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September 27, 2017 01:00 AM

Epic's 'wizards' announce new cognitive computing, patient-engagement tools

Rachel Z. Arndt
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    Cloaked in red velvet with gold flourishes and wearing a pointy hat and pointy shoes, Judy Faulkner took the stage in front of thousands at Epic's users group meeting on Tuesday, where she and her staff showed off improvements to the patient portal, data analysis and interoperability, and electronic health record voice assistant integration.

    Harnessing their "World of Wizards" theme, the Epic CEO and many others took the stage in wizard regalia to tout the importance of a better EHR experience for both patients and providers.

    Epic says it's improving its portal in part via cognitive computing, which the company will use in its 2018 release to help providers find trends and patterns. They might identify patients' opioid-abuse risk, for instance, or plan staffing by analyzing hospital flow.

    Other improvements will come from bringing new sources of data to the EHR.

    A UGM soundtrack, as heard in Judy Faulkner's presentation

    "The EHR is so last year," Faulkner said. Now, the company is interested in a "comprehensive health record," which includes information on diet, sleep, weather, crime, education, food access and more. In the future, this information will exist in a patient's record alongside the more traditional health data already there.

    What's more, this information will help inform decisions to connect the patient with community resources, adding to Epic's existing population health management tool, Healthy Planet Link.

    In the shorter term beginning with the 2018 release, Epic's EHRs will integrate with medical benefit checks from Surescripts so clinicians can view prior authorization and expected patient out-of-pocket costs from within a patient's records—one step among many Epic is taking to improve the user experience for clinicians while simultaneously getting patients involved in their own care.

    Indeed, many of Epic's new capabilities directly engage patients, helping them become more "visible" outside traditional medical settings, Epic developers said. Chief among these capabilities are new MyChart functions, such as MyChart Care Companion, a digital health coach that sends medication reminders and other health information via an app.

    Already, there are 68.2 million MyChart accounts. In September, Epic announced a new feature: Share Everywhere, which allows patients to send their records to outside providers, who can access view-only versions online. Micky Tripathi, CEO of the Massachusetts eHealth Collaborative, called it "very clever" and said "the innovation is that it's patient-driven and that the patient can determine who has access to their record."

    By using the MyChart app, patients one day also will be able to access MyChart information through voice assistants, such as Google Home, Amazon Alexa and Apple's Siri, as well as a yet-to-be-named MyChart assistant.

    This fits into what Sean Bina, Epic's vice president of access applications, called "patient-driven interoperability." Share Everywhere complements Care Everywhere, Epic's method of allowing records to travel among Epic providers.

    The company isn't done developing these interoperability tools, Faulkner said over a backdrop of the Beatles' "Here, There and Everywhere." Eventually, Care Everywhere will alert a provider if a test he or she is ordering has already been done at another site.

    "From a technical standpoint, I think interoperability is already solved," said Christopher Longhurst, chief information officer of UC San Diego Health. "The Care Everywhere network is impressive not because of the technical aspects, but because of the community of clients that has all opted into the network to share."

    Improvements to Care Everywhere, Share Everywhere and other initiatives will come to users in smaller, more frequent updates than they have in the past, Faulkner said. Eighty percent of new features will be turned on automatically, encouraging adoption.

    More frequent updates could be both good and bad, said Pamela McNutt, CIO of Methodist Health System, though she said she and her system won't know for sure until they've experienced them. On the plus side, smaller updates could mean less training time, she said. On the other hand, "we will be pretty much in a continuous upgrade mode while the same staff is trying to move user requests and projects," she said.

    Time will tell whether users will appreciate the new schedule. Epic staff seemed pleased with current satisfaction levels, sending a KLAS statistician to the stage to show that Epic's user base is the most pleased among EHR vendors, with 24% of Epic users being "very satisfied" and 46% "satisfied."

    Still, being the leading vendor for usability means only so much in the EHR world. "Epic appears to be the cream of the crap," Longhurst said with a smile.

    That's in no small part due to regulatory burdens, he said. "We have done much of this to ourselves."

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