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EpicCare's first shaky steps include records breach

By Josette Keelor

Health care visits should be easier now for patients and medical staff since Valley Health's launch of a new EpicCare database across the Northern Shenandoah Valley; however, the health care system has faced unexpected trials.

Launched after 11 months of preparation instead of the expected 18 to 24 months, EpicCare software streamlines medical records into one computer system, replacing the need for health care employees to jump from one program to another while registering, treating or following up with patients. It also allows patients to view and update their records online.

The system is integrated from the physician's office to acute care centers, according Joan Roscoe, chief information officer for Valley Health.

"It's designed as an integrated single database with all the pertinent patient information," she said.

But in addition to longer-than-expected waits during Valley Health's first weeks using EpicCare, Roscoe confirmed another unfortunate side effect, brought to her attention by one of Valley Health's patients.

In June, after Winchester resident Howard Sprouse, 45, had surgery at Winchester Medical Center, the hospital printed out 300 to 400 pages of records detailing his care at the hospital. He also received pages from another patient's file -- a patient who lives in Inwood, West Virginia, and whom Sprouse had never met.

"In my set of records was this lady's records," he said. "They were merged as part of my permanent record there."

The woman's records were "sensitive in nature," Sprouse recalled. "They were OB-related, you know, definitely I guess a breach of confidence in that respect."

After realizing the mistake, Sprouse returned the extra pages to the hospital, where he said an employee planned to correct the two files. He said the employee confirmed that the Inwood resident's records were merged with his in Valley Health's computer system.

"I think she [the employee] was appreciative of the fact that I had promptly returned those records to her," Sprouse said.

Roscoe, who said she doesn't know of such an issue happening during her 10 years with Valley Health, attributed the mistake to the hospital's switch to EpicCare. Sprouse's inpatient care took place toward the end of May, and he requested a printout of his records in early June. He said his records were ready for him to pick up almost three weeks later.

Winchester Medical Center was part of Valley Health's second phase of transitioning to EpicCare on May 30. The first phase occurred on April 8 and focused on ambulatory medical practices and offices not affiliated with hospitals.

According to Roscoe, "Those two events in April and May, that was the largest transformation [or] single event in the history of Valley Health. There's no doubt in my mind."

She said Valley Health trained more than 5,000 employees on the system using 18 classrooms booked seven days a week during the previous several weeks and that 83 people were working on the project full time for a year.

"We're in sort of a stabilization mode now," Roscoe said. A few employees have returned to their previous operations, and the rest plan to resume theirs later this year.

Roscoe estimated Valley Health transitioned 8 million medical encounters into its EpicCare system over the previous several months -- "that's millions of appointments or schedules or procedures or admissions," she said.

"A lot of this is driven by humans, and, you know, you start thinking about people in this area with a similar last name and ... you start thinking about all the people that you know that have the same last name," she said.

"If we are ... registering you as a patient or looking at your results we have to make sure that what we're doing or acting upon is accurate and that you are who you are," she said. "That's why we've implemented bar coding and specimen labels. ... Everyone has what's called a medical record number."

"Hundreds of thousands of test results were converted from the old to the new," she said. "I mean we tested everything."

But Sprouse's name is not similar to the woman whose records were combined with his, both he and Roscoe confirmed.

"I can't explain to you what happened," said Roscoe, who learned of the records breach from Valley Health's compliance officer, an in-house attorney responsible for assuring correct use of privacy policies and procedures. She said the officer works with the office of security in information systems solutions to ensure compliance with federal regulations to protect health information.

"I wish I knew more," Roscoe said. "Everyone is very grateful that there was no harm done."

Roscoe also acknowledged long wait times following the EpicCare launch because of all the training involved.

"If you came in for a test, we had some patients waiting a very long time, because it was a brand new system," she said. "This was a huge event so our wait times averaged 45 minutes."

She said emergency room waits were no longer than usual, since even before EpicCare's launch, patient waiting times varied depending on the number of patients and their levels of distress.

"They take the most critical first, they have to," Roscoe said. A wait could potentially be "five or six hours, you know it depends."

Still, in spite of the one-time records breach and long hospital waits, she said, "It was a fantastic go live."

"And now we're down to 11 minutes," which she said "is pretty normal."

Contact staff writer Josette Keelor at 540-465-5137, ext. 176, or jkeelor@nvdaily.com

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