Scott Webb (Host): On today's podcast, we're going to learn about Epic, which is Summa Health's electronic health record system and MyChart, which is essentially a patient portal, but a really good one, and how both are game changers for patients and healthcare providers from Elbridge Locklear, he's a Senior Vice President and the Chief Information Officer with Summa Health and Dr. Justin Catlett. He's a Vice President and the Chief Medical Information Officer with Summa Health.

 This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb.

So I want to thank you both for joining me today. We're going to learn about Epic and MyChart and lots of good stuff today. Before we get to that though, Elbridge, tell us about yourself, your role at Summa, what made you want to work there and so on.

Elbridge Locklear, MBA, CHCIO, CDH-E: Okay, sounds great. Elbridge Locklear. I joined Summa Health March of 2021. I've worked in numerous CIO roles in the past. I'm responsible for all information technology at Summa Health, and I've been here about two years and a month or so and one of the reasons that I joined Summa and just looking at different options that I had at the particular time is just what Summa does for the community.

If the community demands something, then Summa will invest into it. If you didn't know Summa has a dentist office, right? So we have a dental office, even though we're more around the healthcare providing sector, so.

Scott Webb: Yeah, I've been hosting Summa's podcast for a long time, and I'm always impressed. Never surprised, but always impressed with how much Summa does for the community, how much they reach out and listen to the community. So, uh, great to have you here. Dr. Catlett, tell us about yourself, your role, how long have you worked at Summa Health, and how'd you end up in IT and everything that you do.

Justin Catlett, MD: Sure. Yeah, I'm, uh, I'm a local guy. So I grew up in northeast Ohio in Mentor about an hour northeast of here. Did my undergrad at University of Akron, went to Neomed in Rootstown, and then was lucky enough to be at Summa for basically my entire career. So, even starting last century, you know, in, in 1999, doing my first rotation at Summa as a student.

I then matched in my family medicine residency at Summa in 2003. Did my residency for three years and was lucky enough again to be offered a spot in the faculty. So I joined the faculty to help teach residents at Summa, at the Akron City campus. At about, uh, 2014, 2015, my then program director left an article on my desk about something called clinical informatics, which was something that I wasn't aware was a thing.

 But clinical informatics is really where clinical work and technology meet and we need people who have a knowledge of both so that we can help translate and interpret between the technical folks who don't have a lot of clinical knowledge, and then the clinical folks who are doing the work of seeing patients.

So I started to look into that more and then studied and became Board Certified in Clinical Informatics in 2016. About the same time we were installing our first version of Epic. Which was an Epic hosted by Bon Secours Mercy Health. And with that installation we needed a Chief Medical Information Officer as a part-time role.

So I did that for four years while we installed Epic, and then transitioned back into my role as a primary care doctor, back at the residency. But with our new project that started about 18 months ago, the system needed a CMIO again. So I, uh, interviewed for that job and was selected and have been working full-time nonstop for the last 18 months on this Epic project with our very successful GoLive on 10/29 of last year.

Scott Webb: Yeah, I joked before we got rolling here that it does sound pretty epic, you know, all pun intended. So, Elbridge, what is Epic?

Elbridge Locklear, MBA, CHCIO, CDH-E: Epic is our electronic health record. So one way to look at that is it's more of a, a one stop shop for everything about an individual's healthcare, regardless of any stage that person may be in their life. And this is also considered a one stop shop for say patients, providers, family members, to look at anything that would be in an electronic medical record, to help patients, provide care.

Scott Webb: Yeah, and I'm familiar with MyChart more than Epic, and we're going to get to MyChart as well. But Dr. Catlett, maybe tell us a little bit more, like, what does it do for Summa Health? How does it impact the community, the patients you serve, and so on?

Justin Catlett, MD: Sure. Yeah. There's many wonderful things about Epic. Before this point, as we would find new technology, we would incorporate new technology, but all of those different platforms were separate and didn't really talk to each other. The unique and wonderful thing about Epic, it's, it is, it's a complete electronic health record platform.

So we don't need ancillary or other programs to do the work. It's all integrated in one system, and this system covers inpatient, radiology, lab, outpatient settings, emergency rooms, anything you can think of in the healthcare system, we can use Epic to accomplish whatever we need to accomplish in that sort of space.

The beautiful thing about it for our community is that all of their data is stored in one area. So we have a saying, which is one patient, one chart, one Summa. And what that means is that patients don't have to go to multiple places to engage in their healthcare. They can go to one place, they can go to Summa, they can go to MyChart, which is our patient portal that we'll be talking about and all of their care, all of their data, all of their information, all of their ability to communicate; it's all located in one spot, making it very easy for patients to navigate our system.

Scott Webb: Yeah, easy sounds like the appropriate word. Does sound like it would make patients' lives so much easier. And wondering, Elbridge, why did Summa decide or make the decision to implement its own instance of Epic? Right. And, I'm assuming there was some substantial costs involved. Maybe you can break that down for us.

Elbridge Locklear, MBA, CHCIO, CDH-E: When I go back to when I first joined Summa, as Dr. Catlett stated, we were on a shared instance of Epic. So an EHR that was shared by another institution that wasn't necessarily local in our community. And what was important to us and what we discussed as overall executive team, leadership team is that we needed something that would help make Summa more nimble, give us the ability to respond to changes that are unique to our community, not necessarily for organizations or patients nationally. We needed to be able to focus on the strategy we had for the community, be able to respond to patient needs or short-term community needs regardless of whatever breakout or whatever influenza issues that we have, or you, you name it. I'm sure Dr. Catlett could label off many.

Uh, so that was the genesis around it. And what that has done is with the upscaling, with all of our employees and staff and expertise that we've infused into the environment, whenever there's a need from a, a marketing or a special case or from a provider perspective, we have a special services that we provide here from a joint center of excellence, that we have other things in the environment. We can specialize that very unique for our community by having our own EHR. Now you asked a question about, you know, was the cost like? Well, it was, uh, about 85 million dollars.

Scott Webb: Mm.

Elbridge Locklear, MBA, CHCIO, CDH-E: So going into that cost would be the staff, the resources, internal, external resources, experts to help us get that implementation done. Also, the Epic, the software that was purchased as a whole, all of the modules from oncology to radiology, which everyone gets radiology to, lab I mean, you, you name it. Surgery. It's exciting time. And MyChart also. We have our own MyChart mobile app.

Justin Catlett, MD: Summa has a lot of areas of excellence. Our bariatric center is a nationally recognized center. We have trauma services, oncology, geriatrics and palliative care. We have some really wonderful services that we are, in many cases, better than the competition locally and having our own platform, our own version of Epic that we can customize and build based on our needs and the needs of our community, allows us to grow those programs to make them more available to the members of our community and to save cost ultimately. If we can do things more efficiently, because we have the ability to change our own system, then we can reduce cost for patients and increase the value of the care that they're getting.

Scott Webb: Yeah. Despite the substantial investment by Summa, you see over time how this saves time, money, frustration, and so on. Doctor, how long did it take to implement? Were there lots of folks involved in this project?

Justin Catlett, MD: Uh, yes. This was a very large project. We had a very quick timeline. We accomplished this project in a little bit over a year. Many other organizations will take multiple years to do the same. But with the size of our organization and the need of our community, we decided to really put our nose to the grindstone and work as hard as we could over that process to build everything appropriately in a short timeline. There were hundreds of people involved. We had work from our own folks at Summa and partnering with Epic. Epic sent us many, many, individuals, many different times, to help us on this project. And they, they really have partnered with us to build this out to be exactly what we need. I'm not sure, Elbridge, do you have more of an idea of the closer to a number of people that we used?

Elbridge Locklear, MBA, CHCIO, CDH-E: We were approximately over 300 people that did the implementation, but that doesn't include staff, subject matter experts, clinicians in the environment. So it was a big lift for the entire organization. organization

Justin Catlett, MD: And I'd have to say that it was really pretty amazing to see how your organization responded. One of the things that we wanted to identify to help our users during our GoLive was a group of people we call power users. Power users are staff. They don't have any special IT training, but they're staff that are active and engaged, and want to help the system. And we had more than 800 power users volunteer during this project on the clinical side and on the operational side to help IT make sure that we build everything exactly how we need in order for us to be successful.

Scott Webb: Yeah. And Doctor, I you know, I know you're just sort of getting your sea legs, and working things out, probably still, lots of bugs and kinks and getting it just right for patients and employees and so on. But what's next? Like, what's on the roadmap for patients that they're probably going to be excited about.

Justin Catlett, MD: Right now we're in the middle of what we call stabilization, which is when whenever you install an electronic health record like this, you need to make sure that the system is functioning as intended. And there are thousands of settings, thousands of things that needed to be built. And we don't get it all right right away. We get the very important ones, the ones that make sure safety's right, but efficiency can sometimes lag a little bit behind a GoLive. So we're taking this time to do stabilization. Our next step is when we can really expand into what we call enhancements.

So that's when we engage with our users, engage with nurses and, you know, our environmental staff and providers and pharmacists, everybody. And as they look at the system and find things that they think that could be improved, they'll submit a request to have that thing changed, and then we have a process where we look at all those requests and prioritize them and then start building them. So the next phase is really when we get to realize the potential of the EHR of Epic that we've purchased. In the past, being on a shared instance, we had input on how to develop the system, but we also had to contend with the needs of the other organization that we were working with. In this case, we have carte blanche, we can do what we want. So we're looking to expand in the areas for what our community needs, more access to care, more access to primary care. One of the other things Summa has done recently is we've built the Juvi Behavioral Health Center. So we're expanding our behavioral healthcare, which is a definite need in our community and northeast Ohio.

We have options to be able to develop the program to better support all the efforts that we're putting into our opioid crisis that we have in this state, in this country. But as you know, our state has been hit harder than many other states. And northeast Ohio has also been hit hard compared to a lot of other places. So we can start developing into those areas to really address the needs of the community, by building the electronic health record to support the medical things that we need to do to help them, but also to help give them the access and growth in our hospital to give the services to the community that they so desperately need.

Scott Webb: Yeah.

Elbridge Locklear, MBA, CHCIO, CDH-E: Yeah, I kind of want to add a couple of comments to that. So one thing to note that makes us a little different than say, local systems or typical Epic implementation, we implemented most every feature that this Epic EHR has right out of the box, we turned everything on.

So things that would help in that or that actually make this better for the community. So one thing to note, it ranks us as a gold star nine. This is a rating that Epic gives customers. What that means is we are ranked under 14%, meaning. The top 14% of the nation. So less than 14% of the nation in Epic is like the 80% implementation of EHRs in United States from the medium to large size.

And so we're top tier. Things like physician productivity, nursing productivity, patient engagement, increased capability about mobile. So mobile devices. Just a number of things to Dr. Catlett's note though, we have texting to patients for reminders right now as a result of turning this on. But one thing to look for is in the future it'll be two-way texting.

You can text us back. We can carry on communication with you via text. But another thing that patients seek and which you want, and I'm sure you get it through other applications too, is, analytics. Can I run analytics on my healthcare or do I need to go look at a doctor and look at benchmarks about my healthcare or see a doctor that shows me that. Well, we'll give you that capability in the mobile app in the future.

Scott Webb: Yeah, it's very cool. And uh, you know, like I said, when we, I sort of prefaced today, I sort of know a little bit about MyChart. Epic is all epic and new and awesome. So glad to hear about this today. Doctor, let's tell folks about MyChart. I'm sure they've heard about it, maybe used it, but maybe you can break it down for people.

Justin Catlett, MD: Absolutely. MyChart's what's known as a patient portal, so it gives patients access to their own healthcare data and in some cases, the healthcare data of their loved ones, like children or elderly family members or family members who need help. This patient portal could be accessed in a couple different ways. One of the standard ways is through a, just a, a web portal, meaning that you sit at a computer, you log into MyChart, you immediately can see all the information that you need to see. We'll talk about features here in a second as well. But the other way that people tend to use MyChart is via the mobile app.

So MyChart has an Android and Apple app, mobile application. And so you can log in from your phone and the phone brings some additional really neat functionality, some that we have now, and some that we will have in the future. But a lot of patients have experienced patient portals with other electronic health records and you know, there's a variability of how they function. One of the wonderful things about Epic and MyChart is it is a full feature application. So some of the things that you can do, you can, for example, if a, a pregnant woman wants to register for her delivery, she can just get on the app and figure out where she wants to deliver, even set up tours, do things like that.

We have a application in there in MyChart where they can find care now. So I'm sick, I need to be seen. I don't think I'm sick enough to go to the ER. My primary care doctor can't get me in today. What do I do? And so they can go to find care now and they can see who's open in the area. And, one of the future developments is even wait times. So we'll be able to see what are the wait times at these places so I can make a decision, maybe a 20 minute drive is a little bit better than a 30 minute wait. E-Checkin is wonderful. And, and we use something called geofencing as well, meaning that we know by GPS, the location of our offices. So if a patient with their mobile device and MyChart on there, as they walk into that location, it'll already start the process of checking them in so they don't have to wait in line, they don't have to stand at a kiosk or do things like that.

But even while sitting in the waiting room, they can open up their MyChart, they can check in, they can answer questions, verify their medications, they can even pay outstanding balances. And the wonderful thing about being on one unified program is they can pay balances for inpatient charges. And they can pay copays, they can pay balances for outpatient charges. It really is a very easy way to just handle all the financial stuff right then.

Scott Webb: Yeah.

Justin Catlett, MD: One, other feature, and there's many, many more, but one that I'm very excited about, something called Care Companion. So, Care Companion is something that a provider can sign a patient up for. The one we've started with first, is for pregnancy. So normal pregnancy. So during a initial visit with a OBGYN provider or family medicine provider, the patient can sign up for Care Companion. And what that'll do is that will give them education and tasks and monitoring throughout their pregnancy, right through MyChart so that when the appropriate time is, you know, it gives information about how big is your baby right now.

And here's some information about breastfeeding. And, then as we get later on in the pregnancy, the information's more about how to swaddle your child and safe sleeping and how to be prepared for postpartum blues and what to do if you have postpartum blues or depression. So, that's one of our care companions.

The next one that we're looking at is about total joint replacement, where again, there's a lot of care that happens outside the hospital with joint replacements. And this gives a patient the ability to kind of take their own time, read the education as they want to read it, engage in the team if they need to, and be able to have an understanding of what's going on in their process through that joint replacement. The other thing is the ability to message healthcare professionals.

So, waiting on the phone to try to talk to somebody to get a refill or to get an appointment scheduled, you don't need to do that, if you have MyChart. You can log on, you can schedule appointments, you can ask for medication refills. You can edit your own information, and most importantly, you can communicate with your care team. So you can send in a message to your doctor, to your provider to ask a question, to answer some questions to, you know, discuss lab work, things like that. So it really is a very modern way to communicate where you don't have to wait on the phone.

Scott Webb: Yeah, modern. I think that that's the appropriate word. Wondering,Elbridge. You know, do patients have to create their own account? Do they automatically get one? Is there a cost involved? Maybe you can handle some of the nuts and bolts here.

Elbridge Locklear, MBA, CHCIO, CDH-E: When a patient is actually seen by a provider, at that particular time, they get a code, they get signed up, they have the ability to use MyChart when they walk out the door. So from that point, they go in fully activate their account. They have the ability to see that current visit and any other visit that they had before if they decided not to previously use MyChart.

There is no cost involved. You would just simply need a mobile device. Or if you don't have a mobile device, you can go to, say a laptop or maybe any computer that you might have.

Justin Catlett, MD: One of the things that I encourage listeners to do is go to summahealth.org/mychart. You know, that's a place where you can sign up, but there's also a ton of information about all of the features that we have in MyChart. So, I, I listed some of those a minute ago, but, uh, it doesn't even scratch the surface of all the things that we have.

But that's the way to get more information at SummaHealth.Org/MyChart and you can sign up there, you can see all the different features that we have, including features about proxy. So for my example, I have three children, 17, 14, and 10.

And, they're not going to deal with their own MyChart. They're, they're too busy on TikTok.

Scott Webb: And snapchat. Yeah.

Justin Catlett, MD: Yeah, Snapchat. And of course we don't want to have to share passwords, so I want them to have, especially my teenage children, they should have their own privacy.

But I can log into my MyChart and because I've been set up as a proxy for my children, I get a set of data that they get to determine, so I can see for my 14 year old son, I get to see his appointments. I can help him schedule appointments, I can communicate with his doctor on his behalf. For my 17 year old son who's a little bit more independent, he's got some of those features that I can't do because he can handle themselves. So we're both protecting privacy, but also allowing family members to help care for their loved ones.

Elbridge Locklear, MBA, CHCIO, CDH-E: One great benefit about MyChart that I'm proud to tell this group, or at least announce here in looking at our measures since we went live; we have some of the best response time on messaging from providers to patients when using MyChart in the nation. It's approximately a half a day, and if you are on MyChart, you leave the doctor, you decide 10 hours later, oh, I had this question about medication. It could be about anything that's important to your provider. And our average turnaround times is about a half a day, and that's some of the best times in the nation.

Justin Catlett, MD: Another unique thing that we have this quickly after GoLive. We're, you know, six months out from our GoLive, and we already have more than 63% of our patient population signed up for MyChart. If you look around the country, that is in the top 10% of other Epic clients, and we're only about 10% away from being the top 1%.

So our community craves this sort of feature in their healthcare systems. And one of the other features is in Ohio and especially northeast Ohio, we have a lot of other organizations that are Epic, they use Epic as their EHR and Epic very easily talks to other Epic, meaning that we're able to, on behalf of the patient, exchange data with other hospital systems. If they happen to get in a, you know, accident or get sick while they're up in Cleveland, they might go to a different organization. Chances are that information's going to be very easily retrievable by their primary care doctor down in Akron.

Scott Webb: Well, no surprise, as I said, early on, you know, I'm never surprised to hear that Summa Health is leading the way in on all fronts at so many different levels. But especially today, learning about how you're using MyChart and how epic, Epic is. All good stuff. Thank you both. You both stay well.

Justin Catlett, MD: Thank you very much.

Elbridge Locklear, MBA, CHCIO, CDH-E: Thank you.

Scott Webb: And to activate your MyChart account, go to summahealth.org/mychart. And if you found this podcast to be helpful and informative, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. Stay well, and we'll talk again next time.