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Dome - An Epic Effort

Dome January 2013

An Epic Effort

Date: January 4, 2013

This month, the first groups of clinicians and staff at Johns Hopkins Medicine start learning how to use Epic, our new electronic medical record system. Online instruction, followed by classroom training, will prepare them for a carefully planned series of launches that begin in April and stretch into 2016.

It is truly an exciting time. The Epic software system will eventually integrate medical records across our health system into one central database, help to deliver the best possible care to our patients and improve communication and teamwork among our providers. It marks an important stage in our mission to provide the best patient and family-centered care.

Ensuring success, however, requires adequate preparation. From personal experience, I can say that carving out time to learn how to use this new system is crucial. The University of Iowa’s Carver School of Medicine, where I served as dean before coming to Hopkins, was an early implementer of Epic. Over the course of several years  I was able to observe the hospital community take on the challenge of transforming health care delivery for thousands of patients. And I picked up valuable lessons along the way.

One thing we learned is how important it is for clinicians and staff to become familiar and engaged with Epic so that it can best serve their needs. At Iowa, getting involved included suggesting how specialties could best customize the documentation systems, taking training sessions seriously and practicing in Epic’s simulated workplace.

For those departments that prepared diligently, the transition to Epic went very smoothly. Not surprisingly, departments that had the most difficulty were those that didn’t put in enough time on the front end.

When you are a health care provider with a perpetually demanding schedule, the call to engage with Epic can be easy to ignore. However, it’s better to commit the time now, rather than later. After the system goes live, you will still have the same heavy workload. And we learned that trying to master or improve the system retrospectively is far more time-consuming.

Perhaps the best thing about Epic is that patients love it. For one thing, all Hopkins providers can work together from the same set of records, ensuring continuity of care for patients. And MyChart, Epic’s patient portal, gives patients access into part of their medical records and also provides a secure way to communicate with their care teams.

Although some physicians worry that MyChart will bring a heavy bombardment of email, we found that this was not the case. In fact, the system actually allowed physicians and patients to communicate more effectively.

It did require one change in the provider-patient relationship, though. Sometimes the software allows patients to see the results of certain lab tests before physicians have the chance to explain them. This means that physicians must talk to their patients, ahead of time, about what certain findings might indicate. Now that patients can read their own charts, providers must also be careful about how they write their notes, paying close attention to their words and descriptions.

Patient safety will also improve with this system. For example, Epic prompts physicians to avoid potential drug interactions and improper medication dosages. And soon, tracking patients as they are treated at our different hospitals will be easier than ever.

Epic is a wonderful tool. It’s going to help us take better care of our patients, offer them more safeguards and, down the road, enhance clinical research. But moving ahead with Epic requires everyone to become engaged. In planning ahead for the new year, it’s important to schedule time to prepare for it properly.

Paul B. Rothman

Dean of the Medical Faculty

CEO, Johns Hopkins Medicine