Flash FAX : 2009-08-14 - EPIC GO-LIVE

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Flash FAX

   August, 14, 2009 

EPIC GO-LIVE: We are now at T-11 and counting for the go-live. Over 160
      staff members have registered for or completed their training in EPIC. A
      second mailing was sent to those who have yet to respond. After August 25,
      2009, virtually all inpatient documentation will take place in EPIC. To
      read a chart, to perform a consult, to order a medication or a lab test,
      and to write a progress note will require a password to access the record
      and the training to use the record. All of our assigned residents will
      also complete training before August 25. There have been a number of
      questions that have surfaced and here are some answers (in no specific
        What if my fingerprints won’t register with the reader? We expect there
        will be a finite number of staff whose fingerprints won’t be detectable.
        Those individuals will be required to use the challenge questions as
        their backup system.
        I have identified some changes to order-sets that I would like to see
        implemented. What do I do? We have implemented a build freeze. That
        means that the staff is finishing the build for EPIC. We will start to
        store requests for changes that will not be implemented until after we
        complete the go-live and start the “optimization” phase. This is the
        time, probably starting in October, when we will add “improvements.” In
        the interim, only changes that have direct impact on patient safety will
        be implemented.
        Medication alerts: What are we doing about “alert fatigue?” If you look
        at the New England Journal of Medicine, you are likely aware that
        electronic medical records are linked to an outside vendor that provides
        drug alerts, drug food-interactions, etc. For those of you who have used
        EMRs, you are aware that these alerts are very common and in many cases
        not very useful. This has led to providers often “blowing by” the
        alerts. We have tried to limit the number of alerts by filtering out the
        level III alerts as defined by First Data Bank and placing limits on
        duplicate medication and duplicate therapy alerts. Our plans are
        virtually identical to what at least four other children’s hospitals
        have elected to implement. But, you will still see many alerts. We will
        continue efforts to refine the process.
        How many order-sets do we have available to use and where did they come
        from? There will be 150 specific order-sets that are available at
        go-live. Many of these have been in existence on paper for years (direct
        admit, asthma, fever and neutropenia, appendicitis – perforated). Many
        others have been created by our staff (seizures, lymphadenitis, UTI). No
        new order-sets will be created before August 25. If after we go live,
        you find the need to develop a specific order-set, please give Thomas
        Murphy, MD, a call at 937-641-5871 and we can discuss the process.
        What do I do after go-live if I have a problem? Call 3-CIS, or look
        around you for one of the EPIC staff who are dressed in blue shirts.
        They can help. Ask a resident. They can help. Ask one of the nurses.
        They can help. For the first two weeks after go-live, there will be a
        command center that is staffed 24 hours a day by Dayton Children’s and
        EPIC staff. Don’t hesitate to ask.
        Can I order from home on my inpatients? Not at go-live. You can access
        and read the record.
        I forgot my password. What do I do? Once you change your generic
        password (done the first time you sign on to the system), you will have
        to contact the CIS help desk to get the password reset. None of us have
        access to whatever you chose initially as a password.
        What can I do to help? Be patient with our staff. While this is a great
        step forward, it will not be without hiccups. We’ll do our best to help
        you survive.


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