Mayo rolls out big health record project

The centerpiece of Mayo Clinic's ongoing $1.5 billion technology upgrade, already underway in Wisconsin, is expected to arrive later this year at some hospitals and clinics in Minnesota.

The Rochester-based health system announced two years ago it would invest in a new electronic health record system that would span all of Mayo's operations, which stretch into Arizona, Florida and Iowa.

Mayo Clinic has used electronic records for years, but the new unified system will be easier to update when it comes to alerts and information tools, said Cris Ross, the health system's chief information officer.

"Over the last decade, our medical leadership has been moving strongly to create a single, converged practice of medicine across all locations, so we practice in a consistent way everywhere," Ross said. "As that progressed, our technology was getting in the way … so it was time to make a change."

Electronic health records capture information on a patient's medical history including medications, allergies and health issues. Doctors also use the systems to order treatments for patients.

The computer systems can alert doctors to potential problems before placing orders while also giving them access to the latest research on treatment options.

The systems have become almost ubiquitous in health care due in part to federal incentives, said Allan Baumgarten, an independent health care analyst in St. Louis Park. Hospital and clinic networks tout computer systems as essential for providing high-quality care, Baumgarten said, since they can provide real-time information about a patient's conditions, medicines and test results across an expanse of inpatient and outpatient medical offices.

But there also are concerns about the systems, Baumgarten said.

"I talk to providers all the time who tell me they end up sitting in front of the terminal, and it's really degraded the quality of their interactions with patients," he said.

Electronic health records are important not just in caring for patients, but also for the business of running hospitals and clinics. The new system at Mayo, for example, will generate the bills for medical services that supply most of the health system's revenue, which hit $11 billion in 2016.

When large health systems switch to a new health record, it can create a short-term financial risk, according to a report this summer from Moody's Investors Service.

Health providers spend a lot of money to train staff on new systems, and the training time lowers productivity. When there are troubles with installations, health systems can struggle to send bills in a timely manner.

The Moody's report cited the example of one hospital in North Carolina that experienced two downgrades in its bond rating following an installation, although the medical center's financial performance has since rebounded.

"They ended up not being able to send bills out for a very long time and ultimately had to write off a lot of accounts receivable," said Daniel Steingart, an analyst with Moody's. "It's not a typical result, but it does illustrate what can happen at the extreme."

There's no reason to think Mayo runs any greater risk of problems than any other health system, Steingart said. Ross said the health system is aware of the risks but added: "We feel we do have it under control."

Mayo has hired a Wisconsin-based company called Epic to develop its new record system. Most large health systems in Minnesota already use software from Epic, so Ross said the change "will allow us to increase our ability to exchange records with other health systems."

The $1.5 billion investment goes toward not just the health record, but also updating Mayo's network for security and efficiency.

In July, Mayo rolled out the new system at hospitals and clinics in Wisconsin. In November, the clinic expects to launch the new electronic health record at many hospitals and clinics in Minnesota and Iowa. Implementation at hospitals in Rochester, Arizona and Florida is scheduled for 2018.

"Having an integrated electronic health record across all of our sites can help us with our core mission of meeting patient needs," said Dr. Steve Peters, Mayo Clinic's chief medical information officer, in a statement.

The new health record system has been dubbed the "Plummer Project" in honor of Dr. Henry Plummer, the early 20th-century physician at Mayo who developed the clinic's multi-specialty model along with a paper medical record system — also known as a "dossier" system — so doctors could better share information.

"Dr. Plummer's creation of the idea of teams working together, supported by common data and record keeping, was really one of the foundations that made Mayo Mayo," Ross said. "So, when we started this project to develop a single, integrated electronic medical record system for all of Mayo Clinic, it just seemed natural to honor his legacy."

Plummer came to Mayo in 1901 and helped the clinic transition to a multi-specialty group practice that operated with an integrated medical record, said Dr. Peter Kernahan, a medical historian at the University of Minnesota.

At the time, most physicians were in solo practice, Kernahan said, and kept their own, individual records for patients. When they needed to, doctors shared information by letter or verbally.

Hospital medical records evolved over the 19th and early 20th century from a ledger system to an individual chart for each patient with standardized forms, Kernahan said. Mayo Clinic and Plummer were both part of this transition, he said, and leaders in it.

"William Mayo once described hiring Plummer as the 'best day's work I ever did,' " Kernahan said via e-mail. "His reputation is well-deserved."

Christopher Snowbeck • 612-673-4744

Twitter: @chrissnowbeck