Optimizing your EpicCare Ambulatory EMR

By Tracy Welsh

There are many reasons to optimize your Epic system and operational workflow: increased efficiency, reduced costs, improved quality and staff and patient satisfaction.  The American Recovery and Reinvestment Act (ARRA) provides an additional reason – financial incentives!

The following seven optimizations will bring you closer to meeting meaningful use criteria and qualifying for ARRA federal incentives.

Epic Optimizations

• Surescripts: E-prescribing is a requirement for meaningful use. This application generates and transmits allowable electronic prescriptions and allows pharmacists to transmit refill requests directly to the physician via the EMR.
• MyChart, a module for primary care and specialties, allows patients to access their health information (such as lab results), and communicate electronically with their primary care physician regarding refills and appointments, etc. It dramatically improves the patient experience.
• Health Maintenance and Best Practice Alerts utilization analysis: Analyzing the use of these EpicCare components can offer opportunities for further quality improvement, affecting care outcomes.
• CareEverywhere: This module helps providers and staff coordinate patient care with other healthcare organizations by providing access at the point of care to key components of the patient’s medical record.
• PQRI: Implementing PQRI allows your organization to report ambulatory quality measures to CMS and to qualify for incentive payments.
• Computerized Physician Order Entry (CPOE) is an important quality safety initiative and most likely be required for meaningful use.
• Workflow and System Optimization: By assessing current workflows and end users’ command of the system, we can ensure that the system is being utilized at an optimal level, establish utilization benchmarks and subsequently improve quality outcomes.

Optimization Support: Reports
The availability of a seasoned report writer during build, implementation, and optimization is vital to the success of the project.  A good report writer can tailor reports to the organization’s specific needs, directly supporting the system build and optimization efforts.  This enables the build team to assess the integrity of Epic’s master files, troubleshoot problems as they arise and continually build a maximized system.

Here are some examples or reports created to ensure the success of a recent e-prescribe go-live:

• Report created from the Pharmacy master file to assist with mapping to Surescript pharmacies
• Provider reports to help manage the assignment of provider SPI ID and demographics required by the vendor
• Destination map reports to ensure perfect order transmittal setup prior to go-live
• Report created from Smartset orders and users’ personal preference lists to change the default order class (“Fax”) to “E-Rx”
• Reports to locate order templates containing ambiguous dosing instructions so they could be converted to discrete dispense units as required for e-prescribing
• Order tracking reports to determine which pharmacies received electronic transmissions vs. faxed prescriptions and to identify providers who were not successfully e-prescribing
• In-basket reports to track the number of e-prescribing error messages and users’ response to them

The implementation of an EMR is just a step in the journey. Optimization is just as important as the selection and implementation. Continue to assess your system, see how it is being used, and find ways to improve it. This will ensure that you’re getting the best return on your EMR investment.