Abstract
Background As healthcare markets have become more dynamic and turbulent, healthcare organizations have evolved by becoming increasingly “Smart-Agile” in their business practices. Smart-Agility definition-ally ensures success due to its inherent ability to rapidly detect and react appropriately to varied and evolving unclear, complex, and seemingly tumultuous situations and produce high-quality, low-cost goods and services with high customer satisfaction. Thus, there is a vital need for Smart-Agile healthcare IT systems for collection, analyses, and reporting of substantial quantities of healthcare data to inform patient treatment and organizational decisions. EPIC® and its meaningful-use components appear increasingly popular, capturing a majority portion of the healthcare Electronic Healthcare Records (EHR) IT market (>~30%).Yet, there are few, if any, studies reporting on EPIC in terms of Smart-Agility. Aim The intent of this article is to report a systematic review of scientific literature regarding EPIC’s healthcare IT systems meaningful-use features cross-compared with Smart-Agility aspects to produce a positive vs. negative report card—and whether its features are critical vs. non-critical in terms of Smart-Agility. Method Findings reported herein derive from a grounded, iterative review of open-source, peer-reviewed scientific literature following PRISMA. Findings Report card results were mixed. EPIC clearly succeeds and excels (better than average) on Smart-Agile healthcare IT system core aspects that are the most central, critical and valuable in terms of informing healthcare organizations’ decisions and their patients’ care (6 out of 7; B+, -A), specifically: Standardized Data Collection / Connectivity, Real-Time Data Warehousing/Outcome Measures, Enhanced Patient Safety, Patient Tracking and Follow-up (Continuity of Care), Patient Involvement, and Potential Use in Medical Education. The only critical core criterion it failed on was End-User Satisfaction, and some of that appears to dissipate with new users’ software familiarity. Conclusion EPIC provides a solid and relatively inexpensive foundation with great potential for enabling Smart Agility in healthcare organizations with its high-quality collection and management of vast amounts of inter-connected raw data, auto-analysis, and fast report generation. But it does so with hidden costs and inefficiencies. Avenues of further inquiry are suggested.
Highlights
As healthcare markets have become more dynamic and turbulent, healthcare organizations have evolved by becoming increasingly “Smart-Agile” in their business practices
EPIC’s potential for providing Smart-Agile healthcare lies in its ability to quickly connect information and retrieve standardized data for comparative analysis and because it requires pre-determined data outcome measurements. [28,29, 46 -65, cf.66] EPIC is able to generate accurate and timely reports based on requirements for entry of standardized data (e.g., EPIC “hard stops”*) [28,48,cf.66]
There has been concern about a disadvantage of a monopoly or market dominance that locks purchasers into a monoculture and maintains antiquated programming and retards responsiveness, de-confliction, flexibility, enhancement, and the ability to evolve—antithetical to the very essence of Smart Agility. [28,48,cf.10] EPIC provides “...the additional software layers for easy access to clinical information and serves as an accessible, evaluable platform for collecting and analyzing clinical outcomes....”[28]. EPIC can be conformed to shepherd data entry and pre-identify errors and error patterns at the moment clinicians enter data. [28,51,52] data points can be identified and evaluated virtually in real time, almost immediately enhancing accuracy and quality of data as well as informing medical service adjustments. [28, 60, 61,63, 67-79, cf. 64]
Summary
As healthcare markets have become more dynamic and turbulent, healthcare organizations have evolved by becoming increasingly “Smart-Agile” in their business practices. Smart-Agility definition-ally ensures success due to its inherent ability to rapidly detect and react appropriately to varied and evolving unclear, complex, and seemingly tumultuous situations and produce high-quality, low-cost goods and services with high customer satisfaction. There is a vital need for Smart-Agile healthcare IT systems for collection, analyses, and reporting of substantial quantities of healthcare data to inform patient treatment and organizational decisions. [1] This highlights the need for information technology and systems for detection of intra-organization and external market characteristics and performance criteria in healthcare organizations. This requires large quantities of data and the infrastructure to collect and analyze it accurately and efficiently. This requires large quantities of data and the infrastructure to collect and analyze it accurately and efficiently. [1, 5, 22 see 23,24]
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