More practices are getting ready for Go Live day

While change can be stressful, everyone wants to see less paper

Judy DiChello (left) and medical assistant Cindia Alvira abstract data from paper records in preparation for the Yale Diabetes Center’s Epic Ambulatory implementation.

With Epic now part of the day-to-day business at Yale Internal Medicine Associates (YIMA), several other Yale Medical Group (YMG) practices are in the process of joining the fold. The Yale Diabetes Center, Yale Endocrinology, and Yale Bone Center went live with Epic on November 29, and the electronic medical record (EMR) application is scheduled to debut on January 10 for Digestive Diseases and Nephrology.

Prior to the Yale Diabetes Center’s go-live date, administrative associate Judy DeChello reported on its progress. “We’re very excited, but it’s very stressful,” said DeChello, as training wrapped up and Epic experts started an occupation of the center’s offices in the Dana Building. “We’re making a transition from all-paper charts to fully electronic ones, and it’s a pretty painful process. But in the end, we know it’s going to be worth it,” she said.

Around the office, harried providers may have threatened to take those paper charts with them to their graves, but as Go Live approached, DeChello noticed an increase in positive comments. She said one doctor summed it up this way: “I have clinic in Dana 2, my charts are in Fitkin 1 and my office is in TAC. But with Epic, I can access all the information I need wherever I am, whether that’s at home or at a conference in California, and help my patients. Epic will be a big plus for us and really improve care. However hard this has been, it will be worth it in the end.”

Learning about Epic’s complexity

The next practices to implement EpicCare Ambulatory, the EMR that YMG providers will use, will have benefited from what the Epic team learned with YIMA, said David Smith, the ambulatory implementation project director for YMG, noting that one important change revolved around the use of Epic’s key communications tools, including the In Basket, and message routing to and from the call center. “We came away from our first implementation with a better understanding of this tool’s complexity, and this led us to improve our curriculum, focus on work flow standardization, and update the tips and tricks sheets we hand out during training,” Smith said.

Donna SanGiovanni, manager in Digestive Diseases who has been involved with the Epic implementation in Digestive Diseases since the process began almost a year ago, is confident that her practice’s metamorphosis from paper to EMR will be smooth. “Sure, we know there’ll be hiccups along the way, but we all see the value in eliminating the paper trail,” she said.

If nothing else, an EMR will eventually free up office space, including her office at the Temple Medical Center and a number of faculty offices around campus that are currently filled with the file cabinets that house paper charts.

“Epic will save us all that time we currently devote to gathering widely scattered patient information,” SanGiovanni explained. Her staff has already started the process of abstracting data from those charts for patients scheduled for appointments in January, February, and March. “The abstraction process will help us learn the application, and as we get better at it, we’ll all be able to learn from each other,” she said. “The Epic team has reassured us that even though there’s a lot to do in a short time, we’ll be fine. In the end it’s all about quality patient care.”