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
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
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