New York City Health and Hospitals Corporation (HHC) entered into a $302 million contract with Epic Systems Corporation for a new state-of-the-art EMR system to span all of HHC’s patient care facilities. HHHC anticipates the system will be in full operation by 2017 for 22,000 users and will replace HHC’s current EMR system.
The new EMR system will be implemented at eleven HHC hospitals, four long term care facilities, six diagnostic treatment centers, and more than 70 community-based clinics. The 15 year contract includes software and database licenses, professional services, testing and technical training, software maintenance, and database support and upgrades.
To select the new EMR system, HHC conducted a multi-year comprehensive competitive process to evaluate interested companies. A fifteen member selection committee initially invited nine vendors to submit proposals based on prequalification guidelines and then selected five vendors that met those guidelines.
At this point, expert workgroups were established in ambulatory care, anesthesia, clinical documentation, decision support, laboratory operations, radiology, pharmacy, and technology. The workgroups evaluated and scored the functional capabilities of the vendors’ proposals to determine how they would function in each clinical area and whether they would be able to meet the needs of patients and staff.
Vendors were given a test scenario to see if their systems could deal with the volume and complexity of the HHC’s patient population and would be able to ensure coordination of care to include emergency departments, primary care physicians, nursing homes, behavioral health programs, and healthcare provided in the community.
The committee narrowed the field to three finalists after full proposals were submitted and evaluated. Site visits were conducted at the finalist’s corporate headquarters and some of their current clients and company operations were observed, but in the end, EPIC was chosen as the preferred vendor.
To further support the needs of the New York State (NYS) Health Homes program and the larger Patient-Centered Medical Home (PCMH) program, HHC acquired a Care Plan Management System (CPMS) from Microsoft. The web-based platform will enable patient care plans to greatly improve the exchange of information and provide access to all care team providers, including both HHC and non-HHC providers. In addition, the system supports patient tracking and reporting, consent management, and triggers automatic alerts.
CPMS will be able to link critical information that may not be well documented in the medical record. The system goes beyond typical care management and also encompasses non-clinical aspects of care such as in the case of social services and homecare. CPMS helps the team have a much more integrated view of the care coordination activities needed by the patient.
To date, the software components of the system have been installed with a number of key interfaces. The system will able to send patient demographics and select clinical information that will be included in the CPMS database. A working version of the Phase 1 (provider portal) is expected to go live March 2013 with Phase 2 (patient portal) scheduled for May 2013.
Microsoft has entered into a joint venture with GE to form a new company called Caradigm to support the CPMS product. Microsoft and GE are now each 50 percent owners of the new company.
Connectivity with various RHIOS in the state is progressing. The New York Health Collaborative is working towards consolidating the infrastructure and integrating the RHIOs. It has now been confirmed that HHC is technically prepared to connect to the RHIOs in April 2013. Other future plans are to connect the City and State RHIOs.