Thursday, December 5, 2013
PORTLAND – Maine Medical Center's new $150 million electronic health records system failed to properly charge for some services, prompting the state's largest hospital to go back to insurance companies and government programs such as MaineCare to recover its fees.
Maine Medical Center in Portland on Tuesday May 7, 2013.
John Patriquin / Staff Photographer
The hospital launched the computer system in December, centralizing in one place all the information about Maine Med patients' doctor visits, hospital stays, prescriptions, lab work, X-rays, outpatient therapies, billing and scheduling.
Hospital officials noticed the problems with the system when patient charges failed to properly appear, said Mark Harris, vice president of planning and marketing at Maine Med and at the hospital's parent company, MaineHealth.
Harris said there is no indication that patients' medical records were affected, or that any medical procedures were not noted in patients' records. He would not say how many patients were incorrectly billed.
The issue was mentioned in a letter that Maine Med's president and chief executive, Richard Petersen, sent to employees. In the letter, Petersen wrote, "The launch of the Shared Electronic Health Record (SeHR) has had some unintended financial consequences. In some cases, we've been unable to accurately charge for the services we provide. This lack of charge capture is hurting our financial picture."
Petersen disclosed the problem with SeHR as part of an array of other issues that led to a $13.4 million operating loss through the first six months of the hospital's fiscal year. The other issues included declining patient volume, an increase in free care for poor patients and bad debts from patients who can't pay their bills.
Together, the financial issues prompted the hospital to implement a hiring freeze and other budget cuts. The 637-bed hospital aims to save about $15 million in order to break even by the end of the year.
Harris declined to comment on how much of the budget shortfall was attributable to the SeHR system problems, or how many charges the hospital failed to capture. He said the SeHR problem was "not the bulk of the operating loss."
The problems, however, have forced MaineHealth to hold off on rolling out the system to other hospitals in its network.
In the MaineHealth network, Miles Memorial Hospital in Damariscotta, Pen Bay Medical Center in Rockland, St. Andrews Hospital in Boothbay Harbor and Waldo County General Hospital in Belfast were scheduled to adopt the system in July. Southern Maine Medical Center in Biddeford, Stephens Memorial Hospital in Norway and Goodall Hospital in Sanford were expected to follow by December.
Maine Med is working to collect the missed charges, Harris said. Each insurer has different contract terms on the length of time that charges can be disputed, he said. Maine Med is currently talking with commercial insurers, which tend to have a shorter window to address billing issues than government payers such as MaineCare and Medicare.
Anthem, Aetna and Harvard Pilgrim Health Care, the largest health insurers in Maine, did not immediately return calls seeking comment.
The launch of the SeHR system in December was lauded at the time by Dr. Barry Blumenfeld, senior vice president and chief information officer for MaineHealth, as "a big leap forward for us."
"It's one of the best things we can do to improve the quality and saftey of the care we provide," he told the Portland Press Herald then.
Blumenfeld no longer works for MaineHealth. When contacted at home, Blumenfeld said he left the organization three months ago.
"Most of my reasons for leaving were personal," said Blumenfeld, who declined further comment.
The federal government has been promoting electronic health records as a way to reduce paperwork, medical errors and costs, and improve care. MaineHealth was scheduled to receive a $50 million federal subsidy to adopt the new system.
Maine Med bought the system from Epic System Corp. of Wisconsin, which was described as the leading up-and-comer in the electronic medical records industry in a June 2011 report by KLAS Enterprises LLC, a health-care technology market research firm.
"Epic offers integrated clinical, patient financial, and ambulatory solutions with above-average usability and an unmatched track record of successful implementations in hospitals with more than 200 beds," the report said. "Even though they lag behind in technology and are not the cheapest solution available, their ability to integrate systems and show strengths that cater perfectly to the current market trends helped them lure many clients away from competitors last year."
Maine Med has been working with Epic to resolve the problem with SeHR, Harris said. Epic officials declined to comment.
The hospital said the problems occurred during the "build out" phase of the software, which was specialized to suit Maine Med's and MaineHealth's needs. Harris said the problems did not involve training employees on the system.
"Many of the 'charge capture' challenges have been identified and there are teams of individuals from Epic, our own IS (information system) professionals, clinical and financial support personnel that are ... finding solutions to these problems," Petersen said in the letter to employees.
MaineHealth plans to proceed with the rollout once the problems are solved, Harris said.
Staff Writer J. Craig Anderson contributed to this report.
Jessica Hall can be contacted at 791-6316 or at: