of its support contacts at Cerner following Oracle’s acquisition of the company in 2022.
“We were at a bit of a crossroads: You sign a short-term agreement with Oracle and hope they prove themselves out, or a long-term agreement with Epic, who have proven themselves time and time again with a number of other health systems,” Mr. Alexander said. “The known path, surprisingly enough as an existing Cerner client, was to move forward with Epic.”
At the time the health system signed with Cerner in 2014, Epic wouldn’t “return our phone calls,” Mr. Alexander said.
“They weren’t really looking for clients of our size at the time,” he said. “We really had no actual choice but to move to Cerner to get to where we wanted to be.”
But as Epic has fortified its foothold on large, academic medical centers, it has shown more willingness to work directly with smaller health systems, he said. Great River Health has also grown by about a third in that time, while Epic has tied its pricing models to patient volumes.
While Epic is more expensive, it is “well-integrated into the revenue cycle space,” allowing for the opportunity for more revenue and charge capture, Mr. Alexander said.
Being a private company also “affords Epic pretty good latitude,” he said. “They’re able to really be more customer-centric.”
And the EHR has artificial intelligence capabilities to automate workflows and allows for add-ons, such as home healthcare and hospice, that Great River Health might have sought a third-party vendor for in the past.
“When you have to make a decision for the long-term health of your organization and the people you serve — it sounds so weird to say — we had to choose the ‘safe’ path, which was with a brand new partner,” Mr. Alexander said.
