Wiki EPIC in Physician-Owned Primary Care Office

[rthomas@impcna.com]

We are a Physician-Owned Internal Medicine & Pediatric Primary Care office. We looking into switching our EHR & PM to EPIC since both of the major hospitals in our area are on EPIC. Looking for input, pros & cons, and advice. I am the billing manager & credentialing specialist. Since I have been with the practice for 19 years, my input and concerns are taken into consideration. We have 6 physicians, 8 FNPs, and 1 PA. All billing and coding is done in-house. I have 6 others on my teams. All feed back is greatly appreciated!
So far here are the few concerns I have:
1. Since EPIC will not migrate your current A/R this means we will be working out of 2 PM systems and I am afraid that my team will get overwhelmed trying to manage 2 systems.
2. Changing clearinghouses as well so payments will be coming in on the same remit for both systems and we will have to manually post some of our payments.
3. The front desk not checking both systems for balances.

 

[ny2scgirl]

I personally find EPIC to be not as user friendly as other systems I have used, but with that said EPIC is completely customizable. I find when the people building the system are not the people using the system that's when it becomes confusing. I work for a hospital system that also has individual practices; all have very different needs. Trying to build a system to work for so many different needs is no small task and is bound to have issues. Since you are one practice building it for your practice only you might have better workflow. I am a biller for hospitalist so my experience with EPIC is only with the billing side and because I work for a large company my permissions are limited to only what I need.
As to your three concerns, those are real issues you will have. I have worked for a practice that switched PM but not EHR and all the scenarios you listed happened. It was a real challenge for months for the front-end staff and the billers and our patients. It is doable with a great staff but it's very stressful.

 

[csperoni]

Switching your EHR & PM is definitely possible. There are definite downsides as you mentioned. You will also have reduced staff productivity during the transition and will need to allot for training time. You are only addressing the revenue cycle challenges here, not to mention the clinical challenges. I personally would not switch EHRs unless there was a definitive reason to do so. Like your current system is being discontinued. Or you have a server based system and your server needs replacement for $18,000 and you don't like your system. Your current EHR has significant issues that could impact patient care. Your evaluation of the new system is that it is soooo amazing that your clinicians can see 10% more patients, or you can eliminate 3 administrative positions.
My experience has been all EHR/PM systems have pluses and minuses. None are perfect. You need to make a thorough evaluation to determine which is best for your particular needs/wants. Once implemented, switching is more difficult than the initial transition from paper. For awhile (years), you will be paying 2 companies to maintain both systems. You definitely need to find out what information can be transferred, and that cost.
Bottom line: if you don't have SIGNIFICANT issues/problems with your current system, I wouldn't switch. Several years ago our private practice merged with a large healthcare system and they required us to transition to their systems. We had 2 temp RNs doing chart extraction, 2 temp administrative people doing scanning, all 4 full time for almost 2 months. For the first 1-2 weeks of the switch, we had to reduce the clinician's office schedules to allow extra time. We had to pay the old EHR for years just to maintain the clinical records, even after we worked down the AR. All of that was paid by the healthcare system we merged with, but if as a private practice I had to incur all these costs, plus reduced revenue, we may have gone bankrupt from switch EHRs.