A Comprehensive Review of an Electronic Health Record System Soon to Assume Market Ascendancy: EPIC®

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.