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EPIC Ambulatory Update

EPIC Ambulatory Update. November 29 th , 2006 Pete Newcomer & Alev Wilk Guests: Deb Boushea, Betsy Trowbridge, Laurence Williams. Learning Objectives. Epic Highlights & Timeline Patient/Provider Room Arrangement Productivity Data before & after Epic Implementation

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EPIC Ambulatory Update

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  1. EPIC Ambulatory Update November 29th, 2006 Pete Newcomer & Alev Wilk Guests: Deb Boushea, Betsy Trowbridge, Laurence Williams

  2. Learning Objectives • Epic Highlights & Timeline • Patient/Provider Room Arrangement • Productivity Data before & after Epic Implementation • Epic Software Future Updates • Resident Clinic Workflow • Q&A with Guest Speakers

  3. Project Highlights so far • UWMF continues to “roll out” EPIC at new clinics in our system. • Preparation/planning for UWHC sites continues. Interface concerns between and EPIC scheduling and A2K scheduling software have slowed preparations some.

  4. EPIC Timeline • EPIC will be installed as the EMR for both inpatient and outpatient sites over next 4 years. • The EPIC project is being coordinated between the UWMF sites and the UWHC sites in an integrated fashion.

  5. Specific Timelines • EPIC Ambulatory will be rolled out in the Primary Care sites throughout 2007 for UWMF-working on rollout schedule for UWHC clinics • EPICRx Inpatient (the pharmacy program should replace our current system by end of 2007) • Specialty clinics will start EpicCare by end of 2007 and continue implementation for the next couple years in a rolling fashion. • EPIC inpatient will start with flowsheets and rounds report by early 2008 and be completed by 2009.

  6. Current Timeline for UWHC Internal Medicine sites • We now have a firm date for the Epic Cadence/Prelude go live at West: itwill be 2nd floor on 2/27, followed by floors 1 and 3 on March 20. (This is the registration and scheduling software) • The “Go Live’ for AB will be a month or two later assuming everything goes well. • CD and EF (the clinic formerly known as Women’s Health) will be next –schedule coming soon.

  7. Room Arrangement • Working effectively with EPIC and the patient will involve rearranging the exam rooms to be more conducive to the patient interview. • Examples are in J3/1 at the Hospital and on the second floor in A/B. • 3 styles are currently being considered.

  8. Angled Toward Patient (ATP) option

  9. Computer On Wheels option (COW)

  10. Standard (SAS) option

  11. Epic’s Effect of Productivity • One of our concerns with the EPIC EMR implementation is the effect on physician productivity. • In May of 2006 the first UWMF internal medicine clinic went “live”. • This event has given us the ability to more closely evaluate what is likely to happen in UWHC internal medicine clinics in 2007. • The following slide shows 10 providers at 20 S. Park and the average RVU/Hour worked before and after the “go live” date.

  12. Productivity continued. • The prior slide showed significant variability among providers as regards RVU/hour worked. • The current trend after the “go live” appears to be more neutral than in prior implementations. • The following slide shows the entire group of physicians average RVU/hour worked over that time period.

  13. Effect on Productivity at 20 S. Park

  14. What’s New in Spring ‘06 Upgrades. • Improved color schemes to make text easier to read. • Snapshot page with a summary of patient’s clinical data. • Charting tools such as point and click; documenting the physical exam and ROS.

  15. Resident Clinic Workflow • Residents will have access to EPIC EMR, their clinic schedule, patient data & documentation. • They will see and evaluate their patient. • They will present to you and describe an assessment and plan. • They will complete a progress note and place orders, ie labs, radiology, injections.

  16. Resident Clinic Workflow(our recommendations) • Resident documentation will be limited to smartsets and tools, as well as free typing. • We believe staff should have the ability and responsibility to close the encounter (sign the chart) once resident documentation and patient care is complete. • This allows for accurate documentation & patient care. • This allows for accurate billing.

  17. Resident Clinic Workflow(our recommendations) • Residents will not close the encounter • Advantages • All work and documentation is completed that day. • No wait-time for reviewing and correcting resident dictations. • Residents are well-versed in this type of documentation. • Disadvantages • Staff need to take more time reviewing resident documentation during or after clinic hours.

  18. Q and A • Recent implementation at 20 S. Park • Laurence Williams, Betsy Trowbridge, and Deb Boushea will be open to questions.

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