April 29, 2019

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What’s missing from Epic?

Closing the content gaps that exist within your EHR is the key to completing the patient record and optimizing patient care.

Ken Congdon

Expertise in the healthcare technology industry

An implementation of Epic — or any electronic health record (EHR) system, for that matter — is likely the single most significant IT investment your healthcare facility will ever make. This core clinical system provides a solid foundation to drive operational efficiencies, enhance patient care and improve outcomes. However, an EHR isn’t a self-contained super system. In fact, when you consider that approximately 80 percent of all patient data in healthcare is unstructured, there is potentially a vast amount of clinically relevant content that isn’t inherently managed by EHR systems like Epic. Most EHRs (including Epic) are fantastic when it comes to collecting detailed patient information in the discrete fields that are native to the software. However, a patient record doesn’t consist of digital fields alone. Historical charts, referral documents, medical images, clinical narratives and other types of content are required to tell the whole patient story.

Epic has embedded tools that allow for the ingestion of some of these content types. However, many providers may desire more robust capabilities when it comes to managing these assets both within and outside the EHR.

By integrating a proven ECM (enterprise content management) system with Epic, you can provide your clinicians with access to critical patient documents, photos and other unstructured content from within the EHR. An ECM integration can also provide users with enhanced workflow, data capture and integration capabilities that can allow you to extract even more value out of these assets.

Furthermore, most broad-based ECM platforms are based on universal standards rather than a proprietary EHR coding language. This means that the system (and the clinical and business documents it contains) can be leveraged by other departments that may not have access to Epic (e.g. Patient Registration, Accounts Payable, Human Resources, etc.). This enhances the overall enterprise value of the documents.

Integrating medical images with Epic has also become a primary focus area for many healthcare facilities, given the criteria outlined in Stage 2 Meaningful Use. There are a variety of ways to image-enable Epic, but it’s important that your efforts don’t focus solely on the DICOM images stored in radiology and cardiology PACS (picture archiving and communications systems). While these systems may contain the bulk of patient images you want to link to Epic (e.g. MRIs, CT Scans, etc.) they aren’t all-inclusive. In fact, there are a variety of clinically vital medical images and videos stored in specialty systems outside of PACS. These include ultrasound images, gastroenterology images and video (e.g. endoscopy, colonoscopy, etc.), dermatology photos, surgery and OR photos, ED images and more. You’ll want to ensure that all of these images are integrated with and accessible via Epic at some point in the process.

Finally, patient-generated health data is also largely absent from Epic. Technologies that support the transmission of this type of data into the EHR can prove instrumental in developing tailored and patient-centered treatment plans, improving chronic disease monitoring and management, and feeding current and future population health management programs. Epic’s highly publicized development efforts with Apple Health are one example of this type of integration. However, a seemingly endless number of devices and apps exist that can infuse Epic with near real-time patient data on everything from key vitals and biometric data (e.g. weight, A1C levels, heart activity, etc.) to lifestyle information (e.g. activity levels, sleep patterns, etc.).

Epic is a wonderful piece of technology that is already improving the way care is delivered, but it can be even better. By augmenting the solution with the right add-ons, you can really take your EHR, and your patient care efforts, to the next level.