One Patient, One Record

A new electronic health record system will improve patient care and provide researchers with important data.

Patients know the drill: They visit the doctor and are asked to recite their prescription lists, along with dosages and frequency. But what if their report isn’t accurate? Wouldn’t it be nice if every clinician had access to the same patient information? At BJC HealthCare and Washington University School of Medicine, they soon will.

By summer 2018, most of BJC and Washington University healthcare system will be using a single electronic health record (EHR) system called Epic, with the remaining sites coming online by spring 2019. Epic was selected as the platform of choice by a working group that consists of representatives from all areas of the system, including the Institute for Informatics. Epic replaces more than 50 standalone EHR systems that had been used by individual physician groups, specialty clinics, hospitals and even departments within the hospitals. And it brings patient records and data into one centralized location that all clinicians will be able to access as authorized.

“Patient information used to be distributed across lots of different information systems, and so a clinician did not always get the whole picture of what was going on with a patient across all of the places and providers where they had received care previously,” says Philip R.O. Payne, PhD, FACMI, director of the Institute for Informatics at Washington University. “But Epic allows us to see everything that happens to our patients across the entire continuum of care, whether they’re seeing their primary care physician in a community-based practice, being treated in a hospital emergency room, seeing a specialist or receiving follow-up services through, say, our occupational and physical therapy groups.”

And that means patients will have fewer questions to answer at each visit.

“If your medicine gets changed by a specialist at one of the Wash U clinics, then your primary care doctor in the medical group has that reflected in their EHR,” says Keith F. Woeltje, MD, PhD, vice president and chief medical information officer for BJC HealthCare. “They won’t have to try to remember to ask you about your new medicines or input the same information again. It’s all automatically in sync by virtue of being on a single electronic health record platform. The medicines you’re discharged from the hospital with are now available for all your providers to see, so there’s no question about what you were sent home with.”

The platform is particularly beneficial when it comes to recalling medical history and recounting complex diagnoses and treatment plans.

“A lot of patients see multiple physicians in multiple different areas,” says Sam Bhayani, MD, chief medical officer of Washington University Physicians. “Particularly at Wash U where we draw patients from hours and hours away who have complex problems and see multiple physicians. We’re able to have all their information in one place. That’s advantageous, because they may not remember something that happened four years ago at another hospital. But we’ll have all that information at our fingertips.”

And it’s more than just convenient for patients and physicians. It’s also safer. Epic can reduce treatment redundancies and help eliminate harmful drug interactions.

“Epic is a big improvement in patient safety as it makes it less likely that important facts will slip through the cracks because clinicians will have access to an updated problem list, and medications and allergies will be brought in automatically,” Dr. Woeltje says.

Using Epic Data to Analyze Patient Outcomes

A centralized EHR has benefits that extend far beyond the patient’s bedside. Researchers can use the data in Epic to track patient outcomes, study disease prevalence and trends, and improve care. The platform’s research capabilities are a big reason the health system’s collaboration group chose Epic. And the Institute for Informatics is playing a key role in establishing how Epic will be used for the greater good.

“At the Institute for Informatics, our primary role in this project is really to make sure that as Epic is deployed across our entire system, we think about how to make sure that it’s not only the best platform it can be to support clinical care, but also the best platform it can be to support our research and education missions, so that, as an academic health center, we’re being intentional about ensuring our EHR is beneficial to our entire tripartite mission,” Dr. Payne says. “That mission of not only delivering excellent clinical care, but also generating new evidence that improves care and that can be used to train future care providers.”

Researchers can use the data in Epic to track patient outcomes, study disease prevalence and trends, and improve care.