Abstract
Introduction: Federal and state mandates have compelled healthcare systems to adopt “meaningful use” electronic health record (EHR) systems. Off-the-shelf, onthe- spot, one-source EHR systems such as EPIC® have become popular choices. Indeed, EPIC® recently captured a substantial proportion of the Houston Texas Medical Center (TMC), CVS Pharmacy mini-clinics, and extended into academic institutions. Current reported estimates are contentious but vary between 20- 47% of the EHR market share. Therefore, it is only sensible to conduct a review of EPIC. Aim: The intent of this article is to report a systematic and comprehensive review of the scientific literature regarding EPIC’s advantages and disadvantages in terms of “meaningful use”. Method: Findings reported herein derive from a grounded, iterative review of open-source, peer-reviewed scientific literature on EPIC. Findings: EPIC excels providing accurate/connected information virtually in real time with which to adjust medical practice. However, hidden costs are associated with EPIC, including expensive vendor support and add-on programs, “technological somnambulism,” increased data entry “after-hours tax,” and training. Nevertheless, EPIC can enhance patient safety, monitoring, tracking, continuity of care, and patient involvement. It also has promise as a medical education tool. However, end-user satisfaction has never exceeded 70% (C-). EPIC has failed in terms of e-document management, especially for human research subject protection. Finally, results are reported from a preliminary examination of EPIC transition Help Desk online responses. Conclusion: EPIC provides a high-quality, tech-savvy front-end-to-back-end EHR system for collecting and managing accurate “raw” inter-connected medical record data for timely reporting. However, it carries substantial hidden costs. Also, EPIC is lacking in the management of e-documentation. Avenues for future research are considered regarding EPIC.
Highlights
Federal and state mandates have compelled healthcare systems to adopt “meaningful use” electronic health record (EHR) systems
EPIC is lacking in the management of e-documentation
This study revealed that the rate of evidence adherence was 86% and statistically significant and patient satisfaction surrounding this EPIC feature was 80%
Summary
Federal and state mandates have compelled healthcare systems to adopt “meaningful use” electronic health record (EHR) systems. The federal and state governments have enacted legislation and regulatory mandates and penalties for not embracing EHRs that are certified “meaningful data producers” [9]. This is because the traditional or legacy EHR was developed strictly as a document storage, management, and retrieval system for provision of clinical care. Legacy EHRs permitted unstandardized and disjointed entries, thereby producing variation in content This resulted in clinical data housed in multiple disconnected systems, further restraining efficient and meaningful EHR analyses [14]
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