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Vanderbilt University Medical Center Begins Epic Journey

December 20, 2015
by David Raths
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VUMC joins other academic medical centers in switching to commercial EHRs

Vanderbilt University Medical Center is joining the bandwagon of academic medical centers dropping their homegrown health information technology for commercial options. VUMC announced Dec. 18 that it would replace most of its clinical information system with software from Epic Systems Corp.

Nashville, Tenn.-based Vanderbilt said it sought new software and considered both Epic and Cerner because in March 2018 McKesson Corp. will stop supporting applications VUMC currently uses for hospital clinician order entry, nurse documentation, medication administration and pharmacy management. Other major clinical systems were developed in-house.

VUMC said that in November 2017, staff and faculty would switch to Epic software for medical record-keeping and clinic workflow, ordering of tests and treatments in hospitals and clinics, hospital scheduling and admissions, nursing documentation, medical management of surgical patients, outpatient prescribing, medication administration, (non-retail) pharmacy management and hospital billing.

Kevin Johnson, M.D., professor and chair of Biomedical Informatics and chief informatics officer, stressed that IT innovation will continue at VUMC, and none of the prized functionality developed there need be lost in the transition. Also, under the agreement, innovations arising at VUMC may be incorporated into Epic software in general release.

 “We’ve had an innovation agenda that was catalyzed by having access to and ownership of the clinical data, and an information model that connected the data to the workflow, and we will be preserving that level of access to data and workflow,” Johnson said in a prepared statement. “All the data from our new electronic health record will be available to us outside the vendor product. We’ve been pioneers forever. I see this transition as an opportunity for us to start to mature as an organization around the technology that underpins all our work, while being pioneers, ideally working with Epic, addressing present and future challenges in health care.”

The Nashville Tennessean newspaper noted that the price tag for such EHR implementations can be very high. For instance, the Partners Healthcare Epic implementation cost was $1.2 billion. In an interview with the Tennessean, Johnson declined to disclose a cost estimate, but said the hospital would get the software “at the fair price. We’re doing a lot of things to be fiscally conscious about who we hire and the space used for the people we’re hiring.”

In 2015, 700 staff and faculty participated in a review of information systems needs at VUMC, and helped assess how well these needs matched the capabilities of two prospective vendors: Epic and Cerner Corp. The clinical laboratory uses, and will continue to use, software from Cerner; and Epic software has been used at Vanderbilt since the mid-1990s for clinic scheduling and professional billing.

Decades of intensive clinical IT development have led to a degree of excess variability of tools and workflows across different clinical areas at VUMC. Among the guiding principles of the transition include reducing unnecessary variability of tools and processes across clinical areas, streamlining workflows, enhancing care coordination, supporting patient engagement and reducing redundancy and wasted effort.

Early next year some 130 staff and faculty, mostly from the health IT division, will begin traveling to Wisconsin for Epic training.