CONWAY — On Saturday, Memorial Hospital will flip a switch to usher in a new era.
The much-anticipated Epic electronic records system will replace three systems now in place at Memorial to let doctors quickly access lab work and other test results as well as data from medical visits at the North Conway hospital and throughout the MaineHealth system.
“It’s a tremendous enhancement for a small hospital,” said Lee Myles, interim CEO at Memorial.
Though not a clinician himself, Myles knows people using the now-ubiquitous Epic system in hospitals around the country — about 45 percent of medical records in the United States are already on it — and once it was in place, he said, they wouldn’t change it.
“They say it’s the best thing we have in terms of connecting the patient, the practice and the hospital,” Myles said.
Dr. Matt Dunn, medical director of the emergency department at Memorial, says Epic is the best medical records system he’s ever worked with.
“There’s so much involved with this that it’s going to be very exciting to use it as a clinician,” he said.
Dunn grew up in North Conway, graduating from Kennett High School in 1991. He’s old enough at 45 to have started out in medicine when records were kept on paper, and he’s seen the evolution of electronic medical records firsthand, working with eight different electronic systems and helping to build a number of them, over the course of his career.
Of all the record systems in the different departments at Memorial, he said, “You can see them all, you can view them all, but it’s not a synergistic record, it’s not a singular record. In fact, it’s very similar to paper.”
According to Dunn, “What happens at 5 a.m. on Saturday is we end up with a singular record for a singular patient that truly follows the patient anywhere in the system; it really allows seamless visibility for anyone opening that record.
“No matter where they are, they have all of their health records following them, which allows us to understand their health on a more holistic basis,” Dunn said.
With the new system there will be changes in job descriptions at Memorial, but no jobs will be lost. That said, “There will be jobs that will exist on Saturday that did not exist on Friday,” Dunn said.
And while glitches could happen, Memorial has the advantage of joining a system that is already in place at six MaineHealth hospitals. In addition, more than 100 support staff are helping with the implementation, with additional support available over the coming weeks.
All the staff at Memorial have been trained in advance of the system going online.
“When I try to explain a very practical example of Epic,” Myles said, “I think back to my own personal situation where my mother, who now is 90.”
Myles’ mother went to three different specialists who were part of the same system but not on a shared records system. Subsequently, all three put her on different medications, which did not interact well, resulting in her being sick for more than a year.
Had those doctors all been on an Epic system, not only would the doctors all have had immediate access to the medications she was taking, but the system itself would have flagged contraindications.
Another big advantage of Epic is that it provides what doctors call “decision support.”
“These originally were storage vehicles for information,” Dunn said. “Now we have all this information available to us, the systems are being built in such a way to understand and utilize this information.”
In addition to medical records of individual patients, Epic contains best practice protocols developed by MaineHealth doctors. As medical providers put a patient’s information into the system, Epic can identify patterns, prompting doctors to check for diagnoses and then suggest tests and treatments.
One example of decision support, Dunn said, would be: “A patient arrives at the emergency department and is triaged by a nurse. The system, looking at the data that’s put in will understand and suggest that this patient may meet criteria for sepsis, a very dangerous and severe infection. The system will identify that and alert the nurse to alert the physician before we even see the patient.
“The way we treat sepsis, the way we treat heart attacks and the way we treat strokes is contained within the MaineHealth system through Epic,” he said.
Another advantage is that Epic will cut down on duplication of tests. Under the old system, doctors might not have been able to get test results or even know a test was done, so they would order a new one.
Also, doctors can easily message one another about details of tests, medical procedures and patient histories.
“Just from that standpoint, it is dramatically different,” Dunn said.
Then there’s the “patient portal.”
With Epic, patients can log into the system through MyChart — available on MaineHealth’s website (mychart.mainehealth.org) or through a smartphone app — to view their own medical records and communicate with their doctors to set up appointments, request prescription refills and get answers to medical questions.
Patients will receive an After Visit Summary after a doctor’s appointment, which will include an activation code and instructions for signing up for MyChart. There is also MyChart support phone number, (855) 255-2300.
While the patient portal does not contain every bit of data that’s in the system, what MyChart does contain, Dunn said, is information that patients most want to have, such as a list of problems or diagnoses, medications and diagnostic or lab tests.
Test results will be posted in the system as soon as they are available from the lab, rather than going through the doctor’s office.
“If someone is coming into our system and they’re getting labs done, they’re going to see those labs pop into their portal within 48 hours,” Dunn said.
“It’s allowing the patient to be much more interactive and in control of the information and communicate with the practices that way.”
Medical assistants and nurses also will be responding to messages from patients through the portal, much as they do now to telephone messages.
Dunn compares Epic to the Excel spreadsheet program commonly used in business. Like Excel, it is versatile and can be easily adapted to different providers’ needs.
“The MaineHealth version of Epic, although it’s Epic and they all look alike, is not the exact same as Dartmouth’s or Mass General’s or Kaisers or Cleveland’s,” he said.
Since most larger medical institutions and networks across the United States already use Epics, doctors will be able to share, view and transfer data (with proper releases from patients) into the MaineHealth system.
The “Epic Care Link” is for providers who use different electronic records systems, so they can easily access a patient’s Epic records.
And, with MyChart, if a patient is seeing a doctor outside the system, they can show them their test results on their own smartphone.
“It’s to the patient’s advantage for their providers to use Epic Care Link to have access to those records,” Dunn said. “There’s a very large MaineHealth team that I’m a part of that is actively hooking up people with the Epic Care Link. This is ultimately about the patient and what’s best for the patient.”