David Monroe, M.D. - Emergency physician
at Howard County General Hospital
Emergency Medicine in High Gear with Epic ASAP Project
These days, you’ll find dozens of Department of Emergency Medicine and the Pediatric Emergency Department staff in high gear designing and building their departments’ customized versions of the new Epic electronic health record system — with an eye on going live with it August 1, 2014.
While that nine-month window may seem a long way off, it actually represents a tight timetable for all the complicated work and key decisions that must occur well before the launch date, notes Tammi Miller, Emergency Medicine’s “Business Owner” for the Epic project.
Miller notes that the Emergency Medicine team working on the project is currently faced with a host of complex decisions to ensure the system works well when it is launched. But, she notes, the team is highly capable and committed to a smooth rollout of the Epic system for the Johns Hopkins Hospital Emergency Department and The Johns Hopkins Children’s Center Pediatric Emergency Department.
They will have the distinction of being the first non-ambulatory clinical departments at The Johns Hopkins Hospital (JHH) and The Johns Hopkins Children’s Center (JHCC) to go live with an Epic portal for clinicians.
They’ll also be the first non-ambulatory clinical departments at JHH and JHCC to launch Epic’s companion online portal for patients, known as MyChart, so they can access personal medical records.
Two other Johns Hopkins hospitals - Howard County General Hospital and Sibley Memorial Hospital – have Epic systems up and running. Those institutions went live with Epic June 1. Meanwhile, Suburban Hospital, including their Adult and Pediatric Emergency Departments, plans to go live with Epic July 1, 2014. Johns Hopkins Bayview Medical Center’s Emergency Department “live” date has not been determined yet.
The decisions Miller and the rest of the Emergency Medicine Epic team - known as the Emergency Medicine Council - make in designing and building the Epic product will be vital for the adult and pediatric Emergency Departments, of course. But those decisions will also affect most, if not all, other inpatient clinical departments at The Johns Hopkins Hospital.
The reason: Emergency Medicine has multiple daily interactions with other clinical units at the hospital, from requesting specialty consults to admitting patients to other units for treatment and care.
As a result, all such interactions need to be reflected in the software code for the department’s Epic system, dubbed Epic ASAP. This calls for a high level of integration and planning with nearly every other electronic system and department in the hospital.
This “harmonization,” as it’s called, will not only help the JHH Emergency Department’s Epic system operate smoothly when it is launched, but will help other clinical departments effectively design and build their own Epic modules, notes Miller.
Peter Hill, M.D., M.Sc., is Vice Chair of Clinical Affairs for the Emergency Department and an Epic project leader along with Miller. He says one of the key goals — and benefits — of the Epic project will be a high level of integration with Epic systems at other Johns Hopkins hospitals, primary care physician offices, and out-patient clinics.
“I have no doubt when we have Epic finally launched, we’ll look back and say it was a great story of success and teamwork for Emergency Medicine across the health system,” said Dr. Hill.
Dr. Hill, Miller and the rest of the EM Council have been drawing on lessons and tips gathered from emergency department colleagues at Howard County General Hospital and Sibley Memorial Hospital. Both have already launched their own Epic systems, and have been assisting with the Johns Hopkins Hospital Epic project, as part of the Epic Emergency Medicine Council.
For example, recently doctors, nurses, and other clinicians and staff from the Johns Hopkins Hospital adult and pediatric Emergency Medicine departments, along with staff from Suburban Hospital Emergency Department, traveled to Sibley Memorial and Howard County General to watch providers at those hospitals use the Epic system and see how it integrated with workflow procedures.
Ultimately, said Dr. Hill, all the hard work and effort will have long-term upsides for patients.
For example, if a patient who is being seen and cared for by a cardiologist at Howard County General Hospital is rushed to the Johns Hopkins Hospital’s Emergency Department while on a visit to Baltimore, doctors tending to the patient will be able to quickly access the patient’s medical records for invaluable information that could help the emergency doctors with their care decisions.
In turn, when the patient returns to see their cardiologist at Howard County General, the doctor will be able to easily access the records of the patient’s emergency visit in Baltimore -- information that could help with that doctor’s treatment and care decisions. And, as long as the patient signs up for MyChart, they’ll be able to access the records of their emergency and cardiology visits so they can share accurate information with loved ones -and make smart lifestyle and health decisions in the future.
“There are so many upsides to Epic that will have big payoffs for providers and patients once it is live that it makes all the hard work on it today really worthwhile,” notes Miller.
-- Mark Guidera