Mary Prybylo is the president of St. Joseph Healthcare and a member of the Community Health Leadership Board, a collective of area health and social services leaders. Credit: Gabor Degre

When the parent organization of St. Joseph Hospital in Bangor rolled out a new electronic medical record program two years ago, it said the change would help patients better understand their medical bills and make it easier for health care providers to access their records.

Yet in the first two years of the new program, patients encountered a variety of challenges that included erroneous bills, trouble verifying whether they’d paid their medical expenses and confusion over the need to send payments to St. Mary’s Regional Medical Center in Lewiston — which is also part of the Covenant Health network — according to St. Joseph Healthcare President and CEO Mary Prybylo.

At the same time, hospital workers had a hard time adjusting to the new program. As they got up to speed, the hospital spent considerably on training and extra staffing, heavily contributing to its $13 million operating loss in 2018, Prybylo said. The only Maine hospital with a greater total operating loss that year — $23 million — was St. Mary’s in Lewiston, according to the Maine Health Data Organization.

Besides working to investigate and address every complaint that St. Joseph Healthcare has received, Prybylo said that the hospital has been making a series of changes that have helped patients better understand their bills and helped staff use the new software, which is called Epic. In time, Prybylo said, the program is meant to make records more seamlessly available to both patients and their providers.

“Is it perfect?” Prybylo said. “No. Billing is a very personal thing for a lot of people, so we will stay very attuned and try to be very responsive if anyone is having a problem with their bill.”

“We’re in a much better place now than we were when we went live,” she added.

Data provided by the hospital showed that its office of patient relations received a surge of inquiries about billing and other issues in the first year of the new system. The total number of inquiries jumped from 29 in the last quarter of 2017 to 76 and 104 over the first two quarters of 2018, but then dropped and hovered around 40 over the last three quarters of 2019.

It’s not clear how much of the jump in early 2018 was a result of billing problems, because the hospital apparently only began distinguishing between billing and other inquiries in 2018, according to hospital spokeswoman Kelly David. After it started distinguishing them, the total number of billing-related inquiries dropped somewhat between 2018 and 2019, from 62 to 54.

While those were not large volumes compared to the total number of patients St. Joe’s treats in a year, Prybylo said, “We always say, ‘One is too many,’ in terms of who has been impacted.”

To help prevent future complaints, the hospital has tried to communicate better with patients about why, for example, they must send their payments to St. Mary’s in Lewiston. It has also tried to equip staff who take billing questions from patients with more information to answer those questions. And while the Bangor hospital previously had a service for patients who wanted to pay their bills in person, it has relocated that service to the hospital lobby.

To help with the rollout of the electronic medical record program, Covenant Health also announced last summer that it was outsourcing at least 230 billing and coding jobs from its three hospitals — the third is St. Joseph Hospital in Nashua, New Hampshire — to an outside company that has expertise in Epic programs.

At the time, Covenant said that 12 employees of St. Joseph Healthcare were not guaranteed jobs under the new company, Ensemble Health Partners. Last week, Prybylo said that around two employees ended up voluntarily leaving the Bangor hospital as a result of the switch.

Besides causing headaches for workers and patients, the switch also interfered with the hospital’s ability to bring in revenue, according to Prybylo. For example, insurance providers denied some claims after staff made mistakes while entering information. Now, Prybylo said, the switch to Ensemble has helped the hospital avoid those mistakes and more quickly use the software.

“I think staff were just thrilled to get people who understood it and knew how to make it hum,” Prybylo said.