Frequently Asked Questions about the Epic Upgrade ____________________________________________________________________________________
Why are we upgrading Epic? Providence will be upgrading our Epic electronic health record (EHR) in conjunction with optimization efforts focused on improving the usability of Epic for our caregivers. We are currently using the “2010” version of Epic and will move to the “2014” version. The Epic upgrade will allow us to take advantage of new features and functionality which will help ease the way of caregivers who use the system. Epic usability within Providence is a high priority. When will the upgrade take place? In order to ensure that the transition to the 2014 version of Epic goes as smoothly as possible and to improve our ability to adjust to any unexpected issues, the Epic upgrade will take place over two nights, Feb. 7-8, 2015. The sequence and timing are as follows:
Alaska ministries will be upgraded first, early Saturday morning, Feb. 7. The remaining Providence ministries in Washington, Oregon, California and Montana will be upgraded early Sunday morning, Feb. 8.
Key fact to keep in mind about when the upgrade occurs:
The upgrade will start after midnight. There will be approximately three hours of downtime when the upgrade goes live. Specifically, Alaska ministries can expect to experience downtime after midnight on Feb. 7. The remaining Providence ministries can expect to experience downtime after midnight on Sunday Feb. 8.
What are the key benefits of the Epic upgrade? Increasing Epic usability is a key reason for upgrading Epic. While the upgrade will not fix every issue that caregivers are struggling with, it will allow us to address many main concerns and some of the root problems. Other drivers for the upgrade include: Easing the way for caregivers and patients. Staying current with Epic maintenance agreements. Remaining competitive with other customers who use Epic, or similar programs, to increase patient satisfaction. Staying current with regulatory goals. The opportunity to add new products such as Cupid (Cardiology) and Healthy Planet (Population Health Management). Updated October 17, 2014
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How did you decide which new products we will implement as part of the upgrade? More than 200 caregivers across Providence from clinical informaticists, physician champions, nursing leadership, One Revenue cycle, training, healthcare intelligence, quality assurance and Epic analysts came together Oct. 2 and 3 to review the changes that will occur in Epic as a result of the February upgrade. During the work sessions, two overarching themes became clear: these improvements will increase the efficiency and speed with which patients move across the Providence care continuum and they will ease the way of caregivers by making the system simpler to use and more efficient. Existing governance groups determined, via a scoring system, which enhancements best support the Providence strategic goals as well as what can be realistically accomplished within our timeframe. The products and enhancements decided for implementation are available via the Epic intranet site [requires Providence network access]. Who made up the governing groups? Individuals from the following governance groups were engaged to finalize and recommend the list of enhancements to be implemented as a result of the upgrade:
Ambulatory Nursing/acute/professional Pharmacy Radiology Lab ORC/revenue cycle/access ASAP Acute/medicine doctoring MyChart Steering Perioperative
How many changes will be made with the upgrade? More than 300 changes have been approved by governance groups made up of clinical and operational leaders, as well as user groups and Epic analysts. Some of the changes will require training in the form of e-learnings or tips and tricks sheets, but many changes are intuitive or can be addressed after the upgrade goes live.
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What new products and enhancements will be part of the upgrade? In general, there are improvements to the user interface, the amount of information that can be viewed on the screen and the time and number of clicks it takes to complete documentation. A full list of enhancements can be viewed here [requires Providence network access]. Please note this list gives the technical descriptions and that training materials are being developed for each change to be implemented). Below are the top overall changes that will impact the largest number of caregivers: Improved user interface with the Medication Administration Record (MAR) Affected areas: inpatient, medical oncology, ambulatory, surgery, anesthesia, pharmacy, emergency department. Summary of improvements: - Only the most important details appear immediately. - Less scrolling to see all medications. - Navigation and review tools conveniently located in one area and can clearly see which date range is being displayed. - More visible Rx Message responses - Appearance of the MAR is updated to be consistent with other recently redesigned activities Easier chart review search Affected areas: ambulatory (All Chart Review users) Summary of improvements: - A powerful new search engine lets clinicians enter a keyword, such as hypertension, to search the patient chart for problems, progress notes, medications, labs, and other orders from one search bar. - Users can also find and open SmartSets, Synopsis views, and other available Hyperspace activities through this search—without needing to remember the necessary menu paths. Quicker Review of Allergies, Medications, and the Problem List Affected areas: ambulatory (All Chart Review users) Summary of improvements: - Clinicians can review allergies, medications, and the problem list in one place on the new Review Navigator section. - All of the relevant information now appears in a compact view, and clinicians can indicate that they've reviewed everything with a single click. - A Mark as Reviewed button has also been added to the Problem List and Medications navigator sections.
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Improvements to Flowsheet Navigator Affected areas: inpatient, emergency department, surgery, inpatient Summary of improvements: - Clinicians can document quicker and more efficiently. - Easier to review flow sheet information within an ED navigator or ED Narrator. - Reduces the need for scrolling by allowing sections to collapse. - Nurses and clinicians can also click buttons to view all custom lists, category lists, row information, and last filed values. - System will remember preferences made so at next log in the caregivers won’t have to make the same selections. Better blood product administration Affected areas: inpatient, emergency department, surgery, anesthesia, medical oncology, lab, blood bank Summary of improvements: - Matching against multiple pieces of blood product information makes for more comprehensive safety checks. - Intuitive design with a screen layout that resembles standard blood product packaging that helps clinicians identify which barcode to scan or enter. - Inline directions and warnings are contained in one administration window. Improved scheduling with new “Snapboard” view Affected areas: surgery, anesthesia, obstetrics, radiology, patient scheduling Summary of improvements: - Schedulers can make appointments using the Snapboard view or from schedulable orders. - Case schedulers can schedule cases. - Resource coordinators can assign resources to cases and appointments. Updated report for Rx Request Messages Affected areas: ambulatory Summary of improvements: - Shows a patient's requested medications, phone calls, and appointments. - Replaced past and future appointments with only the most relevant information. - Removed outstanding procedure orders because it's not useful in this report.
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How much training will be required? We expect training to begin in January 2015. In most cases, training will average around two hours per person. Of course, the amount of training will vary depending on your role. As with any software upgrade, there will be some changes to the way the Epic looks and operates, but most things will stay the same. Most training will be completed in HealthStream and through webinars or, possibly, video. Providence Health Care (eastern Washington) will host optional Provider Optimization Workshops (POWs), otherwise, we do not expect to have classroom based training. We will also provide tips and tricks sheets and super users will be available for elbow-to-elbow support. We are sensitive to the training that is going on for other Providence initiatives and will try to package trainings together, whenever possible. Specific to Providence Health Care, providers can be trained in these ways: 1. Optional Provider Optimization Workshops (POWs). 2. Online training. 3. Tip sheets with playground practice. 4. Any combination o There will be a Provider Engagement Center (PEC) at Sacred Heart Medical Center and a virtual PEC at the other campuses for ambulatory providers. o We will offer labs post go-live in the PEC or at other venues so providers can set their order set defaults and clean up their preference lists. Where can I find more information about the Epic upgrade? We will communicate regularly with clinical and adminstrative leaders to keep them updated on the preparations we are making for the upgrade. Once key decisions are made they will be published on the Epic upgrade page [requires Providence network access], located on the Epic intranet site. On that page you will also find links to important information and documents as well as access to an Epic mailbox where you can submit questions about the upgrade.
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