By Tom Still
MADISON, Wis. – Until a few months ago, some health-care professionals were just as likely to view the use of electronic health records as a burden as an asset. Today, with the COVID-19 crisis nearing a disturbing crescendo in many U.S. states, those attitudes may be changing.
Experience thus far in the coronavirus outbreak suggests that digital health records and related online tools, such as telemedicine, are helping hospitals and health systems cope with the surge in requests for virtual diagnoses, analyzing trends in COVID-19 testing and managing cases requiring critical care.
Wisconsin-based Epic, a pioneer in the development of electronic medical records, provides such records for more than half of all Americans through 491 health systems. Its evolving story is a leading example of how health information technologies are making a difference in the lives of millions.
Because Epic is based in Verona, just outside Madison, its legacy customers include many of Wisconsin’s health systems. Perhaps because those health systems were early adopters or developed their own EMRs, such as the Marshfield Clinic, Wisconsin runs anywhere from a few percentage points to 10 percentage points ahead of national averages for EMR adoption by patients, office physicians and hospitals.
How is that concentration helping patients and providers in Wisconsin? Dr. Sam Butler, a physician and self-described “EMR evangelist” at Epic, describes the presence of integrated clinical, assess and revenue systems as the “central nervous system” of a health organization. That nervous system triggers a quicker response than what otherwise would occur.
One such rapid response is telemedicine, which was a remote curiosity for most patients – and even some practitioners – until COVID-19 hit. Today, millions of consultations are taking place virtually, many of them on Epic platforms that were underused in the past.
In a matter of roughly a month, Epic has helped 200 of its customers set up or expand such platforms, training medical professionals along the way. Reports from health-care systems such as University of California-San Diego Health, Providence St. Joseph Health, the Children’s Hospital of Philadelphia and New York University’s Langone Medical Center show that more than half of primary care are being done virtually. That compares to single-digit percentages a few weeks ago.
Reported one Pennsylvania physician: “Through telehealth, we’re seeing patients in their homes, meeting their families, seeing the art on their walls, learning about the things they care about most… I thought telehealth would remove the human aspect, but it actually enhanced it.”
Telemedicine is also a part of Epic’s volunteer effort at the recast Javits Center in New York City, which has been turned into a 1,000-bed hospital, and Chicago’s McCormick Place Convention Center.
The story is much the same in Wisconsin, where Epic’s MyChart tool is being used for the digital adaptation of the bygone days when doctors went on “house calls.”
“Care providers are transitioning many of their visits from in-person meetings to video visits, resulting in a 3,000% increase in video visits, on average, from February to March,” said Dave Fuhrmann, a senior vice president for research and development at Epic. “Patients are also doing more self-management from home, such as tracking their symptoms and entering their temperatures, which is shared with their care provider.”
Electronic medical record systems can’t process COVID-19 tests, of course, but they can help spot directions.
“An organization or state can zoom out to see trends in testing, including where testing is ramping up or turn-around time for tests that could be improved,” said Seth Hain, also a senior vice president for R&D at Epic. He added that EMRs also help to measure how effectively resources such as beds and ventilators are being used across Wisconsin.
There are limits, of course, on who can access virtual medicine and when – sometimes tied to the “digital divide” or economic hardship. For many people, however, electronic health tools may be a way to fight back against COVID-19.
Still is president of the Wisconsin Technology Council. He can be reached at email@example.com.