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Dome - Leading the Way: An Epic Goal

Dome November 2012

Leading the Way: An Epic Goal

Date: November 16, 2012

Leading the Way
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Soon, thousands of Johns Hopkins Medicine employees will begin a challenging journey from familiar to unknown territory. Across the enterprise, clinicians and support staff accustomed to documenting patient care on paper or in a hodgepodge of databases will learn how to use Epic, the software system that will integrate medical records throughout Hopkins into a central digital warehouse.

The first wave of Epic training begins in December with online introductory lessons and will be followed by classroom instruction that will vary in length according to employees’ roles. Although the transition promises a safer, more cohesive health care delivery model for all Hopkins Medicine patients, time-strapped physicians, nurses, medical assistants and others may question the point of spending long hours in a classroom.

“We’re acutely aware of how valuable time is for physicians and nurses and everybody else. The last thing we want them to do is to sit in on training that’s not productive,” says Tom Piccin, a member of the Epic instructional design team.

Piccin and co-workers have spent nearly a year creating a training program that takes into consideration the expertise, time constraints and problem-solving skills of their student body. “We don’t want to be standing up there lecturing,” he says. “We want to involve learners in hands-on ways and use patient scenarios that are relevant to their work.”

In an Epic class for nurses, for example, the trainer, using a large projection screen, will demonstrate how to document a patient’s vital statistics and then have class members repeat the process independently or with a partner. “It’s about communicating the core meaning of a lesson and then allowing participants the opportunity to apply that in a realistic setting,” Piccin says. 

Get Your Feet Wet

Introductory e-Learning courses, mandatory for attending classroom training, begin in December for the first group of Epic users—ambulatory medicine at Johns Hopkins Community Physicians (JHCP) sites along with affiliated faculty practices, Johns Hopkins at Odenton, Wilmer at Frederick, and all scheduling and registration staff. Registration for these groups begins within the next several weeks, while e-Learning for ambulatory services elsewhere will be scheduled at a later date.

The e-Learning modules are based on Epic’s standard content, says senior training manager Jeff Ostrow. Users will receive more Hopkins-specific training and information in the classroom. “The intent,” Ostrow says, “is for users to gain a general understanding of how Epic works and familiarize themselves with the screen layout and navigation prior to attending classroom training where they will learn how to use Epic with Johns Hopkins workflows.”

Classroom training for this group begins in February 2013. Training begins in April for Howard County General Hospital and Sibley Memorial Hospital. All of these organizations will “go live” in waves from April through August 2013. Other groups will receive access to training with the approach of their own go-live dates, some of which won’t occur until 2015.

A core group of trainers will remain at Hopkins for ongoing staff instruction and assistance. Before Epic launches, “end-users” are also encouraged to practice as much as possible in the software system’s simulated workplace environment known as the “playground.”

Peer-to-Peer Pep Talks

As a physician champion for Epic, Matthew Kashima is one of more than 75 providers throughout the health system seeking feedback on the new software system from clinical specialists. Kashima, medical director for ambulatory services for Johns Hopkins Bayview Medical Center, will also receive training to become a “super-user” ready to lend support to peers as they hone their Epic skills.

To providers, he stresses the rewards of learning how to make the most of the software system’s versatility. Working in Epic, physicians will be able to “pull the records of all patients with diabetes to see how each is doing. They can also look at combined data from that patient population to evaluate their own clinical performance and improve upon the quality of patient care.”

Before they can tap Epic’s full potential, though, employees must relinquish accustomed workflows and documentation methods, says Tiffani Freeman, assistant director of operations training for JHCP. For seven years, JHCP providers have used an electronic medical record system tailored to their needs, Freeman says. From now on, “they can no longer decide in isolation how things work or look in the system because Epic will be shared by everyone, not just JHCP.”

It’s important for trainers to recognize the emotional toll on those who are losing their independence, Freeman says. “You’re not just there to tell people how to use the system; you’re the face of change.”

Freeman urges everyone to embrace the transition to Epic, starting with timely enrollment in the e-Learning courses. “It’s a way to become familiar with the Epic environment and establish a comfort level there,” she says. “It’s also an opportunity to generate questions for trainers once classes begin.”

Taking the time to prepare for Epic is a responsibility, Freeman says. “If you don’t do the e-Learning, later on in class, you will put yourself and everyone else at a disadvantage. It eats away at your confidence and slows the class down.”

—Stephanie Shapiro