Baptist Health Consolidates Legacy EHR into Epic, Adds AI-Powered Rx Tech

To provide high quality patient care, physicians and other practitioners need quick and easy access to patient records. Yet many health systems struggle to deliver comprehensive information in a consistent format when it is needed most – at the point of care.

Problem

Baptist Health, which serves the Jacksonville, Florida community through a wide-reaching healthcare network consisting of six hospitals and more than 200 specialty physicians and primary care practices, uses a variety of electronic health record systems for its hospitals. Had been. ambulatory clinics and other care settings.

Unfortunately, these disparate systems did not communicate with each other.

As a result, physicians were unable to view the full drug history of their patients. Physicians were relying on patients as a source of truth, which required them to manually enter data into a local EHR each time a patient presented at a different Baptist health facility. The drug reconciliation process was not only inefficient but also prone to error.

“To address these issues and ensure that we provide our physicians with robust data to make the best care decisions, our health system has decided to eliminate disparate systems and integrate with a single, enterprise-wide Epic EHR. We have set a goal of consolidating patient data in the U.S.,” said Dr. Stacey. Johnson, vice president, chief applications officer and epic program executive at Baptist Health.

The goals of the project included:

• Improve patient care by sharing health information seamlessly across all practice sites.
• Improve operational efficiency by spending less time transcribing medication data, making phone calls, or otherwise tracking medication details for each patient.
• Improving evidence-based decision making capability as an organization by making all data points available on a single platform. Without this, it would be extremely difficult to analyze massive amounts of data, as reporting structures are not uniform between EHR platforms.

Proposal

“We plan an Epic implementation for five existing hospitals and one new hospital, three free-standing emergency departments, our outpatient oncology clinic, and more than 200 points of care,” Johnson explained. “As part of the project, we need to consolidate millions of medications, clean up prescription instructions (known as “sigs”), and make sure the new EHR has free text in the individual fields. was recorded in. After researching a few vendors, we chose DrFirst’s MedHx because its AI normalizes the data for us.

“MedHx delivers six months of medication data from pharmacy benefit managers, EHRs, pharmacy fill data and payer records,” she continued. “Its artificial intelligence uses clinical and statistical context to clean and structure drug history data to prevent missing information while avoiding manual entry.”

“With the addition of our EHR consolidation and AI-powered medication history solution, we can provide better care for our patients while providing our physicians with robust data at their fingertips to make the best care decisions.”

Dr. Stacey Johnson, Baptist Health

It normalizes sig information into consistent words, translates national drug codes between different databases, safely infers missing information, and processes free text so that it is pre-populated in discrete regions. It also enables staff to transition Continuity of Care documents from legacy EHR systems to Epic.

“The AI-powered medication history solution directly improves the quantity and quality of available medication in clinical workflows to create an effective medication solution,” Johnston said. “This is important when patients become unable to communicate in the emergency department, and is necessary to prevent inaccuracies reported by patients and families.

“This can help streamline admission and discharge processes and avoid errors in medication reconciliation during transfer of care levels,” she said.

meet the challenge

Baptist Health’s clinical applications team worked with multiple stakeholders throughout the organization to test, validate, and ensure physicians and other practitioners have consolidated drug data in real time.

“Early in 2020, and continuing until our official project launch in October 2020, we worked with more than 170 clinic partners running a plethora of different EHR platforms, to demonstrate the benefits of integration and their purchase- To trade,” Johnson recalled. “Next, we worked with the inpatient units to understand and document the old workflows for medication history and medication reconciliation so we could ensure that the new EHR configuration would accommodate workflows for all practice areas.

“We then teamed up with Epic and Dofirst to build, implement and test the new EHR system and medication history tools in partnership with our operations team.” “Following implementation, we launched a training program on the new drug history tools and workflows, and ensured the appropriate people had access to security.”

Result

When medication records are imported into the EHR system, sigs arrive as unstructured free text, often missing pieces of information and using different words for the same instruction (for example, “by mouth”). vs “oral”).

MedHx uses AI to understand clinical language and interpret missing clinical details that are implied, but not present.

“Consider a prescription for Lisinopril 10mg Tablets (a drug to treat high blood pressure) that includes the instruction ‘tk 1xD’,” Johnson explained. “The AI ​​not only interprets the clinical intent, but also sees that for this drug, an ‘oral’ route can be safely predicted.

“Since our epic go-live on July 30, 2022, our health system has converted over 7,352,000 drug sigs without physician intervention using MedHex,” she continued. “In a subset of these conversions no indication was given in the third party data, and the indication was estimated by the technology.”

Another subset had a sig available, but only as free text, and Epic converted these to a discretely defined sig in the database. Prior to the EHR consolidation and integration of MedHx, physicians would be responsible for manually converting all 7,352,000 sigs. By avoiding this conversion, Baptist Health has saved significant time for its physicians and reduced the potential for transcription errors.

“We identified more than 3,000 additional high-risk drugs from more than 1,700 unique patient drug profiles that would not be recognized by legacy EHR systems,” Johnson said. “Awareness of these drugs improves patient safety and informs better prescribing and medication management by our physicians.

He further added, “We enabled our drug history technicians to conduct tele-consultations and do drug history efficiently.”

advice for others

“Sharing high-quality data across your health system is critical to your EHR’s ability to trigger critical safety investigations, such as drug interaction and allergy alerts, which can help reduce adverse drug events,” Johnson said. can do.” “Seamless data-sharing gives your physicians access to all drug information that was documented during any encounter with your health system so that they can make evidence-based decisions and provide the best possible patient care.

“With the addition of our EHR consolidation and AI-powered medication history solution, we can provide better care for our patients while providing our physicians with robust data at their fingertips to make the best care decisions,” she said. to continue.

Another important goal was to give patients access to their health information and medication records from any web browser – not only from Baptist Health but also from other health systems running the same EHR.

“This will be important moving forward as new regulations ensure patients’ rights to their medical records,” she concluded.

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