ENTERPRISE EPIC SPECIALTY IMPLEMENTATION (EESI)
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EESI To
Overview
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Enterprise EpicCare Specialty Implementation (EESI)
•
Shared EHR across all ambulatory clinics
•
HMC, NWH, UWMC
WHY:
BY THE NUMBERS
85+
CLINICS
30+
SPECIALTIES
1000
PROVIDERS
2000
STAFF
• Opportunity to standardize & improve individual patient care & population health
• Ability to collect & report on discrete data for quality management & research
• Ability to achieve regulatory compliance (MU, ICD-10, PQRS, etc)
WHEN:
•EESI Go Live is May 20, 2014 (167 days and counting…)
UW Medicine
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BENEFITS
• Facilitates meeting organizational Meaningful Use and other regulatory
requirements.
• Enables cross site communication
– Within UW Medicine Ambulatory Clinics
– With external users of EpicCare (eg. Swedish, Valley, Group Health)
• No more paper fee sheets. Billing will be electronic!
• No more paper requisitions.
• Prescriptions are electronically sent to the patient’s pharmacy of choice.
• Facilitates patient’s access to their medical information via eCare (patient
portal).
• Improves communication within the clinic care team and with referring
practitioners.
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ENTERPRISE EPIC SPECIALTY IMPLEMENTATION (EESI)
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EESI To
Program
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Timeline
Title Style
WE ARE HERE
DISCOVERY
MAY-JUNE
2013
ALIGNMENT
JULY-AUG
2013
BUILD
SEPT-JAN
2013-2014
TESTING & TRAINING
FEB - MAY
2014
GO-LIVE
MAY 20
2014
SPECIALTY BUILD CONTINUES
Cycle Two completed, testing in progress
FINALIZED SPECIALTY BUILD DESIGN
Completed collaborative meetings, sign off
FUTURE STATE APPLICATION DESIGN
Reviewed with clinic managers
COMPLETED DISCOVERY & ENGAGEMENT
Collected data required for implementation
UW Medicine
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ENTERPRISE EPIC SPECIALTY IMPLEMENTATION (EESI)
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Specialty
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Master Title Style
•
Collaborative specialty groups with representation from HMC, NWH, UWMC
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Specialty Navigator Build
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Common Chief Complaints
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Medical History
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Surgical History
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Family History
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Patient at a Glance (Epic Term: SnapShot)
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Data Collection Over Time (Epic Term: Documentation Flowsheets)
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Long Term Disease Management (Epic Term: Synopsis)
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Preference lists
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Note templates (Epic Term: Smart Texts)
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Order sets (Epic Term: Smart Sets)
UW Medicine
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EESI Project Update
WhatTo
You
Need
to Know
Now
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Title Style
Training:
• Provider
registration
and
scheduling
now open
• Remaining
user
registration/
scheduling
starts midNov
UW Medicine
Ops
Planning:
Device
Placement:
Transcription
& Dictation:
• Schedule
reductions
(5/20 – 6/6)
• Vacations by
exception
(5/14 – 6/6)
• Walkthroughs
complete by
11/1
• Device plan
sign-off by
12/6
• Two parallel
projects
• Dragon
approval for
site licenses
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EESI Project Update
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Planning
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Go-live Title
Schedule
Style Changes
•
•
Managers & Medical Directors ensure appropriate schedule
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Discourage time away from clinic during 3 weeks post go-Live
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Strongly consider holding slots for urgent/semi-urgent patients
Sensitivity to learning needs:
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Return to full productivity according to practitioner’s ability
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Quick learners can add additional visits as requested; No increases in first
week
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Current EpicCare users (those who cross clinics) may not need schedule
reductions; Consider impact on staff
•
Encourage providers to schedule more clinics with fewer patients during go-live
weeks if possible to increase access and increase provider learning when
support available
UW Medicine
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EESI Project Update
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Schedule
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Reduction
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Guidelines
Style
Block schedules now for go-live!
Week 1
50% reduction in volume (no more than 4
patients per charting provider each half-day
session)
Week 2
40% reduction in volume (no more than 6
patients per each half-day session)
Week 3
30% reduction in volume (no more than 7
patients in each half day session)
Week 4
20% reduction in volume
Week 5
10% reduction in volume
Week 6
0% reduction in volume
UW Medicine
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ENTERPRISE EPIC SPECIALTY IMPLEMENTATION (EESI)
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WhatTo
can
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youMaster
do to make
Title Style
this EESIer ?
•
Preparation
•
Clean up your problem lists (ICD-9 or SNOMED code based) and medication lists in Orca
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If you are computer-challenged (typing or navigation skills), problem solve with your clinic
manager or clinic chief ahead of time
•
•
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Work with your clinic leadership to adopt compliant clinic workflows ahead of implementation
Training
•
Sign up for training
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Complete the e-learnings before you go to class
Implementation
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Down-schedule your clinics during go-live
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Schedule as many extra clinic sessions as you can while there is at-the-elbow support
available
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Acknowledge that this will be hard work and the first few months will be stressful
UW Medicine
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ENTERPRISE EPIC SPECIALTY IMPLEMENTATION
DraftToCompliance
Discussion:
Orders
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Style
Position
MA,
Eye
Technician
RX
•
•
•
RN
•
•
ORDERS
Can pend medication orders
-existing medication refill
-active but expired refill
CANNOT
-sign medication refills
- set up to pend discontinued meds
- set up to pend new RX requests
• Can pend labs, imaging, referrals
• Can order, sign and perform POCT
tests if there is a written protocol
(requires cosign)
• CANNOT sign any other orders
• ?? Eye tech can administer
diagnostic eye drops with protocol
Can pend medication orders
-existing medication refill
-active but expired refill
Can order and sign RX (not controlled
substances) with verbal orders under
urgent conditions – needs cosign (within 48
hours)
CANNOT
-sign routine medication refills
- set up to pend discontinued meds
- set up to pend new RX requests
• Can pend labs, imaging, referrals
• Can order, sign and perform POCT
tests if there is a written protocol
(requires cosign)
• Can order and sign for labs,
Imaging, EKG with verbal orders
under urgent conditions – needs
cosign (within 48 hours?)
• Can administer flu/pneumo vaccine
without individual physician order
*POCT – chemstick, UA dip, urine pregnancy, EKG (probably not POCT?), rapid strep, urine drug screen, others?????
(policy on other protocol orders is pending)
UW Medicine
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ENTERPRISE EPIC SPECIALTY IMPLEMENTATION (EESI)
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UW Medicine
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