HHC Board Approves Contract for New "SMART" Electronic Medical Record System to Span City's Entire Public Hospital System
Oct 17, 2012
The Board of Directors of the New York City Health and Hospitals Corporation (HHC) on September 27 approved a resolution that authorizes HHC to contract with Epic Systems Corporation for a new, state-of-the-art electronic medical record (EMR) system to span all of HHC’s patient care facilities. HHC anticipates the system will be in full operation by its 22,000 users in 2018 and will replace HHC’s current EMR system that is nearly 20 years old. The approval is contingent on a review of a complaint by a vendor that was not selected for the contract.
The new EMR system will be implemented at 11 HHC hospitals, four long-term care facilities, six diagnostic treatment centers, and more than 70 community based clinics. The 15-year contract, which includes software and database licenses, professional services, testing and technical training, software maintenance, and database support and upgrades, is not to exceed $302.8 million. The cost of the new system will be offset by federal funding that HHC recently qualified for.
“HHC was a pioneer of electronic medical records in the 1980’s and became one of the first large hospital systems in the country to implement EMR,” said HHC President Alan D. Aviles. “While we have leveraged that system as much as we can and worked to improve it over the years, the new, smart EMR systems are highly advanced and offer robust decision support functionality, far better data mining and interoperability, and greater capacity to advance quality initiatives, care coordination, and efficiency.”
Ross Wilson, MD, HHC Chief Medical Officer, cited some of the numerous medical advantages of modern EMR systems, which will provide one integrated patient record across all HHC facilities.
“This initiative builds on our existing experience and will improve patient care by providing complete and timely access to patients’ medical records and supporting clinicians to make better decisions with the available information” said Dr. Wilson. “Patient outcomes improve when a complete medication history is available, particularly when combined with lab test results, electronic order entry systems and decision prompts also being provided through a state-of-the-art electronic medical record system. And when doctors and staff spend less time dealing with paper records they have more time to care for patients.
“Modern EMRs can provide clinical alerts and reminders, improve diagnostic and therapeutic choices, enhance research and monitoring for improvements in clinical quality, all while providing built-in safeguards against treatments that might result in adverse events. This will be an important step forward for the City’s public hospital system both in efficiency and improving patient outcomes,” said Wilson.
Use of an EMR system is required by the end of 2015 in order to avoid Medicare reimbursement penalties. It is also a requirement to meet Patient Centered Medical Home designation by the federal government, which provides incentive payments to make primary and preventive healthcare a priority.
Bert Robles, HHC’s Chief Information Officer, whose office will oversee the installation of the new Epic system, said, “With the new Epic system, doctors and staff in any part of HHC will be able to access accurate patient records at any time, and patients themselves will be able to view their medical records online. The records will also be more secure from damage from hazards such as fire and replicated at a back-up to ensure business continuity. Epic is generally recognized as the leading provider of EMR systems. HHC’s implementation of Epic will be scalable and flexible enough to conform to evolving health IT standards and allow for future interoperability with external systems, health information exchanges, and other providers.”
HHC completed a four-year comprehensive, competitive process to evaluate interested companies and select an EMR product that best meets the needs of the City’s public hospital system. A 15-member selection committee initially invited nine vendors to submit proposals based on prequalification guidelines. The committee selected five vendors that met those guidelines.
Expert workgroups were established in the areas of ambulatory care, anesthesia, clinical documentation, decision support, laboratory operations, radiology, pharmacy and technology. The workgroups evaluated and scored the functional capabilities of the vendors’ proposals to determine how they would function in each clinical area and whether they were able to meet the needs of patients and staff. Vendors were also given a test scenario to see if their systems could deal with the volume and complexity of HHC’s patient population and ensure coordination of care as they access different areas of care, including the ED, primary care, nursing home care, behavioral health, and care in the community.
The committee then narrowed the field to three finalist vendors after full proposals were submitted and evaluated. Site visits were conducted to the finalists’ corporate headquarters, and some of their current clients, to observe company operations, meet with executives, review vendor capability and see if the organizational culture fit with HHC. At the end of the process, the selection committee proposed Epic as the preferred vendor to the HHC Board of Directors.
HHC became an early adopter of electronic medical records in the 1980’s when it purchased and implemented an early EMR system that is still in use today. HHC modified and enhanced that system over time when it embedded depression screening aids, asthma action plans, Coumadin dosing safeguards, deep-vein thrombosis prophylaxis guides, and other meaningful functionality. That system helped HHC receive substantial recognition as an EMR pioneer, and in July HHC announced that all11 city-run public hospitals had achieved full “Meaningful Use” status for their existing legacy EMR systems and could begin receiving nearly $200 million of American Recovery and Reinvestment Act (ARRA) funds, which will be reinvested to support the new EMR costs.
HHC’s existing EMR system allows for program alerts and strategically placed data fields that have helped guide evidence-based care. It also has allowed HHC to run electronic chronic disease registries that have proven to be an effective tool in helping clinicians better manage diabetes and hypertension. As a result, all HHC facilities now qualify under the National Committee for Quality Assurance’s Diabetes Recognition Program as excellent providers of diabetes care.
Two of HHC’s healthcare networks – Generations Plus/Northern Manhattan (Harlem and Lincoln hospitals) and Queens (Elmhurst and Queens hospitals) – earned the coveted Nicholas E. Davies Award from the Healthcare Information and Management Systems Society for excellence in using electronic medical records to improve healthcare delivery. In addition, HHC President Aviles received the National CEO IT Achievement Award from the Healthcare Information and Management Systems Society and Modern Healthcare magazine for leadership in the use of information technology to advance healthcare excellence.
Contact: Ian Michaels (HHC)
The New York City Health and Hospitals Corporation (HHC) is a $6.7 billion integrated healthcare delivery system with its own 420,000 member health plan, MetroPlusHealth, and is the largest municipal healthcare organization in the country. HHC serves 1.4 million New Yorkers every year and more than 475,000 are uninsured. HHC provides medical, mental health and substance abuse services through its 11 acute care hospitals, four skilled nursing facilities, six large diagnostic and treatment centers and more than 70 community based clinics. HHC Health and Home Care also provides in-home services for New Yorkers. HHC was the 2008 recipient of the National Quality Forum and The Joint Commission’s John M. Eisenberg Award for Innovation in Patient Safety and Quality. For more information, visit www.nychhc.org/hhc or find us on facebook.com/NYCHealthSystem or twitter.com/NYCHealthSystem.