Not long ago, Contra Costa County, California spent $45 million on an Epic Systems installation designed to tie different sectors of the county health system together. The implementation, which the county dubbed “ccLink” went live on July 1st. The tale that follows here is all second hand, taken from a great piece in an area newspaper, but it’s quite believable, as you’ll see.
To wit, emergency department waits at the county’s hospitals have shot up, with one in 10 patients leaving without being seen due to the backlog. One patient waited 40 hours to get a bed, according to Dr. Brenda Reilly, who spoke to county board of supervisors earlier this week on behalf of doctors working in county facilities.
In addition to live testimony, 15 doctors co-signed a letter to the board pleading for hospital administrators to cut back on physician workload further — some cuts have already been made — as physicians feel they’re unable to keep up and provide adequate care under the circumstances.
“We were not ready for Epic and Epic was not ready for us,” pediatrician Dr. Keith White told the board, according a report in the Contra Costa Times. “As a result, the providers are struggling to provide safe and effective care…many doctors have left and all are considering leaving.”
This week’s protests follow earlier complaints in August, when nurses at the county’s detention facilities told supervisors that ccLink was jeopardizing patient safety due to the rapid install of the system.
Dr. William Walker, the county’s health services director, told the audience at the hearing that he plans to create teams of medical care providers formed to make the doctors’ paperwork trials easier.
As things stood, however, doctors weren’t mollified, calling ccLink “clunky and time-consuming, designed more for bureaucrats than physicians,” the paper reports.
Given their Epic obstacles, which have seemingly slowed medical care to a crawl, doctors are seeing half or fewer of the patients they’d been seeing.
With those patients seemingly spilling over to the emergency department, the average time a patient spends waiting in the county hospital EDs has gone from three to four hours, arguably as a result of the Epic install issues. It’s hard to argue that the new EMR is at least partly responsible for the logjam.
To be fair, I’ve heard of many an EMR installation which created temporary havoc and pumped up wait times in the ED for a while. But the level of paralysis I’m reading about hear seems to be setting some kind of record.
P.S. A side note: I called the nice young man who wrote the story to give him a backgrounder on Epic and some of the interoperability and just plain functionality problems I’ve gotten wind of elsewhere. He told me he’d gotten tons of calls already! Seems the Epic critics/watchers have their teeth into this one.