Jason Anderson and his daughter both have significant medical problems that require them to see specialists often.
When visiting the Mayo Clinic in Minnesota, Anderson, who has Crohn's disease, said he used to have to bring a "huge stack" of medical records to share with doctors there.
"That is a pain in the butt," the Lincoln man said.
But that was before Bryan Health instituted a new electronic health record system last year.
"Now I don't have to worry about any of that," Anderson said.
Instead, his records from his doctor in Lincoln, Anthony Dresbach, are transferred to Mayo electronically, and doctors there have his medical information before he arrives.
Bryan instituted its system, from Epic Systems Corp., in March 2018.
Some employees of the health system spoke with the Journal Star recently about what the first year has been like.
The Affordable Care Act several years ago mandated that all health providers move to an electronic records system.
Bryan had an electronic system that met the requirements of the ACA, but in 2016 decided to look for a new system that would provide more benefits to both patients and providers.
Bryan officials put together a committee consisting of doctors and administrators. That committee devised a road map of what members wanted to accomplish, said Scott Heasty, a hospitalist and director of clinical informatics.
There are dozens of companies that offer electronic health record systems, but there are two major players in the U.S., Epic and Cerner Corp. Bryan officials knew from the start that they were only going to consider the two large companies.
"That's where we started, and that made it easier," said George Carr, vice president and chief information officer at Bryan Health.
Carr said that as the committee went through the process, Epic emerged as the "only reasonable choice."
He said Epic's business model was a better fit for Bryan.
"We wanted this to be able to make a difference for patients and for practitioners as well," Carr said.
To do that, Bryan had to get more than 4,000 employees and more than 800 doctors and other health care providers that are part of its networks trained on how to use the new system.
It did that in six weeks in what Heasty described as a "Herculean effort."
It also involved more than 40 doctors in the decision-making process to address issues and work out bugs during the testing and training phase.
"I think that's why we were so successful here," Heasty said.
Bryan was so successful, in fact, that out of all the organizations using the Epic system, it ranked second-highest in the quality of its implementation, Carr said.
The result is something Bryan says is not only more efficient but also improves communication and interactivity for patients.
Along with the rollout of the electronic records system, Bryan also introduced an interactive patient portal, called MyChart, that allows patients to schedule appointments, see test results, email their care providers, pay bills and do other things.
As an example of how the system benefits patients, Bryan said that 92% of blood test results are entered into the system and available for patients to see within 24 hours.
Providers say the new system saves them time and allows them to provide better patient care.
Heasty, who works in Bryan's emergency department, said that before Bryan installed the Epic system, he had to log into three different computer systems to get the information he needed for one patient.
"Now I just log in once, and I see it all," he said.
Heasty said no longer needing to use paper records has saved him and his partners several hours a week.
"I can now spend more time in front of a patient than I could before," he said.
Bryan officials also said that the new system has reduced traditional dictation by 98% over the past year. Eliminating that step means there's no waiting for reports, and notes are immediately available in charts.
The system also has made sharing records with other hospitals and medical providers easier. Bryan said that as of February, it had shared more than 783,000 patient records electronically through the system with providers and facilities in all 50 states.
Bryan appears to have largely avoided problems with electronic health records systems that have been documented in academic studies and media reports.
Those include physician burnout, record-keeping errors and even patient harm.
A study from the American Journal of Emergency Medicine found that the average emergency room doctor using an electronic records system makes 4,000 computer clicks per shift.
Another study, from the Kaiser Family Foundation, found that 21% of patients had found at least one error in their electronic medical records, including 9% who found an error in their medical history.
Carr, the chief information officer, admitted that Bryan hasn't had "universal success" with its Epic system, but he said he thinks the health system has avoided some of the issues that others have encountered because of the proactive decisions it made at the outset and adjustments along the way.
Those have included reducing the number of clicks providers have to make when using the system, cutting down the number of notifications they get to reduce false alarms and allowing user personalization.
"We put a lot of TLC on the floor for the doctors at the beginning of things," Carr said.
Heasty, the clinical informatics director, said that to some degree, using an electronic system just means "you are trading where you are spending your time" when it comes to recording notes and filing reports.
And he admitted that Bryan's Epic system is complicated — "because this is a complicated business."
But for those providers who are willing to learn and take advantage of the personalization options and ongoing training, it's likely to make their lives easier.
"The more familiar you are with the system, the more efficient you are going to be," he said.