Epic Systems Corp.
has been selected by drugstore chain CVS Caremark Corp.
as the provider of an electronic health-record system
for its MinuteClinic division, a deal that will extend Epic's ambulatory-care footprint across 800 healthcare clinics in 28 states and as many as 1,500 locations in the not too distant future.
Epic built its reputation on EHRs, first in ambulatory care, then with inpatient EHR systems. It had focused on large healthcare organizations, what its founder and CEO once described as “whales,” the opposite of the small, limited service clinics the pharmacy chain provides.
But a key strength of Epic's “enterprise” EHR is integrating data from the out-patient and inpatient worlds, and that was a big attraction for MinuteClinic, said Dr. Nancy Gagliano, MinuteClinic's chief medical office.
“In our own way, MinuteClinic is a whale,” Gagliano said. The clinic partners with 30 affiliated healthcare organizations.
“We need a robust IT system, an EHR that will effectively interconnect with our affiliated partners,” as well as health information exchanges, she said. “We're going to have over 1,500 clinics in just over a couple of years. We see 4 million patients a year and we'll see 10 million patients a year in the near future. So we need a big company to support the volume that we'll have.”
Other points affecting their choice, Gagliano said, included customization and data analytics. Practitioners at MinuteClinic follow tight clinical guidelines and the company needed an EHR in which workflow rules could be built to fit their needs, she said, adding that Epic has that ability, as well as good analytics and report-writing functions.
Epic will replace MinuteClinic's home-grown electronic record system and will be run on the company's own information technology infrastructure. “We're certainly looking within two years to having it rolled out across the country,” Gagliano said.
Considering its size, the MinuteClinic installation “will be pretty fast,” said Epic President Carl Dvorak, helped by the MinuteClinic's business model, which is “highly standardized” and relies on about 20 visit types overseen by nurse practitioners.
“We'll be spending the first 12 months getting them through training, getting some specialized interfaces set up, planning and executing some data conversions and creating a training core to roll out across the country,” Dvorak said. “Then, across the next year or so we'll be rolling out the clinics.”
MinuteClinics expect to be big users of Epic's Care Everywhere and Care Elsewhere interoperability tools, given their many relationships with health systems in each of their regions, according to Dvorak. “Support of plug and play national standards for interoperability was a key factor in the selection,” he said.
Care Everywhere is the name of Epic's interoperability suite for health information exchange between Epic users, Care Elsewhere is its module for exchange between Epic systems and other non-Epic providers or health information exchanges.Follow Joseph Conn on Twitter: @MHJConn