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UW Medicine has announced a $180 million clinical transformation (CT) project to standardize and simplify clinical and business functions by unifying on a single electronic health record (EHR) system. To find out more about this strategic priority, we spoke to Chief Information Officer, Joy Grosser, who has been leading the charge on the clinical transformation project.

Q: Why is clinical transformation needed?

A: At UW Medicine today, we have multiple systems for documenting patient care in our hospitals and clinics. The need to access these systems every time care is provided to a patient results in inefficiencies, such as:

    • When I participated in clinical staff rounds at UW Medical Center, I saw that one doctor had to sign into different systems 46 times while visiting eight patients.


    • The patient journey of a typical surgery patient at UW Medicine — from first contact with   primary care to post-surgery follow up — is currently documented in four different clinical systems.


    • Patients must choose among four different eCare portals to access their medical records depending on where they receive care, and there are more than eight other billing portals.


Q: What is most exciting to you about clinical transformation?

A: This initiative gives us a unique opportunity to bring clinical and business leaders together to simplify workflows and processes throughout our system and make things work better for everyone. By using one core vendor, Epic, we’ll be able to hardwire these changes and create a more standard approach to care. Decommissioning many of the existing systems will mean a lot of change initially, but the end result will be much more efficient. The doctor will spend less time signing into systems; the journey of the surgery patient will be visible in one place; and patients will have one portal for all clinical and billing needs.

Q: Is clinical transformation an information technology (IT) project?

A:  In clinical transformation, the focus is on healthcare rather than information technology. Our major objectives are to improve patient engagement and experience, physician experience and efficiencies, patient care staff experience and efficiencies, and business and operating efficiencies.

In contrast to many of our current systems, the new system will be clinically informed. We are asking clinical and business leaders from all entities and locations to help lead the design of the system. Through this structure, we will get input from the people who know most about clinical care and business operations: front-line physicians and staff.

Our IT staff will work with these clinical and business leaders to provide support and guidance from a technological perspective when there are choices about workflows or questions about how to make the system most efficient and user-friendly.

Q: Has a software vendor been chosen?

A: We will be standardizing on the Epic System. We already use Epic as our ambulatory/outpatient EHR at our entities and for our registration, scheduling and billing system. Valley Medical Center has actually standardized on Epic for all inpatient and outpatient functions across its organization already. With its large local and national footprint, Epic is a good platform for exchanging information with other healthcare organizations when patients are transferred to and from our facilities.

Q: What are some of the benefits that we can expect from clinical transformation?

A:  Physicians, nurses, therapists and other health professionals will save time by no longer documenting and searching for patient information in multiple systems. We also plan to eliminate duplicative documentation (for instance, by doctors and nurses) whenever possible. From a staff perspective, a single EHR for inpatient and outpatient records will eliminate the great amount of time that is currently spent scanning these records from one system to another.

Joy Grosser talking with Harborview employee

In designing the EHR, we have the opportunity to standardize and simplify workflows in ways that are optimized for each member of the care team. We will also be better able to manage care under our new “value-based” contracts; for instance, when patients are due for certain tests, the prompts will be seen by providers everywhere in our system.

In healthcare, as in other industries, patients want to engage with us online. By providing them with a single portal for their clinical and billing needs, we are creating a more seamless and satisfying experience. In addition to the patient tools within the Epic system, we will also look at how to incorporate additional tools to allow patients to further engage with us.

Q: Is clinical transformation part of our Financial Improvement and Transformation (FIT) program?

A:  Clinical transformation is one of the pillars of FIT. This is a case where we are investing money now to save money in the future. Based on conservative estimates, we expect to achieve more than $191 million in benefits by fiscal year 2027. This will more than offset the cost of the project, and the benefit will continue to grow in subsequent years.

Much of these savings will come from reduced IT costs because we will be eliminating more than 70 ancillary systems that are currently in use. This will reduce our licensing and subscription costs as well as the cost of supporting multiple systems.

By standardizing and simplifying workflows, we will also achieve cost savings from revenue cycle management, clinical staff efficiencies, health information management cost reductions and other cost management benefits.

Q: What will happen next?

A: We are currently working with our clinical and business leaders to identify leadership for our committees within the clinical transformation initiative. Once the leadership team is formed, we will work to have members from across UW Medicine on each committee. We are hoping that the committees will have their first meetings in September.

We will have a kickoff event in early October when all of our committees are in place. At that time, we will also launch a clinical transformation website.

The overall timeline for our design, build, test, site preparation and go-live is 30 months, with our first go-live in the first half of calendar year 2020. Look for a single EHR that shows our patients in one view and one story to be up and running across all of UW Medicine by December 2020!


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