As a patient started to seize at UMass, doctors and nurses rushed to his aid, administering Ativan and other drugs, eventually intubating him and working to get him stable.
They shouted out exactly how much of each drug they gave the patient, so other nurses could enter each and every move into the computer system.
This was a mannequin patient and a vital part of UMass Memorial Health Care’s training to implement its new health care record system, Epic.
Doctors, nurses and staff across the board at UMass say Epic will be instrumental in improving patient care and preparing for the future of healthcare, which is predicted to shift into a virtual space.
Bringing Epic to UMass came with a $700 million investment over 10 years, according to UMass Memorial Health Care CEO Dr. Eric Dickson.
Most of the nation’s academic health centers use Epic. The company says close to 60 percent of the U.S. population has a record in Epic, as well as more than 75 percent of New England and nearly 65 percent of Massachusetts.
With today’s system, one doctor may not be able to access all records associated with a particular patient. As other hospitals and healthcare systems started becoming a part of UMass over the years, it meant more health records came in. But the electronic platforms that hosted all that data didn’t match up with one another.
To best service the 3 million unique patients at UMass, they needed to compile data from past visits to streamline the process in the future. With Epic, all those separate files will become a single integrated health record.
“It’s almost emotional,” Dickson said. “For so many years, we’ve been using a system that takes a lot of time … and now it’s all right there. It will be transformative for our practice of medicine here.”
Pamela Manor, a nurse, associate vice president for clinical informatics and the chief nursing information officer for the Epic system, said this is the kind of system they’ve been hoping for.
“It’s a big improvement for the patient because if the patient will subscribe to the patient health record that’s available, they’re going to see so much more information,” she said. “So the patients will be better informed and the staff will be better informed, so it’s a better care situation for both.”
A $700 million investment meant that UMass has had to put other initiatives on the back burner. But, if the system utilizes Epic to become about 2 percent more efficient every year for the next five years, the system will have paid for itself, Dickson said.
“This will be, by far, the largest clinical data repository in Central Massachusetts, and possibly one of the largest in New England because of the number of patients and the amount of data we will migrate,” Dickson said.
The system will go live on Oct. 1. Before then, employees are spending hours training with computers and mannequin patients in the UMass Medical School simulation lab. Physicians spend about 12 hours training in the lab, and nurses spend 20 or more, according to Dr. Eric Alper, chief clinical informatics officer and the physician champion for the Epic project.
With the training, staff will help make transitioning easier when they working with live patients.
“I think the thing that’s so hard for nursing, as we adapt to this new system, is in the most urgent of situations, making sure we’re able to document electronically so that we have everything well recorded at the same time as we’re delivering great care,” Alper said.
Epic will also allow UMass records to be easily available outside the hospital, say if a patient has an emergency and is transported to one of the Boston hospitals that also use the system.
Dickson likened the ease of the system to using Amazon.com, which remembers his log on and knows what he has purchased before.
“It’s game changing,” he said. “The future of healthcare is we’re going to interact with our patients through a virtual environment. The future is about constantly working with patients, especially complex patients, through a virtual environment.”
It won’t be smooth sailing right off the bat. Dickson said they expect between 50,000 and 100,000 problems to be recorded after going live on Oct. 1, which is a typical number for a system of its size. A “massive” team will be in place to address those issues as they arise, Dickson said.
Dickson said the staff was surveyed on what they thought would be most important for the future of UMass. Was it more buildings and more beds or a robust IT system?
About 85 percent wanted to invest in a large-scale information technology system, he said.
“What has been the most amazing thing for a long time UMass Memorial guy, I’ve been attached to this system for 25 years, I have never seen an initiative where our people have come together across the system,” Dickson said.
Listening to the staff and working to fulfill their needs also was a step toward achieving UMass’ goal of engaging its employees, Dickson said.
UMass considered several health systems, but feedback from the nurses and doctors who tested them decided that Epic seemed most efficient, Dickson said.
As the doctors and nurses worked on the seizing mannequin, they got the training they’ll need during a live emergency.
“What happens when you participate in a live simulation like this is things happen in real-time that are clinically relevant,” said Paul Boisvert, an educator at the hospital and director of the clinical training center at Health Alliance Hospital. “What’s happening to the mannequin, simulator, is clinically relevant to them, it means something to them. It helps them to prioritize what to do in the computer software first, how it impacts the patient, how it impacts their own personal workflow.”