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Tompkins County health staff seek board support for $800K–$1M Epic EHR investment to replace failing records system
Summary
County public-health staff told the board the department's current EHR is antiquated and unreliable and requested a board letter supporting a legislative over-target funding request for Epic; staff estimated first-year implementation costs of about $800,000–$1,000,000 and ongoing costs near $800,000.
Tompkins County public-health leaders on Thursday urged the Board of Health to support a major investment to replace the department's aging electronic health record (EHR) with Epic, saying the current system increases staff workload, creates billing and quality gaps, and impairs patient access and continuity of care.
Jenny, who led the presentation, said the proposed switch would affect nine programs across five divisions and roughly 95 licensed users. She described five major challenges with the current EHR: clinical continuity, quality/compliance and billing limits, lack of a patient portal and client dignity issues, poor staff morale tied to duplicate manual work, and recurring financial waste from failed implementations and workarounds.
Explaining the request, Jenny said the county is exploring a "community connect" relationship that would attach the county to a larger Epic instance (implemented by an external host), which would allow interoperability with regional health systems and reduce long-term maintenance risks. She said preliminary implementation estimates ranged "between $800,000 and $1,000,000 for the first year" and ongoing costs near $800,000, and asked the board to consider drafting a single letter of support to accompany a legislative over-target funding request.
Board members pressed on cost-effectiveness, implementation risk and training. One member noted that Epic implementations are disruptive and urged a clear change-management plan. A representative of a regional Epic host described interoperability benefits and said Epic instances can share records through standard 'Care Everywhere' connections once patient permission is granted.
Jenny offered to draft a short template letter for board review and signature; board members agreed to consider signing after reviewing a draft. Staff indicated additional materials — screenshots of the current system and a prototype patient portal view, hard numbers on revenue-cycle lift, and a staffing/transition plan — will be prepared for future board review and for legislative briefings.
The board did not take a formal funding vote at the meeting; members asked staff to refine the cost and implementation plan and to circulate a draft letter for consideration.
