September 23, 2009 | | Comments 37
Print This Post
Email This Post

Does your hospital use the Epic software system? Let’s hear about it

Hi ACDIS members, I’ve had a few questions recently regarding the Epic software system. It was a subject of a member’s question on the most recent quarterly conference call, and I’ve since received a few additional e-mails from facilities that are going to Epic, or plan to do so, and are looking for help from experienced Epic users who have been using the system to leave electronic queries and interface with physicians.

If you would like to share your e-mail address, please feel free to leave it right here by leaving a comment on this post, or you can e-mail me directly at bmurphy@cdiassociation.com.

With more and more facilities going electronic, it would be great to see members sharing best practices, implementation strategies, and other ways of helping one another out with this important transition.

Take care,

Brian

Entry Information

Filed Under: Physician queriesQuarterly conference callsQuestions from the Mailbox

Tags:

Brian Murphy About the Author: Brian Murphy, CPC, is director of the Association of Clinical Documentation Improvement Specialists (ACDIS). Brian is also an executive editor in the revenue cycle division of ACDIS’ parent company HCPro, Inc.

RSSComments: 37  |  Post a Comment  |  Trackback URL

  1. Melissa Varnavas

    At the New England Regional Chapter meeting today, the folks at North Shore Medical Center in Lynn, MA, demonstrated its version of the 3M e-query system. It generated a very interesting conversation regarding hybrid records, e-query systems, how different vendor programs interact with each other, and how CDI programs use e-queries.

    This is a great post that I hope will generate some conversation about Epic specifically and the larger needs of CDI in the coming EMR world.

  2. We are in the struggle / development stages of electronic queries. We are in a slow transitional stage between paper and electronic PN, etc.

    There are several potential avenues that I see in EPIC, including the FYI flag, the ‘yellow sticky note’ type section of interdisciplinary communication, in-basket or actual progress notes.

    Our struggle is mostly with the medical staff having previously had resistance to the in-basket function (major draw back with the in basket for us as a teaching institution is that many providers are involved on the primary team and AIUI, the query via in-basket only goes to one provider). The resistance from the providers seems to be not wanting to be overwhelmed with too many items, as the it is used for a number of other communication elements. There are also several political aspects to this process for us.

    We are using both paper queries and the yellow sticky note section. That section has a real draw back in that it is not readily visible (no pop-up, not at the top of the screen — need to scroll down). However, those providers that are actively interested in participating with the CDI process easily find, read and respond with that tool.

    I had just heard about an organization that has successfully deployed using the progress note route, haven’t gotten more info than that at the present time but do plan to pursue further.

    One very important aspect to keep in mind, the avenue that you may adopt WILL directly affect whether the query ends up being part of the legal medical record. This may be a significant change to prepare for in ways other than IS.

    Don

  3. Stanford Hospital & Clinics exclusively uses electronic queries via EPIC to send documentation queries to Attending MDs. Our physician query response rate (concurrent) is 85-90%.
    We have been using EPIC housewide (with CPOE) since July 2008, and transitioned from paper queries to e-queries via EPIC INBOX.
    It mght be a good idea to form a small work group of hospitals/users using electronic queries to develop recmmendations/best practice strategies for new users of e-queries.

    Dexter Dcosta
    Manager, Clinical Documentation
    Stanford Hospital & Clinics
    Palo Alto, CA
    Offce: 650-723-5343
    Cell: 573-529-1791
    Email: dd’costa@stanfordmed.org

  4. Brian Murphy

    Thanks for sharing your information, Dexter and Don.

  5. Please send info on New England Chapter.

  6. Carilion Clinic in Roanoke, Virginia is a 800+ bed teaching facility. We have been using EPIC for Coding queries since July 2008 and CDI inquiries since July 2009 (We implemented EPIC July 2008 and our CDI program April 2009). The CDI documentation of their work is done in SoftMed.

    We are a new CDI program but have instituted the following processes:

    The CDI inquiries are not a part of the permanent chart,which as Don mentioned, is a major determination of how the inquiries can be provided.

    We have a customized CDI “Create Inquiry” link in the patient’s record. Access is given to CDS staff only. This link enables us to create an inquiry that has the message at the top of the screen, followed by a patient summary and links to the patient’s progress notes, labs, other document flowsheets.

    The inquiry is routed to a customized Physician/Provider Clinical Documentation Folder that is restricted to messages from our custom link only. The folder is also restricted to the provider “owner” access to ensure inquiries are not delegated to other non physician/extender staff.

    The provider can view the inquiry and launch directly into the patient’s notes to document. The requirement for physicians is to complete their CDI inquiries within 24 hours. CDI staff check their outbasket for “completion” of the inquiry and the EMR for documentation or none. CDI then complete their inquiry documentation in SoftMed as agreed, disagreed, or unanswered so we can track compliance.

    However, as you all know face to face discussion is usually more successful. If we do not get compliance with an inbasket inquiry, the CDS call and/or meet with the physician to discuss the case.

    ~Patty

  7. Melissa Varnavas

    Hi Kim, you can learn about our local chapters by visiting http://www.cdiassociation.com. Or click on the Tag “local networking” on the right side of this blog.
    Also, Patty Spry, RN, Clinical Documentation Specialist at Emerson Hospital in Concord, MA, and Adrienne Gmeiner, RN, CCS, of Lawrence (MA) General Hospital co-chair the New England ACDIS Chapter. The group, active for more than a year, boasts more than 50 members. For information, e-mail PSpry@emersonhosp.org or adrienne.b.gmeiner@lawrencegeneral.org.

  8. We have been using Epic w/ CPOE for exactly one year. We transitioned this Spring from paper clarifications to what we named the “E-Clarification” which is an electronic process directly in the progress note. We investigated the ‘In-Basket’ route initailly but physicians reacted negitively to having more messages to read. So far, we have been quite successful but still rely on speaking with the providers as nothing replaces the face-to-face interaction between CDS and Doc.
    Let me know if I can provide any more details that might be of help!

  9. Brian Murphy

    Thanks Jennifer! I have been sharing e-mail addresses with folks who have contacted me regarding Epic (both those looking for guidance, or those who are using it successfully and are willing to help others). Please contact me for the list of e-mail addresses if you’re interested.

    Brian

  10. We are a brand new CDI program initiated in August ’09. Epic was already up and running for some time prior to our program starting. We have had many albeit small, hurdles to overcome. These range anywhere from where in the record do we place the query to physician’s ‘active hospital problem lists’ which tend to be copied and pasted into the record.

    We currently place our queries in the ‘physician snapshot’ page of the chart, typically this is seen immediately upon opening a patient’s chart. This is not part of the permanent record.

    Overall, I think we are on our way to being quite successful, although I know we have more hurdles to overcome.

    I would love to hear from other Epic users and their hurdles.

  11. We have introduced EPIC in the Family Medicine portion of the College of Medicine, and are having some inquiries regarding how other institutions handle the progress note section from a compliance standpoint. Basically we are trying to get a better feel of the auditing process you have in place in regards to office visits and connecting the history portion of the exam. As of right now, when a physician goes in and reviews the past, family, social history and marks it as reviewed, it does not pull it into the progress note. I perform educational chart reviews for the Faculty and am unable to see when they actually do review this information, which prevents me from giving them “credit” for doing this. Have you experienced anything such as this? Do your progress notes pull in any section the physician marks as reviewed?

    Thanks so much for your help with this. This has been a rough transition on us all, but we are trying to make sure we stay compliant as it is being implemented rather than years later!

    Thanks Again!

    Jeni Smith, CPC
    Coding/Reimbursement Analyst III
    Community Health and Family Medicine
    P.O Box 100237 Gainesville,FL 32610
    (w)392-4541 x 250(f)846-1825(c)494-5606
    j.smith@ufl.edu

  12. Good afternoon Mr. Murphy,

    I’m very interested in seeing email lists for those who are using EPIC successfully. Please contact me at lamatra@gansgans.com

  13. I have assisted in implementation of the ADT suite for fourteen hospitals. I have participated in the full cycle of implementation. Feel free to drop me a line should you desire information from a revenue cycle perspective.

    Iris

  14. I’m very interested in contacting current EPIC users involved in both hospital and physician/small clinic integration.

    Mark Allen
    Integration Analyst-Physician Practice-EPIC/EHR
    Information Technology Department
    Mount Sinai Medical Center
    4302 Alton Road, Ste 750
    Miami Beach, FL 33140
    Tel: 305-674-2121 x50350
    Fax: 305-674-2547
    mark.allen@msmc.com

  15. I’m also very interested in contacting current EPIC users involved in physician/small clinic integration.

  16. Brian Murphy

    Hi Rosa (and everyone else who has replied to this thread), I thought it would be easiest if I just listed out all of the names and e-mail addresses of folks who have contacted me regarding EPIC.

    Everyone here has been interested in networking and sharing ideas/problems/solutions with integrating EPIC into their CDI program, so please feel free to contact them:

    Rosa Blanco: rbherrera@med.miami.edu
    Mark Allen: mark.allen@msmc.com
    Iris Willingham: idwillingham@aol.com
    LaMatra Barefield: lamatra@gansgans.com
    Jennifer Smith: j.smith@ufl.edu
    Julie Weiss: julie.weiss@northmemorial.com
    Jennifer Woodworth: jennifer.woodworth@multicare.org
    Donald Butler: dbutler@pcmh.com
    Dexter Dcosta: dr_dexterdcosta@yahoo.com
    Patty Steinbach: plsteinbach@carilionclinic.org
    Carla Heyn: cheyn@Elliot-HS.org
    Dawn Smith: dawsmith@methodisthospitals.org

    Take care,
    Brian

  17. Hi Brian,

    I am an RN working at Shands (Gainesville, Florida) and currently helping with the EPIC launch in the hospital (roughly 800 beds). We discovered the patient education section in the EPIC that is strewn with many in-the-basket information. How have you implemented the patient education record and interfacing it with the careplan in your institute? Can you please advise? Thanks in advance for your help.

    Christina

  18. Hello. Can anyone using Epic with a Nutrition Assessment component (ideally one based on the Nutrition Care Process) please provide screen shots?

  19. EPIC has been an epic disaster at our hospital. It is arcane and has resulted in lost billing, delayed care and IMMENSE physician and nurse frustration.

    I think this is a scam – get certified as a “meaningful use” (really incredibly wasteful) system and watch everyone run before a government mandate to implement a terrible system at EPICs inflated prices.

    Use another provider – EPIC is terrible

  20. Patty Steinbach are you also using EPIC on the financial side for billing purposes for the hospital and physician charges?

  21. if you could give me more information on how the querie process works through the progress notes i would appreciate it. we went live Feb 1 and are going the rout of the in basket. Our docs hate it and we have come to a complete standstill with a program that was very successful prior to our Epic go live date.

    thanks in advance.
    Lori K

  22. Is anyone out there about to start using the EPIC Stork product? We are just about to go down that path and wanted to hear from you folks we are currently experiencing this process the right questions to ask such as vendors for surveillance etc.

    Tracy

  23. We are in the process of implementing EPIC for our EMR at New Hanover Regional Medical Center. We are also looking at using 3M CDIS software for the CDI program. (We are currently using Midas). Is anyone using both products (EPIC and 3M) and would you share your experiences. I am particularly interested in how you are sending the electronic queries from 3M to EPIC and back.

    Thanks,
    Linda

  24. Hi,

    I am doing a research on Epic Software usage in Health-care organizations. I am looking for list of U.S. hospitals who are using Epic systems.

    I have tried a lot to find those but in vain. Can any one provide me the lists of hospitals for my analysis purposes.

    Thanks for your time. I look forward to hearing from you soon.

    Regards,

    Bill

  25. Hi,
    I work at a AMC in Florida which is currently in the process of implementing EPIC. However, our clinics will not be included in this roll-out for approximately 2 years. We are looking for ways to do registries that will seamlessly (or relatively so) transition into EPIC once the clinics obtain them. Does anyone know of any academic medical center’s or hospitals with clinics that use EPIC as well as patient registries. If so, please post your contact information. Would love to discuss this with you.
    Thanks!
    Kristin

  26. Hello,
    Our hospital will be up and running with EPIC within a year from now. A facility in Grand Rapids Michigan has invited us for a site visit to view EPIC. Can’t wait! Will share when I get back.
    Cindy

  27. Sentara Healthcare in norfolk/virginia beach virginia uses EPIC. (Sentara ecare) I am a former nurse of Sentara and I truly miss the EPIC charting system. We were completely paperless. All our hospitals and physician offices were connected. In the 3 years as a Sentara employee, all of the staff and physicians loved the system.

  28. I see it has been a while since this was posted, but I am wondering if Shellie received a response and I would like to collaborate with her if possible. Jean . Bouche at stmgb . org

    Shellie | Dec 8, 2010 | Reply

    Hello. Can anyone using Epic with a Nutrition Assessment component (ideally one based on the Nutrition Care Process) please provide screen shots?

  29. I work at the University of Mississippi Medical Center and we are converting to Epic now. Every employee went through a 14 hour training course. The whole hospital system including inpatients, clinics, physicians and all ancillary departments all switched to Epic on
    6/1. I work in the NICU and as a NP we are used to having used Neodata for years and of course we are all comfortable with it. This whole week has been quite the experience! There is no Epic program for less than 1 year old. Our docs have been working with the Epic people for months to try to adapt it for us. Everyday we are finding things that need to be changed completely or streamlined so they are basically still building it as we work with it so what you did one day might be totally different the next day. I think it will be good and hopefully fast when we finally have it like we want it. Right now we all feel really stressed out. The Epic people said we are the biggest hospital system to convert to it all at one time. We hired a new doc who also has a masters in medical informatics and knows Epic very well. He is wonderful and has gotten a lot of changes made for us. This would really be a big mess if he hadn’t been working with the Epic people for months. With Epic itself, the screen seems really busy with so many boxes to click on to accept orders or enter etc, different ways and buttons to click every time you turn around. It also seems like there are multiple ways to do things and still trying to figure out the best and shortest ways to do orders and progress notes etc.
    I think I will like it in about 1 month! I hope so!

  30. My healthcare system is going through the Epic Implementation progres and it has been very eventful for us. We are encountering the same problems as Jennifer Smith mentioned below. This was from 2009 and the problem still exists in 2012.
    “As of right now, when a physician goes in and reviews the past, family, social history and marks it as reviewed, it does not pull it into the progress note.”

    How does anyone truly have an auditable note when using EPIC. How does the inpatient notes look as well.

    Thanks

  31. I am interested in knowing what healthcare facilities have been using EPIC systems as well as any that are just implementing EPIC documentation systems. thanks

  32. Hello there I am so glad I found your weblog, I really found you by error, while I
    was researching on Digg for something else,
    Nonetheless I am here now and would just like to say thank
    you for a fantastic post and a all round entertaining
    blog (I also love the theme/design), I don’t have time to read it all at the moment but I have bookmarked it and also included your RSS feeds, so when I have time I will be back to read more, Please do keep up the excellent work.

  33. Hello everyone!
    I’m completely new here. I have been doing some research in the health care IT field since I’ve recently been taking some IT courses (networking to be exact). I came across some information about this EPIC software. I’m located in the Dallas, TX area where, apparently, there’s much need for experienced EPIC consultants. I’ve been looking for some training or possibly just some advice on how to get started. I wouldn’t mind starting at an entry level position at a health care facility and going from there but it’s hard finding any positions that don’t REQUIRE experience with the software. If anyone can please point me in the right direction or if anyone knows of any recruiters hiring someone with some IT experience please contact me at ilhaan33@yahoo.com. Any help would be greatly appreciated. :)

  34. Have you implemented the EPIC billing module successfully? Have you had success using Epic to match payments and charges successfully? If you have please share any guidelines, tips and pitfalls that might hinder successful adoption in a multiple hospital environment. Thanks.
    Ps implementation is already underway and everyone has attended some training.

  35. Understanding how these systems are configured and built behind the scenes can be invaluable in ones practice as a CDI in project management terms (I was an implementation consultant for Eclipsys). I worked with one of the first 100% paperless EPIC systems in Chicago. EPIC is the “Cadillac” of the EMR industry. That being said, you can mess it up also if not well planned and organized. After the initial go live the next phase of the project is fine tuning and troubleshooting out the kinks. Those who are ready for ICD 10 know that GIGO will make or break your ICD 10 performance in respect to CAC and CDI CAC plug ins. I just read hot off the press from this year’s AHIMA conference that they are estimating a 20% – 65% drop in productivity with the ICD 10 in the first year of go live in hospitals depending on how well prepared they are. That includes how well configured your EMR is. Kaiser has the most advanced EPIC system in the country, seamless across all aspects of their organization. I saw George Halvorson Kaisers former CEO speak in Chicago years ago at the annual HIMSS conference. He got a standing ovation.

  36. Our hospital system has been using Epic since 2008 in the Emergency Rooms, went full hospital in 2010 and completely paperless in 2012. The cut and paste progress note charting from the physician documentation is horrendous.

  37. I have worked in large cardiovascular office for 20 yrs I was a billing specialist working the A/R I have took on a new role putting in charges for our physicians for the office and hospital and we go live on epic in few mo’s I’m scared will I still have a job? My question who puts in the charges for epic the dr’s or who. Who creates a charge for the insurance to be billed out..

RSSPost a Comment  |  Trackback URL

*