Long-planned Epic System Implemented – Teaching Old Dogs New Tricks

If you were anywhere on the BJC campus in the month of June 2018, you couldn’t help but notice the multitude of people wearing shirts emblazoned with the word Epic1.

They were everywhere!

And we were lucky that they were here in force. These were members of the team ensuring the successful implementation of the new Epic electronic medical records (EMR) system.

It was a rollout over four years in the making.

In 2014, after 12 months of research, interviews, site visits and questionnaires, involving over 500 people including clinicians, administrators and staff, the Epic software system was chosen to manage the EMRs for all hospitals within BJC Healthcare and Washington University School of Medicine.

Epic incorporates clinical documentation from all areas of patient care into a single database. It will allow patient information to be shared easily, quickly and safely among healthcare providers across BJC’s multiple hospitals and physician offices.

Epic was rolled out in a scheduled series of “Go-live” events, beginning in 2017.

Barnes Jewish Hospital, Barnes Jewish-West County, St. Louis Children’s Hospital and Washington University Physicians went live in June 2018. This Go-live event was larger than all previous events combined, with over 3,200 physician and 15,000 staff trained.

The Epic project team and leadership provided 24/7 support through the month of June. Assisting end users with on-site issues were more than 3,500 At-the-Elbow staff and Super-Users (end users with extensive knowledge of Epic and the “go-to” person in a department).

Nephrologists Rowena Delos Santos and Frank O’Brien were the Super-Users in our division.

“We went ‘live’ on Epic on Saturday, June 2nd, and it was indeed an epic start!” says Dr. O’Brien. “All four in-patient consult teams made the transition without too much trouble. There were some glitches, but we mostly survived. Two of our fellows worked late the previous Friday to translate all the orders from our old system (Compass) into Epic.”

The Epic rollout for the outpatient clinics, however, proved to be trickier. During the first two weeks of the implementation, Drs. Delos Santos and O’Brien attended every nephrology clinic in the Center for Advanced Medicine at WUSTL to help ease the transition.

Dr. Frank O’Brien (left) and Dr. Rowena Delos Santos.

“We both had past experience using Epic, so we were able to give some useful ‘on the go’ advice,” says O’Brien. “The clinic staff, fellows and faculty showed huge patience and initiative in learning the new system and integrating new work flows. We ran into a few problems, such as the fellows weren’t given prescribing rights initially, but with determination and help from the Epic support staff, we persevered. You really can teach an old dog new tricks!”

Now, two months past the rollout, everyone is an Epic expert, according to O’Brien.

“There is a huge benefit of having all our patient data in one EMR,” he says. Prior to Epic, healthcare providers here had to access at least five different electronic health records to obtain a complete view of a patient’s care. “It is so useful for patient care to be able to access health records from other institutions using the ‘care everywhere’ feature.”

Dr. Delos Santos, the other Super-User in the division, commented that the entire process was a new challenge for everyone involved. Not only were they taking care of patients, they were also transitioning to a new system which was unfamiliar.

“Everyone did a great job even though we had initial ‘growing pains’ with the process,” says Delos Santos. “The initial phase of rollout is complete, but we continue to strive to make improvements on our efficiencies and use of the new system. At the end, I think the transition went better than I had hoped because of the dedication and effort that everyone from our division leadership, faculty, physician extenders, fellows, nurses, and support staff put into the transition.”

More information on the Epic system here.