Heather Ly (Host): Hey there, everyone. Thanks so much for joining us for this latest episode of Medically Speaking. We have a very special guest here today, Courtney Starnes, who is the Chief information Officer for Kaleida Health. Thank you for being here.

Courtney Starnes: Thank you for having me.

Host: Heather. And you've taken some time out of a very, very busy schedule recently. There's a little thing that we've got going on here at Kaleida called Epic. If you could just give us a brief overview of what that means for us, but also for the community, what is Epic?

Courtney Starnes: Absolutely. So, Epic is a digital health system. If you think about when you go to the physician, and it's the way the physicians, the nurses, the care team interact with the computer to see things like your labs, your radiology reports, your physician notes, so that they can take care of you while you're with them.

Host: Yeah. Because back in the old days, it used to be everything on paper and it lived in one spot.

Courtney Starnes: Exactly.

Host: This allows for better collaboration, right? Between doctors, between care teams and, in some cases, between facilities, right?

Courtney Starnes: Right, right. So if you remember those little paper folders that physicians had in their offices in all of those file cabinets, this is the digitized version of that. So, all of that information is more readily available instead of being on paper. And it can be readily available across different health systems as well.

Host: What did we have before? Because this is obviously an upgrade. Did we have different systems that this little piece did this, this little piece did that?

Courtney Starnes: Absolutely. So, we were operating in silos before. So, if you think about all of the different areas of the hospital you could visit from the laboratory to a physician office to the radiology office, there were different systems in all of those locations. And so, this is really the opportunity for us to consolidate everything. As you said, we would have more coordinated care across our health system.

Host: So if we think of Epic as the umbrella, there are several pieces to that. More on that in a moment, but this is a huge endeavor for Kaleida Health and something that we've been talking about for many years. But now, finally, acting on it. Because it's a lot of work.

Courtney Starnes: It is a lot of work. It was years of planning, years of determining when would be the right time, and it absolutely is the right time. So, it's building the system, testing the system. We have thousands of employees involved in this effort from the beginning when we started the project towards the end of 2024. It is a very large effort. And many people have gone into doing testing, training, again, building, discussing workflows.

Host: Talk about all of the pieces that go into this. So right now, we're in our Larkin building in Buffalo. One of the floors is completely dedicated to Epic. What does that look like? Who's down there? I feel like they're really the engine that's making this thing move forward.

Courtney Starnes: They are. Yes. So, when we began the project, all of our IT analysts that had been working on all of those systems previously, they actually went to Epic in Madison, Wisconsin. They were trained on Epic applications and were certified. And then, we created on the second floor of Larkin an Epic floor where we've been holding all of our different project meetings, doing that build, doing that test work, preparing our hardware. So, we have a massive team involved on that second floor. We also bring Epic to Kaleida once a month, and they join us on the floor. It's super collaborative and engaging. And we work through, you know, any problems that we're trying to troubleshoot and just continuing to evolve the project.

Host: Are we talking hundreds of people on this team? Because figure we have thousands of employees.

Courtney Starnes: Yes.

Host: I feel like you have to train the individual teams to then spread it to the masses basically.

Courtney Starnes: We have about 400 IT people including our Epic team that are involved in this project. So, it is a massive effort. And then, we also have a floor that we have dedicated to some training as well. So when we actually implement Epic and go live, in preparation for that, we will train 17,000 users.

Host: Wow. How do you even wrap your mind around that? Because, you know, I think about my small team and, you know, we have small trainings, or you're trying to, you know, teach a new skill. For a group of a couple of people, sometimes that's challenging. This is for an entire health system. And , also you can't skip a beat, you know? It has to be pretty seamless when you're talking about people's health, their records, their privacy.

Courtney Starnes: Exactly. Yes.

Host: It's a big undertaking.

Courtney Starnes: It is a big undertaking. And we're not only teaching our clinicians how to use the system, but we're also teaching them how to navigate and help the patients use the system as well. Because Epic is more than just a system for physicians, nurses, and care teams. It's also the application that our patients will be able to use to find better care to interact with their healthcare provider. So, we're really teaching them those nuts and bolts too.

Host: Yeah. So let's talk about that. Under Epic—well, again, we'll call Epic the overarching umbrella. There are, you know, different segments. And I think about what's called myChart.

Courtney Starnes: Yes.

Host: People want to know what's in it for me. You know, you talk about all of the IT stuff and the inside baseball. How is Epic in this implementation in myChart a component of that going to make it better for patients and for the community, for caregivers?

Courtney Starnes: Absolutely. So, myChart, it is a health app. It's actually the most popular health app in the Apple Store. And it will be leveraged by—hopefully, we'll have all of our patients sign up to use myChart. But myChart is about meeting a patient where they are. And so, you know, the times of, you know, needing to wait until 9:00 AM to call a physician office, hopefully you get through, you get your appointment scheduled. Then, you go to the office, you have to fill out a bunch of paperwork.

Host: Or you're waiting on hold.

Courtney Starnes: Exactly. Playing that phone tag. I always think about the single mom with kids. And that person is trying to coordinate care for her children. And she's trying to schedule her mammogram. And it's just a lot. So, having a digital tool where patients can easily schedule appointments, not only for themselves. But for, you know, their family members. And be able to receive information from their provider directly through that app, that is going to be a game-changer.

Host: The ease of that. I think about, you know, when I often call to make an appointment, if you can't do it first thing, you try to call on your lunch break.

Courtney Starnes: Yes.

Host: But then, everybody else is on lunch.

Courtney Starnes: Exactly.

Host: So, we're trying to make things easier and streamlining the process. And I think you mentioned an important point. You know, when you think about parents or families, it's caring for themselves, too.

Courtney Starnes: It is.

Host: You know, you can't take care of everybody else if you're not taking care of yourself. And sometimes folks, they're so worried about getting appointments for everybody else that maybe they're neglecting their own. So, try to make it as easy as possible to make sure that they get the care.

Courtney Starnes: That's right. That's absolutely right.

Host: It also allows for, I guess, a more direct communication, you were saying, between the patient and the providers, and sort of being that conduit. How will it work to open up the conversations?

Courtney Starnes: Yeah. So if you have an established relationship with a provider, you will be able to message that provider and say, "I'm low on this medication. Could you give me a refill of this, or do I need to be seen first?" It does provide for that seamless communication. If they wake up with an itchy eye, for example, they can reach out to their provider, um, via messaging in myChart. It makes it so much easier.

Host: It makes it so much easier.

Courtney Starnes: Yes.

Host: And then, also, I feel like that can open up or alleviate some of the problems that we sometimes see. You know, you think about busy cold and flu season where everybody's rushing to the ER.

Courtney Starnes: Exactly. That's right.

Host: We might be able to eliminate some of that if you can do a quick message and say, "Hey, I'm a little stuffy. Should I go, you know, to the doctor?" Or, again, "Can you just give me the prescription?"

Courtney Starnes: Absolutely. So even if you are not yet a myChart user, as a patient that wakes up a little stuffy, you can actually find care, same-day care, whether it's through telehealth or just pinpointed to the right location so that you're avoiding that emergency room when it is busy cold and flu season. Those are all features that we'll have for our patients.

Host: This also connects us with others, us being Kaleida, with other hospitals or potentially other health systems. Again, this is a much larger net that we're casting.

Courtney Starnes: It is.

Host: Who will we be connected with, and how does that help a patient?

Courtney Starnes: Yes. So, we will be connected with our partners, UBMD and Erie County Medical Center. And so, if you think about patients in our community, they may see a primary care physician out in the suburbs. They may see specialty care downtown. And really having the ability for all of those clinicians to see their information when they visit so that their patients aren't having to go and call and get records and carry them around with them. You know, I know that in the old days patients would carry bags of records if they had a chronic condition.

Host: Who has time for that? Yeah.

Courtney Starnes: Yes, exactly.

Host: Also, does it help because they can—Well, they can easily access it, so I'm not calling one place to get the records or to release the records to the other place. They can easily just go in and get everything they need. They can see what they need to care for that patient. So, any provider that is taking care of you as a patient will have access to see your information.

You talked about the silos, the old way of doing things. Any other sort of old versus new, with the changes that we're going to see with Epic and MyChart?

Courtney Starnes: Yes. So, some of our Epic technologist friends like to call Epic and the Epic project a transplant of the central nervous system. Essentially, it's that big, and you think, "Well, what does that mean exactly?" So, you know, the central nervous system is what controls everything.

Host: Controls everything.

Courtney Starnes: Controls all of the information in our bodies. And so, this is really the system that will control all of the information around a patient's health. And there's actually 200 other systems that we've been deploying alongside Epic that connect into Epic to make sure that it is that ecosystem.

Host: Does a person have to use— I know we're encouraging folks to use the myChart app, but I think about, you know, perhaps some elderly. You know, I think about my mother-in-law, who's in her 80s, who might be a little hesitant or might not know how to use this new technology and sort of embrace the change. What are we doing to make sure that folks are really on board with that? And we make it as easy as possible for them?

Courtney Starnes: We want it to be easy, and we want it to be accessible for as many people as possible. So there's a couple of things. One, we can actually provide a patient family member with access.

Host: Oh, that's great.

Courtney Starnes: If that's appropriate. And the patient still has control over who has access to their information since we want to adhere, of course, to our privacy guidelines. So, a parent or a healthcare proxy.

Host: Exactly. You know, we help with a lot of the care for my mother-in-law. So, we could go in there, schedule appointments, and—

Courtney Starnes: Correct.

Host: So, it makes it easier not just for the patient but for the people who are helping to care for the patient.

Courtney Starnes: Yes, exactly. There are also digital features that Epic has, if you are not a myChart user, but you want to perhaps receive still your appointment notifications, reminders. Even if you have a flip phone, you will be able to say, "Yes, I'm coming to this appointment," or "Yes, please enroll me in a payment plan for my bill that is now overdue." So, there will still be features available if you don't have a smartphone or if you're not going to be on myChart.

Host: That's really great. When we think about electronic health records and the sharing of information, privacy and security always comes to mind. There are a lot of levels to protect what's going on here and making sure that all of that is safe, right?

Courtney Starnes: Absolutely. And privacy and security is top of mind for us as well in thinking about our patients. Epic does have excellent security and access controls. And as I mentioned, you only see a patient's record if you were the provider taking care of the patient. And so, any access in the system is monitored and controlled.

Host: Okay, that's great.

Courtney Starnes: Really, it's about better, quicker, more efficient care. When you boil it, you know, down to the very basics, it's a lot of investment, it's a lot of people, it's a lot of technology, but that's really the goal here. That's the goal.

Host: Better, quicker, more efficient.

Courtney Starnes: Yes. It's all about being more coordinated as a health system, as a community, with the providers giving care to the patients and just being able to make better decisions or even spot things that they may not have noticed before because they have all of the information in front of them.

Host: And I would imagine that there are other health systems maybe in other parts of the country that have been using this. Why was the timing right for Kaleida now to jump on board with this?

Courtney Starnes: Yes. I mean, it is the perfect time, I think, with us and our partners for ECMC and UB and Kaleida at the table together. I think, you know, we have an excellent team. We have a staff that has been so engaged. Everyone has made this really truly a group effort.

Host: Because to make it work, you have to have the buy-in.

Courtney Starnes: You do. You do. So, I think that's been a huge part of it, is just making sure that we have the community support, the leadership support, and the support of all the employees that are working on this project together.

Host: So, we talked about appointments and billing, sort of access to records, sort of the one-stop shop. Anything that I missed in terms of what this can do? I feel like there are so many possibilities.

Courtney Starnes: There are so many things. So, there's also tools called Care Companions in there. So if you do have a chronic condition, like an asthma or even if you have a pregnancy, there are apps inside of myChart that help you, remind you to take your medications or to do certain things according to your doctor's instructions. So, those are features that we'll have when we go live with Epic, but we will continue actually to enhance and improve our Epic instance every year, multiple times a year. And there will be new features, and we will continue to push those out for our patients.

Host: So more to come. And it's really about also—and we kind of touched on this earlier—removing any roadblocks.

Courtney Starnes: Yes.

Host: Being able to answer the questions, you know, faster, being able to get the appointments and the care quicker, which really just benefits the entire community and the health of the entire community.

Courtney Starnes: It does. It does. And that's really the game-changer. So, I know Epic's a technology project. So, I'm excited of course as a technician, but it's really here to help advance the health of our community, and it is absolutely going to be transformational for care.

Host: If people want to learn more or sign up for myChart, what's the best place for them to go and to learn more about it? Because we touched on a lot, but if they want to get into the nitty-gritty or dive right in and say, "You know what? This sounds cool. I want to be a part of it. Sign me up."

Courtney Starnes: Yes. So, it will be available for them to sign up on our website, on kaleidahealth.org. We also will have our patients when they visit a hospital or one of our practices. Their care team will be able to sign them up as well. There are links that they can be texted or emailed so they can sign up.

Host: Because we definitely don't want there to be any barriers when it comes to care. And certainly with the technology, because change, you know, can be a little bit scary. And I think sometimes we just have to, like, overcome that little hump. But again, a huge, huge project. What can you say? Your team has been working so, so hard to make this happen. It has been more than a year of intense training and, again, making sure those little teams—they're almost like the teams that go in, you know, and infiltrate. And then, teach the other teams.

Courtney Starnes: The little SWAT teams.

Host: Yeah, like the little SWAT teams. They go in and make sure that everybody is prepared for this. How confident are you that Kaleida Health is prepared to, you know, when we flip the switch, so to speak, that we're ready to go?

Courtney Starnes: We are ready, and we will have the entire Kaleida Health team ready to go on that big day. Our IT team has worked tirelessly on this project, and it has been a huge effort. But they are so excited. I know that I always say that as technologists, we could work in many different industries. But I think if you talk to the IT team, you would see that they're very passionate about healthcare. And so, they're here because they believe that what they're doing is going to make a transformational difference for our community. So, it's very exciting.

Host: And it really benefits all of us.

Courtney Starnes: It does.

Host: You know, who receive care here in Western New York. So, a really exciting project. Again, congratulations to you and to your team.

Courtney Starnes: Thank you.

Host: A huge endeavor. Also, much more to come in terms of, you said, updates and improvements.

Courtney Starnes: Oh, yes.

Host: So, something tells me this is not the last time that you and I are going to be speaking about all of the exciting things.

Courtney Starnes: Great. Yes.

Host: All right. Well, Courtney Starnes, she's the Chief Information Officer for Kaleida Health. Thank you so much. Again, congratulations, and we can't wait to see how this benefits the community and makes it easier for all of us. No more waiting on hold during your lunch break.

Courtney Starnes: That's right.

Host: Thanks for tuning in for this episode of Medically Speaking, and we hope to see you next time.