Acumen 2.0

It has been almost a year since the Acumen Physician Solutions division announced a partnership with Epic to create Acumen 2.0 powered by Epic. This week I sat down with Dr. Ahmad Sharif, Chief Medical Information Officer for FMCNA, to talk about why this happened and what it means. As I’m typing this I recognize the irony of creating content for a technology blog about a cool advancement in the Acumen nEHR and not conducting a virtual meeting with a video conference over Skype for Business. Nope, we literally sat down at a table and had a conversation, but the information is cutting edge!

Why is Acumen partnering with Epic?

Dr. Sharif notes that in the year prior to March 2017 the leadership team did a lot of thinking about investing in modernization of the Acumen 1.0 software platform. The team recognized that in the changing nephrology practice environment, EHRs needed more tools for care coordination and population management than Acumen was able to offer. They were also aware that it was time for EHR Meaningful Use recertification, which takes time and resources away from new feature development efforts.

After due diligence, the decision was made to pursue 2015 recertification internally, but to partner with Epic as a broad-presence vendor who could help provide a more robust software platform. Epic has rich functionality and features supporting care coordination and population health. Through its significant hospital and physician practice deployment, Epic captures data on almost one-half of the U.S. patient population, making the Epic Care Everywhere feature a powerful interoperability and continuity-of-care tool. “Plain vanilla” Epic, however, has no features specifically designed for nephrology, which is Acumen’s bread and butter. Epic and Acumen agreed to partner to utilize each other’s strengths for a powerful nephrology office EHR.

Why partner with Epic now?

Value-based models of care, population health management, and meeting MACRA requirements are integral to nephrology practice today and must be supported by the practice EHR. Even with 2015 recertification, Acumen 1.0 would have to be significantly upgraded to meet the breadth of solutions nephrology practices need in today’s healthcare landscape. Instead of building these features internally and creating robust interoperability solutions, Acumen Physician Solutions chose to hook into a bigger, broader existing system. Given a decision to either spend a lot of time building system functionality or to devote time and resources to building a better user interface and experience, Acumen chose the latter.

Why Epic?

Dr. Sharif’s notes that Acumen examined all industry leaders in EHR systems before establishing the Epic partnership. Epic offered many advantages. The Epic footprint mirrors the current Acumen 1.0 customer footprint. Physicians who use Epic in the hospital setting will have a smaller learning curve to transition to new features in Acumen 2.0. Epic has good feature sets to support care coordination activities and longitudinal patient records. In this rapidly evolving health IT environment, Epic is a viable, strong company with a stable outlook.

An Epic strength is the patient engagement platform: The MyChart patient portal. This is an industry-leading EHR feature with robust functionality. The portal features 2-way communication for patients and providers to exchange messages. It provides appointment scheduling, online bill pay, and the opportunity to complete pre-appointment paperwork among other useful features.

The Epic partnership allows Acumen 2.0 to provide robust nephrology-focused user interfaces and features on a powerful platform. In the past year, working with Epic, Acumen has done a lot of trimming and refining of the EHR user interface to optimize features to meet nephrology-specific clinical and practice management needs. Acumen has years of development and user experience in refining the EHR for the nephrology practice workflow. The Acumen Medical Advisory Board and Acumen physician practices have always influenced Acumen functionality and will continue to do so.

An interesting aside is that Epic was equally excited about the partnership with Acumen and FMCNA. Epic has a leading position in multi-specialty hospital deployments in narrow geographic areas, and they viewed the partnership with Acumen as an opportunity to support the nephrology specialty on a national scale. Through this partnership, both teams have committed key expert resources and leadership to making Acumen 2.0 a strong success.

Where are we now?

Since March 2017 Acumen, Epic, and FMCNA teams have methodically built an Acumen 2.0 clinical workflow experience on the Epic platform. In November 2017 RenalCare Associates in Peoria, IL, became an alpha-testing site for Acumen 2.0. The alpha-site is an active product development partner. The practice deployed a minimum viable product version of Acumen 2.0 that is advanced enough to provide safe patient care, but is still in the development phase. Alpha-testing is a special environment with extensive resources devoted to daily support of nephrology-practice EHR use and rapid turnaround for system tweaks and optimization. After 2 months of alpha-testing, the system is much better in supporting daily nephrology practice workflow.

The next step is beta-testing in a second large nephrology practice, which is slated to start in the summer of 2018. The beta-product is very close to the final product, with minimal additional tweaking needed. With the addition of a second nephrology practice to the ongoing Peoria deployment, the product will have several months of “maturity” testing in different geographic and practice settings. Acumen 2.0 should be ready for general release in late 2018.

Q&A with Dr. Sharif

1. What happens now if I’m an Acumen 1.0 customer?

If you are an existing customer, we thank you for your loyalty and continued support! Acumen 1.0 has completed 2015 certification and is the first—and as of this writing, the only—nephrology specific EHR to achieve 2015 certification. Our priority is to ensure seamless support and transition through the upgrade to Acumen 2.0.

The Acumen team will work with you to upgrade to Acumen 2.0 when the testing phase is complete. You should have an Acumen implementation plan in the works by the end of this year.

2. What if I do not use Acumen 1.0, but I’m interested in Acumen 2.0?

In parallel with upgrading existing Acumen users to 2.0, there is a separate path for transitioning new customers to Acumen. If you are new to Acumen, feel free to contact Jason Holcomb or reach out through the Acumen Physician Solutions website. This transition for physicians seems to be easier if you use Epic in your hospital work today.

3. My hospital uses Epic and they offered to integrate our nephrology practice as a node from their Epic instance. Is there an advantage to Acumen 2.0 versus coordinating with my hospital?

The hospital Epic experience is not optimized for outpatient nephrology care. The Acumen team, the Epic team, and our alpha-test site partners have worked to “nephrologize” Epic, including optimizing workflows that are nephrology-specific. This has involved a lot of trimming away general Epic features that are never used in nephrology and adding in workflow tools that are nephrology-specific.

In addition, Acumen 2.0 is supported by the excellent Acumen customer support that has been the hallmark of the Acumen organization. The Acumen team will oversee Acumen 2.0 implementation in your organization and will continue to provide the trademark customer support when you are up and running. In addition, the Acumen team will continue to refine and evolve the Acumen 2.0 product over time to meet the clinical and business needs of your nephrology practice.

4. How much of Acumen 2.0 is Epic and how much is Acumen?

This is how I like to describe it: Acumen needed a stronger, faster engine, so we bought the chassis of a fine car from Epic. Epic will continue to maintain and upgrade the engine and transmission. We have covered the chassis with an Acumen skin and all of the bells and whistles that make a car a pleasure to drive. Acumen is the user interface for the electronics, the beautiful trim, and the entire look and feel of inside of the car.

The evolution of Acumen 2.0 will be influenced by the daily users, including the Acumen Medical Advisory Board, the Provider Advisory Council on technology, and the structured feedback we get from customers every day.

If you have more questions about Acumen 2.0, please add a comment here or send them in!

Dugan Maddux, MD, FACP, is the Vice President for CKD Initiatives for FMC-NA. Before her foray into the business side of medicine, Dr. Maddux spent 18 years practicing nephrology in Danville, Virginia. During this time, she and her husband, Dr. Frank Maddux, developed a nephrology-focused Electronic Health Record. She and Frank also developed Voice Expeditions, which features the Nephrology Oral History project, a collection of interviews of the early dialysis pioneers.

Ahmad Sharif, MD, MPH, is Senior Vice President and Chief Medical Information Officer at Fresenius Medical Care North America. Dr. Sharif has extensive experience in health information technology, consulting with over 25 health systems across the country and abroad, implementing and optimizing electronic health records, clinical practice management and technology solutions for multi-facility large academic institutions and smaller community and critical access hospitals.