Electronic Medical Records Soon to Be Implemented at U.Va., Board Hears

June 10, 2010 — The University of Virginia Health System is on track to implement electronic medical records starting in September, Dr. Marshall Ruffin, chief technology officer, told the Medical Center Operating Board today.

The system, known as EpicCare, will be used wherever U.Va. Health System care is provided, Ruffin said. Patient records will reside in a single database accessible by doctors and nurses. And patients will be able to view their own records anywhere through a feature called MyChart.

"It allows us to educate patients in a more powerful way," he said.

Ed Howell, vice president and chief executive officer of the U.Va. Health System, said, "Everybody's life will change because of this."

EpicCare will provide an integrated system for both in-patient and out-patient services that delivers clinical documentation, test results and doctors' orders. "The goal is patient-centered care," Ruffin said. "Clinicians give up their individual records for a common record."

Nearly $122 million was budgeted for development, implementation and five years of tailoring the system once it's in use. Ruffin said that the project is under budget so far. More than 1,000 new computer monitors and 800 computers are being installed.

On Sept. 28, all ambulatory care clinics will switch to the new system, and the entire Medical Center will use it for communicating and retrieving results. More than 6,000 employees are being trained, with attending physicians, nurses and other care providers receiving more intensive training. "There will be a dress rehearsal in all clinics," Ruffin said.

During implementation week, clinics will scale back their appointments by 50 percent to allow staff more time to use the system; they will return to their regular appointment loads within a few weeks.

Adult oncology will switch to the system on Dec. 1, with all in-patient units and the emergency room implementing on March 5, 2011.

Ruffin noted that the clinical staff was deeply involved in the development of the system and chose the vendor, Epic Systems. The vendor, he added, has said that the doctors' interest has been remarkable.

"Epic Systems had complimented the Health System many times for the extraordinary participation by physicians, including their willingness to receive the additional training to become super-users," he said. Super-users will mentor colleagues as they learn the system.

In other Medical Center Operating Board business, it adopted the Health System's 2010-2011 budget of $1.07 billion. Howell said the budget, developed with the assistance of 300 doctors and staff members, takes into consideration some relatively unknown factors, such as fluctuations in admissions, the July opening of the Transitional Care Hospital at Northridge, challenges with Medicaid and Medicare, and the implementation of electronic medical records and federal health-care reform.

Larry Fitzgerald, chief financial officer, said that a price increase of about 8 percent is planned, but that the impact on revenue is relatively small – about $5 million – because most revenue sources are set by contract.

The budget anticipates a small increase in admissions, which had decreased because of patients' decisions to put off elective procedures during the recession.

Robert "Bo" Cofield, associate vice president for operations, reported that patient satisfaction in the emergency room has shown a significant improvement. In June 2009, 76 percent of patients said they were happy with the hospital's service; in March, nearly 81 percent of patients were pleased. "This is a challenge when you run a trauma center," he said, commending the nursing staff for its contribution to the improvement. "For the first time since we started keeping data, we made the goal."

The class of 2014 at the School of Medicine will be the largest ever, with perhaps as many as 157 students, Dean Steven T. DeKosky said. The introduction of a new curriculum focused on small-team problem solving and individual study, along with the opening of the new Claude Moore Medical Education Building, he said, were key selling points for the nearly 4,300 applicants.

Under-represented minority students make up 20 percent of the class – the most ever – but the class is roughly two-thirds male and only one-third female. DeKosky said that's consistent with a national trend of fewer women going into medicine.