The five MUSC ambulatory clinics did their due diligence in preparation for the March 22 Epic Pilot Go-Live.

Now, with "Big Bang Go-Live" just around the corner on May 17, seasoned pilot physicians tell their stories of what it has been like transitioning to the new electronic medical record – and they're hoping their colleagues, who soon will be going through the same experience, will take some friendly advice.

According to the Epic leadership team the message from the clinics are clear: Epic is a powerful system with the capability to change what's possible in health care for both patients and providers at MUSC.

That said, pilot clinics have learned making Epic work in a clinical environment takes an abundance of focused advance preparation. They also know that implementation of Epic is only the beginning of a larger process meant to eventually enable providers to take advantage of its full potential and capabilities.

Pediatric cardiologist Mark Scheurer, M.D., is an Epic pilot physician and describes the system as a very good product. "It has the potential to work as well as I'd hoped, and better than some I have used before. The clinic support teams are helpful and implementation issues have been resolved in a timely manner."

That report does not indicate that the system is neither completely intuitive nor problem free. Scheurer goes on to caution other clinics preparing to go live that, "planning and adapting clinic workflow to the Epic product is time well spent." Beyond the challenges of implementation, Scheurer sees the potential of Epic. "After better familiarizing myself with Epic workflow and documentation during go-live, it became clear that improvements in patient care and efficiency will come with optimizing Epic for specific areas and patient populations. It will be important to continue the current level of energy and technical support well into the months ahead during optimization."

Andrew Savage, M.D., another pediatric cardiology pilot doctor, remarked on the system as being "phenomenally robust," but is careful to mention that physicians should not expect to master Epic during the mandatory training sessions.

"Clinics need to be prepared for a learning process and that could take a year if not more. The investment in analyzing clinic workflow details prior to go-live is the most important and best use of time when getting ready to transition to Epic." To Savage, that meant considering all the details surrounding the day to day running of a clinic – everything from how a patient gets admitted to how notes are sent to a referring physician

Personalization labs have proven to be an effective way for doctors and their clinics to make Epic their own and have been unanimously recommended by physicians currently using Epic.

Rebecca Freeman, R.N., director of Epic training and chief nursing information officer, advises that setting up things like personal short cuts and "smart tools" are good examples of ways physicians can utilize the labs to decrease the amount of time they will spend documenting in Epic when they go live.

"Personalization labs allow end users to create Smart Tools, personalize their schedule, establish filters, and share their In Basket folders. Doing this work ahead of time really allows users to hit the ground running on go live day one," Freeman said.

Another message from pilot clinics centers on in-clinic rehearsals with entire clinic teams. That means literally walking through an entire patient visit experience and considering every detail of what happens or could happen during a visit.
Michelle Hudspeth, M.D., a pilot physician in the pediatric hematology/oncology department, echoes the messages of her colleagues. "Abstract as much as you can before you go live because it will take longer than you expect. Get into the weeds when it comes to your clinic's workflow and get those details down well ahead of go-live. This is especially important if you are a clinic that writes a lot of orders or are heavy on mid-level workflow." Hudspeth also recommends training early and taking advantage of all training opportunities offered.

The Epic leadership team said users won't be alone as they experience the growing pains of learning and customizing Epic in their clinics. The project's credentialed trainers, technical support specialists and project management team are ready to help facilitate the transition and meet the needs of users as they arise before and during the implementation phases and into optimization. While it's hard to find a pilot physician who doesn't see the potential Epic holds to improve health care delivery, the overwhelmingly message seems to be that like most things in life, Epic is a system that gives back what is put into it.

Need to sign up for Big Bang Go-Live training? Training sign up forms and schedules can be accessed online at the main MUSC Epic project website, http://epic.musc.edu.

Epic support can be reached at epic@musc.edu or 792-EPIC (3742).

Important Epic Go-Live Dates
Go-Live Training: April 9 – May 5
Personalization Labs: Late April, Early May (check CATTS)
Go-Live for MUSC Ambulatory Clinics: May 17