Epic is now part of the daily life of staff in all the delivery networks of Yale New Haven Health System and the practices of NEMG, Yale Medical Group and 120 independent community physicians and their office staffs. Months of intense preparation and training resulted in one of the largest and most successful implementations in the 30-year history of the Epic Corporation.
Implementation, however, is only the beginning of an institution's use of the electronic medical record (EMR) that is at the heart of Epic. Like most industries, change is ongoing in healthcare and Epic has the elasticity that allows its users to keep it viable as patient care, institutional growth, medical advances and regulations evolve.
According to Lisa Stump, vice president, Epic Project and associate chief information officer, "Optimization will go on forever — and that's a good thing because it allows us to use our investment in the EMR to keep ahead of the inevitable changes in health care."
Stump points out that the Epic team learned continuously from each go-live and applied lessons learned to make improvements before the next YNHHS go-live. Even during the first hours of the York Street golive in February, members of the Epic team were improving functionality which made the June 1 go-live on the Saint Raphael Campus even smoother than York Street's.
"Implementations teach us a lot and point us to the areas where we need to work to ensure that users are getting the maximum from their Epic application," explained Stump.
Members of YNHH's Information Technology Services teams work with committees at YNHH, Yale New Haven Health System and Yale Medical Group to develop and implement the Epic features that are valuable to them. For example, the Smilow Optimization Committee looks for tools that standardize care and procedures throughout the hospital, as well as its growing network of care centers.
Other optimization efforts that are under way or being investigated include using photos in the registration process which will contribute to proper patient identification; greater engagement of patients with MyChart, an online medical record portal; and remote monitoring of patients who are in intensive care units on both campuses. From off-site locations, Epic technology allows intensive care physicians to monitor ICU patients 24/7 and interact with staff and families who are in the room with the patient.
"Epic gives us tremendous opportunities to innovate and deliver care that enhances patient safety," said Thomas Balcezak, MD, senior vice president, Safety and Quality. "For example, data shows that remote monitoring of ICU patients leads to better outcomes. We are now monitoring the MICUs on York Street and Saint Raphael Campus and may ultimately monitor ICU patients at Greenwich and Bridgeport hospitals. Epic is a sophisticated tool that allows us to improve the quality of patient care and do it cost-effectively."
"At implementation, users were well trained and ready to use Epic properly — and I compare that to someone who has just gotten his or her drivers' license," says Stump. "Optimization allows us to better understand and effectively use Epic tools and features — and I compare that to having the experience to drive the car around curves at higher speeds."