County pledges $500K to Lincoln software switch

May. 05, 2014 @ 07:13 PM

County Commissioners voted Monday to spend $500,000 to help the Lincoln Community Health Center buy and install a new patient-records database that matches the Duke University Health System’s.

The county contribution is about half as large as Lincoln officials had requested, the commissioners urging them to press Duke to pick up a bigger share of the tab.

The Epic Systems database is supposed to cost about $2 million. Lincoln officials last month said Duke would pay about $1 million; they sought a matching amount from the commissioners.

But commissioners noted the impetus for the switch follows from Duke’s actions, as the health system began a high-profile switch to the Epic software in 2012.

“In the big scheme of what’s been invested [in the software] at Duke, between $500 million and $700 million, this additional half a million, I would hope they would be able to absorb that and do what needs to be done,” Commissioner Wendy Jacobs said.

Commissioner Ellen Reckhow added that Duke Regional Hospital – county owned, but leased to Duke – should also consider kicking in because of its “extremely tight” relationship with the Fayetteville Street clinic.

Lincoln officials, however, said the more likely result is that they’ll be able to afford only part of the Epic Systems database.

Given only a $500,000 contribution from the county, “we have to sit down with Duke and look at the project and see if it can be scaled down, see if it’s possible to still have the core pieces of the software implemented at Lincoln,” said Philip Harewood, the clinic’s chief executive officer.

But even at that, the switch to Epic is still a net plus given the ability to more quickly share patient records with Duke, he said.

“This puts Durham County at considerable advantage to other communities” that lack a standardized patient-records system, Harewood said.

The decision to provide only half of Lincoln’s request came at the urging of County Manager Wendell Davis and Deputy County Manager Marqueta Welton.

Commissioners and administrators signaled last month they felt the request had been sprung on them, with Lincoln giving them little time to evaluate it or negotiate a different deal.

Lincoln officials said then they were pushing so they could meet deadlines associated with a mid-August switchover to the new database.

But Welton said the project’s original timeline had assumed a January switchover. The deadlines moved up because installation work in Duke’s own hospitals and clinics “is moving forward much quicker than originally anticipated,” Welton said.

She added that Duke had asked Epic Systems for permission to install the software at Lincoln “at no additional charge.” But the Wisconsin-based company refused, saying the concession “would be unfair to other community health” clinics that have paid or might.

The Lincoln clinic serves a predominately low-income clientele. Harewood said last month that 95 percent of its patients have incomes at or below the federal poverty level.

County officials will most likely draw the $500,000 out of their community-health trust fund, county Finance Director George Quick said.

The fund is a reserve fueled by the lease payments Duke makes to the county for the use of Duke Regional Hospital.