UT Health San Antonio and University Health System (UHS) are celebrating the conclusion of a huge accomplishment years in the making — UHS has made the transition from Sunrise to Epic.

UT Health San Antonio has been successfully using and expanding its use of Epic’s enterprise tools for more than a decade. Epic is an electronic medical record (EMR) platform and the world leader for securely storing and organizing patients’ medical records, providing revenue cycle efficiency tools and designing practice management solutions for hospitals and outpatient practices.

UHS went “live” with Epic on Saturday, July 11 at 4 a.m.

“It was a long and arduous two-year journey,” said Andrew Krecek, clinical information officer for UT Health Physicians. “The UT Health Physicians-IT and UHS-IT teams have worked diligently and collaboratively in developing a robust and integrated platform connecting the two Epic systems.”

The connection between the two, separate Epic systems is a huge leap in the right direction for patients and providers at both health care systems, said Bob Leverence, MD, FACP, chief medical officer at UT Health Physicians.

“Epic is designed with technological sophistication that allows a patient’s medical record to be seamlessly and securely shared between the care teams at both institutions,” he said. “That’s one reason we are thrilled UHS has adopted the Epic platform. Not only will it improve the level of care we can provide patients, it allows our providers to communicate efficiently and effectively about our shared patients.”

The sharing of medical records between separate hospitals and practices is an important topic in today’s medical community. As patients’ health care choices expand, they are likely to see different doctors and undergo procedures or surgeries at multiple places. At each place, the patient has a separate medical record created for them, filled with important details like medications, lab results, surgical notes and other information their primary doctor or surgeon should know about. As time goes on, this leads to disorganized, even missing, medical records, which ultimately diminishes the level of care any clinician could provide that patient.

Epic has a tool for that, too. UT Health San Antonio uses Care Everywhere to securely request and send patient records, even with practices that don’t use Epic.

“The process of requesting and receiving records from multiple places can be difficult, time-consuming and sometimes impossible,” said Dr. Leverence. “A complete medical record is a paramount service to the patient. The more medical history a doctor has about their patient, the more equipped they are to provide a personalized treatment plan that promises the most successful outcome.”

Issues caused by the complicated process of sharing records are now solved thanks to the new connection between the UT Health Physicians and UHS Epic systems. “Now we have seamless access to our patients’ pre-operative and other history records from our partner institution, just as they do from ours.” said Dr. Leverence. “It’s a connection that promises to improve the level of care we provide our patients, reduce overall health care costs and make communication between providers more efficient than ever.”

Dr. Leverence is also looking forward to expansion into Epic’s other tools, like Secure Chat and Haiku. Secure Chat is Epic’s method for care teams to have secure, HIPAA-compliant group chats about a patient, and Haiku is an Epic app that allows providers to have secure access to their patient’s EMR from their mobile devices.

Because the providers and staff at UT Health Physicians are already familiar with Epic, it is anticipated they will easily be able to work within the UHS instance of the tool.

Should questions or issues arise, the Epic team is available to help. You can access the UT Health Physicians virtual Epic red coats from the Epic home screen. At UHS there are Epic team members wearing bright blue “Epic Team” shirts located throughout the hospital and RBG who are ready to assist. You may also contact the helpdesk at 210-358-4059 and press #9 for Epic Support, or email them at Epic.Training@uhs-sa.com and provide:

• Patient MRN (if you are clinical staff)
• Your name
• Your department
• Your call back number and email
• The hours you are available to receive calls

In health care, “at the heart of our profession, we are here to reduce suffering. Yet, suffering is not just from physical discomfort but also the uncertainties and anxieties arising from delays in care and lapses in coordination. The only way to measure these things is through ‘patient experience’ scores and comments. Some claim patient experience is the most important quality measure, and I agree,” says Dr. Robert Leverence, chief medical officer and primary care physician at UT Health Physicians.

As of Feb. 10, 2020, we have transitioned our patient experience surveys from National Resource Corporation (NRC) to the health care industry leader in patient experience, Press Ganey Associates (Press Ganey).

Press Ganey provides larger sample sizes for comparing our scores to other practices like UT Health Physicians. This allows us to use comprehensive and specific benchmarks for comparing the experience we’re providing our primary and specialty care patients.

Why do we measure patient experience?

The definition of patient experience is encapsulated in this description from the Beryl Institute, which has long been adopted by UT Health Physicians:

“The sum of all interactions, shaped by an organization's culture, influences patient perceptions across the continuum of care.”

Positive patient experiences have been correlated with: 

• • Increased patient engagement
  • Better patient adherence
  • Lower emergency admission and readmission rates
  • Better health outcomes
  • Greater company culture
  • Employee retention
  • Practice growth

Patient experience survey scores also impact our practice’s reimbursement from Medicare and from value-based care models.

JoAnn Rios, manager at UT Health Hill Country adds, “Our patients' experiences have a direct association on their perception and the reputation of UT Health San Antonio. That’s why our strategic plan for ensuring we’re dedicated to creating positive patient experiences includes continuing rich, evidence-based and culture-driven education and training for all managers, staff and providers.”

Compared to other companies, Press Ganey has a higher satisfaction rating for the analytics it provides, and for the ease of using the software. As the industry leader in patient experience surveys for both ambulatory and hospital settings, Press Ganey provides larger sample sizes for comparing our scores to other practices like UT Health Physicians. This allows us to create and analyze more comprehensive and specific benchmarks for monitoring the experience we’re providing our primary and specialty care patients.

The Difference

Patient experience surveys measure loyalty and growth using the feedback our patients provide.

With Press Ganey, we will focus on our patients’ answer to, "Likelihood of you recommending our practice to others."

Some new capabilities we can now execute through Press Ganey include:

Text surveys: Following their appointment, patients will now receive their survey via text message. If no response is received, they will also receive the survey via email.

Previously, patients received an automated call, followed by an email.

Waiting period: Surveys are sent to all patients within 48 hours following their appointment. If the patient revisits the same provider after 90 days, they will receive another survey. This allows us to gather more feedback for comparison.

Previously, with NRC, there was a 6-month waiting period between patients receiving another survey from their provider.

Varied surveys based on type of visit:

Press Ganey allows our practice to send various types of surveys with questions that match the type of visit the patient had.

See examples of the surveys our patients can receive in the gallery below:

• MD – This survey goes to patients who have completed an in-person visit with a physician, NP or PA.
• ON – This survey goes to patients who have received outpatient oncology services appointment.
• OR – this survey goes to patients who have received outpatient rehabilitative (physical therapy) services.
• OU – Radiology Diagnostic Imaging – this survey goes to patients who received outpatient radiology services.
• MT – This survey is currently pending but will go out to patients who see a physician, NP or PA via telemedicine (Video Visit).

All patients who see one of our providers for outpatient services will receive a survey with the exception of those who previously received a survey from a provider they visited in the past 90 days or those who have opted out of being surveyed.

The Patient Experience Practice Champion Award

We will continue to celebrate our achievements in providing excellent experiences and patient-centered care. The Patient Experience Practice Champion Award is awarded each quarter to the practice that achieves the highest survey score.

This celebration and its awards are important:

• • To celebrate achievement together
  • To share the stories and successful behaviors that earned high scores
  • To promote our combined commitment to excellence and a competitive spirit

YOU are the difference

The major difference between UT Health San Antonio and our competitors is YOU.  You are the patient experience - serving our patients every day, making a lasting impact on their life and our reputation.

The patient’s experience is the feeling they have when they leave us.

• • Did we care?
  • Did we try?
  • Did we listen?
  • Do they feel better as a result of seeing us?
  • Are we their provider of choice?
  • Are we who they would recommend?

The Patient Experience Champions team will continue to work collaboratively in their practices, sharing guiding principles and developing best practices across all our locations.

If you would like to learn more or get involved, contact JoAnn Rios at RiosJ5@uthscsa.edu or Stephanie Warren at warrens1@uthscsa.edu.