Providence St. Joseph boosts physician, patient satisfaction with Epic interoperability tool
Providence St. Joseph Health in Renton, Washington, operates 51 hospitals across seven states – Alaska, Montana, Oregon, Washington, California, New Mexico and Texas. It has more than 119,000 caregivers across 51 hospitals and more than 800 clinics.
Tabitha Lieberman, senior vice president of clinical and revenue cycle applications at Providence St. Joseph Health, has been implementing Epic EHR and related technology for more than 20 years. She has witnessed the birth and evolution of EHRs.
"One of the areas I have been able to really see evolve is both the patient portals as well as the interoperability like Care Everywhere in Epic terms really changing the administrative burden and clinical safety components," she said. "One of the evolutions is now me working to give patients their data through the patient portal MyChart."
Lieberman said she is in some Epic-heavy geographic areas, and now Providence patients have five portals because their healthcare is not homogenous to one organization in many places. Additionally, Providence provides Epic to many non-Providence organizations through its Community Connect program.
"The real problem we were trying to solve, and the point of Epic's Happy Together, is making this information about the patient, not the organization," she explained. "Me, as a patient, I can have all of my information starting from an Epic site but growing to any healthcare organization. That is versus saying, 'Sorry, if you are Providence, you go here, and if you are elsewhere, you go there.' It's putting all of the data in one place."
With regard to the Happy Together technology, Lieberman said that Epic had been hearing healthcare professionals like her saying that patient portals are great, but patients do not like having five of them. (It's something patient engagement expert Jan Oldenburg calls "multi-portalitis.")
"So they developed Happy Together, which allowed us to put out the functionality so if they want five they can have five, but if they want to put all that information in one place, they have the ability to do that," she explained. "When Happy Together was released, we were the second customer, we have a large patient population where we could see right away whether or not this was working."
As soon as they released that capability, Providence worked with Epic. And Lieberman said the company agreed to be a good partner because anytime an organization is first or second in something, there is a learning curve.
Beyond Epic, the major EHR vendors on the market today include Allscripts, athenahealth, Cerner, drchrono, eClinicalWorks, eMDs, Greenway Health, Meditech and Medsphere Systems.
MEETING THE CHALLENGE
Basically, Happy Together is another fully integrated tool within the Epic EHR. There is no separate product or interfaces. It is just functionality within the EHR. It's not a new product.
"I've been talking about the Happy Together component that is MyChart-facing but there are actually two other components of Happy Together," Lieberman noted. "The first thing we turned on was our chart review for our providers, and the Happy Together component inside chart review allowed providers to no longer have to go to one tab if it was local to our organization and another tab if it was Care Everywhere and other organizations."
They now can just go to one tab and see all data and where it came from. That made life easier for physicians.
"The second part we turned on made life easier for our patients with the MyChart view which I have discussed," she said. "And the third part of Happy Together is around population health and the longitudinal plan of care functionality. So I can look at not just my labs to determine if this patient is due or overdue for their A1Cs but I could look at the entire ecosystem."
Providence has not turned this part on yet; it has some infrastructure components to put in place before it can take advantage of that aspect of Happy Together.
"Both of these tools are about ease of use and happiness," Lieberman said. "Which is always a fun measurement. From a feedback perspective from the physicians, they have indicated in surveys that they believe this makes it easier for them. If a physician reaches out and tells you this is better, I take that as a win."
Providence has looked at these first two components as meeting the needs of its constituents – providers and patients. It's many fewer clicks, it's convenient to see everything in one place, and that is the feedback Providence is getting from its patients, she added.
ADVICE FOR OTHERS
"The first piece is remember it is about the patient, not the organization," Lieberman advised. "And that is not always easy. People have an enormous pride in ownership in their portals. But this is about the patients. And if you always put it in that lens, you can get past the, 'But it's mine.'"
On another level, just making sure one's support services are ready for that change is important, she added.
"There are new considerations like what if you get a call about something you see in MyChart that is not your organization," she explained. "You have to make sure you have prepped your support mechanisms, whether that is a central call center or an analyst team."
And her third piece of advice is to iterate.
"Nothing starts up perfect, especially if you are an early adopter," she said. "This one is a huge shift. There are a lot of people out there who can tell you why this is not good enough. But it is a really good step; take it and iterate from it."