What's the deal with NYC Health + Hospitals' EHR transition? 9 things to know

NYC Health + Hospitals President and CEO Ramanathan Raju, MD, will testify before City Council Monday regarding the city's proposed budget allotment of $337 million for the public health system. Dr. Raju is also expected to face some questions about the public health system's ongoing EHR implementation.

Here are nine developments regarding New York City Health + Hospitals' EHR rollout and the related executive departures and media reports.

1. NYC Health + Hospitals faces a $1.2 billion budget gap next fiscal year. In January, Mayor Bill de Blasio proposed a 2017 budget allotting $337 million to the hospital system.  On Monday, NYC Health + Hospitals president and CEO Ramanathan Raju is scheduled to testify before City Council on Mayor de Blasio's proposed budget, and he will likely field questions regarding media reports of a turbulent EHR implementation, reports Capital New York.

2. NYC Health + Hospitals signed the contract for its Epic EHR in January 2013 and is investing $764 million over six years to implement it throughout the system. In previous comments to Becker's Hospital Review, NYC Health + Hospitals said this figure represents the implementation and maintenance cost over six years. It's important to note the funds in the budget proposal being discussed Monday are not necessarily linked to the EHR implementation, which NYC Health + Hospitals says "remains on time and on budget." Rather, it appears questions about the Epic project are being posed after a series of media reports detailed alleged problems with the EHR implementation.

3. Recent stories in the New York Post allege NYC Health + Hospitals officials are pushing for an April 1 go-live for its Elmhurst and Queens hospitals despite patient safety concerns. Anonymous sources in the reports suggested Dr. Raju feels pressure to move forward out of fear he may lose his job.

4. NYC Health + Hospitals refutes these claims, saying the idea the system would jeopardize patient safety is "simply wrong." According to an emailed statement from the health system, "[The] New York Post story is unfounded and uses unnamed sources who shared incorrect information. The NYC public healthcare system is implementing the Epic EMR — the best in class product used by many top healthcare systems. The project remains on time and on budget. The implementation will be done in phases, starting with our Queens facilities on April 2. We have assembled a team of about 900 technicians and Epic experts who will work around-the-clock to ensure the transition to the new system goes smoothly."

5. Speaking at a meeting with Mayor de Blasio's staff in City Hall, Dr. Raju said the Epic go-live date is a self-imposed deadline, and he has no qualms about pushing it back if needed. "It could be April 7. If I'm not ready, it's not something we are chasing," Dr. Raju said, according to Capital New York. "If we miss the deadline, no one is going to chop my head off. ... Nobody is going to fire me. That's not a problem."

6. But executives losing or leaving their job is not an uncommon occurrence at the public health system lately. The New York Post also reported Charles Perry, MD, reportedly CMIO of NYC Health + Hospitals' Queens and Elmhurst Hospital Centers, resigned over the Epic implementation. He reportedly sent an email to colleagues comparing the project to the Challenger shuttle and saying it was too early to go live on it. Dr. Raju said in the meeting with Mayor de Blasio's staff that the email was written by a "disgruntled" employee.

7. Reports suggested the email was a resignation letter. The health system confirmed Dr. Perry resigned March 4, but said he was never appointed as CMIO, which is how previous reports and his LinkedIn page identify him. Instead, he was appointed associate executive director at the Elmhurst campus and liaison to the Epic project in Queens. "He was never appointed as CMIO, even if he calls himself that," NYC Health + Hospitals told Becker's.

8. Last year, the system's IT department also experienced a leadership shakeup. Bert Robles was asked to resign from his CIO position in February 2015. During the City Hall meeting, Dr. Raju said Mr. Robles' resignation was due to his lack of experience with the project. "I didn't want someone learning on the job," Dr. Raju said, according to the report. "This is too big to do that."

9. However, in previous comments to Becker's Hospital Review in August, NYC Health + Hospitals said the firings were unrelated to the Epic implementation progress. "Bert Robles and several other members of the Epic implementation team have been terminated for reasons related to personal behavior and conduct that did not affect the Epic implementation project, which remains on schedule and on budget," the hospital told Becker's Hospital Review. "The personnel changes within the Epic team did not affect the performance of the Epic contract."

More articles on NYC Health + Hospitals:

The corner office: NYC Health + Hospitals' Dr. Ram Raju on the 'essentiality' of publc hospital systems
Plan to bring financial stability to NYC Health + Hospitals unveileds
NYC Health + Hospitals CEO shares turnaround plan to narrow $1.2B budget gap


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