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Audit reveals more EPIC problems at UIHC

BY ARIANA WITT | APRIL 28, 2011 7:20 AM

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AMES — A state Board of Regents internal audit of the University of Iowa Hospitals and Clinics found further problems involving the hospital's patient records software program, according to a report presented to the board Wednesday.

In the first instance, physicians in the UIHC Pediatrics Department were found to be using an outdated prescription-filling software.

The software was not consistent with the hospital's medical management policy, which requires the use of the EPIC software system and violated Health Insurance Portability and Accountability Act's regulations, said Todd Stewart, the internal auditor for the regents. EPIC has been in use at the UIHC since May 2009.

The audit also found a charge lag time of about 26 days for patient billing in several pediatric divisions.

"This is an issue that we've seen in other departments," Stewart said. "We're working to improve that turnaround. We had an issue of a mischarge that was also noted, and we recommended departments seek further automation of the process to allow EPIC to feed the billing application."

Overall, officials deemed the audit high priority because of the risks the issues could pose for the hospital.

Ken Fisher, the UIHC chief financial officer, said he was pleased with the timeliness of the audit.

"It's one of the earliest audit opinions that has been issued in many years," he said. "We continue to figure out how to shorten the cycle pretty dramatically."

Regent President David Miles said he's been pleased with what he's seen from UIHC audits involving EPIC.

"You never want your internal or external auditors to find anything," he said. "[The] UIHC is a large complex organization so the way I view it is that [the findings] demonstrate the value of having an internal audit function."

UI officials felt the audit was successful, said UI spokesman Tom Moore, and he himself was "very pleased with the outcome."

Miles said he has no concerns with the UIHC's use of EPIC.

"If there was any indication that the administration at UIHC wasn't responding quickly and effectively when problems are found, I might," he said. "But as long as everybody's working together I'm pleased. I don't expect perfection, they should strive for it, but I know sometimes there's going to be some issues."

In April 2010, an internal audit revealed $11 million in missing patient charges in areas of University of Iowa Health Care.

That audit said the issue likely started in November 2009, when bills for services in the UI heart and vascular areas weren't entered into the system.

The UIHC's Ophthalmology Department was also the subject of an audit in February, when officials found inconsistent use of the EPIC software, which may have led to billing errors and affected officials' abilities to maintain locally supported information systems in compliance with the Health Insurance Portability and Accountability Act's security rule.


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