His advice is to embrace change, not fight it, as the Epic implementation defines 2012
Steven M. Schlossberg , MD, began working at Yale in October 2010 as the chief medical information officer for the School of Medicine and Yale New Haven Health System. The newly created position, a unique joint appointment between two distinct organizations, came about because of the decision by both entities to build an integrated electronic records capability—and a more seamless partnership.
Dr. Schlossberg, a 58-year-old urologist specializing in reconstructive surgery, was instrumental in helping Sentara Healthcare, an integrated delivery system in Norfolk, Virginia, with a large medical group and multiple hospitals, implement an Epic electronic medical record (EMR). At Yale, he also serves as assistant dean for clinical informatics.
Yale Practice spoke with Dr. Schlossberg about the Epic project and the promise of the information revolution.
How is the implementation of the EMR system going at Yale?
I’d say extremely well. To put things into perspective and reflect back, a year and a half ago, the contract with Epic was just signed, and there was no implementation team. Throughout the summer and autumn of 2010, we hired and trained more than 100 people, and late that fall, we began in earnest building and configuring the Epic system for our clinical environment.
Last summer, we started training Yale Medical Group (YMG) practices to use Epic, and our first practice, Yale Internal Medicine Associates, went live in October. We now have four practice sites using the Epic Ambulatory EMR and several more are scheduled to go live in February. Using Epic, doctors are seeing patients, filing charges and sending prescriptions. There are patients up on My Chart, the Epic portal that enables them to more effectively communicate with their health care providers. What we’ve done so far is a remarkable accomplishment in a very short time—and it’s only the beginning.
What advice would you give to physicians and other providers who may be a bit nervous about making the transition to Epic?
Embrace the change rather than fight it. Sure, be skeptical and ask questions. But my experience at Sentara—and there’s plenty of published data to back this up—is that you can decrease your learning time by really focusing on the Epic training classes, then practicing on your own to learn the application. We and others have found that people who try to cut corners and don’t do the work are the ones who struggle, but at YMG, we have the right resources and programs in place to help providers get better and better at Epic over time.
What kinds of challenges do you see for the coming year, and how are you working to meet them?
One issue we’ve discovered at YMG revolves around physicians who don’t see patients very often. It’s a fairly common situation and one that doctors have mentioned as a concern, because it might make it more difficult for them to learn to use the software. This has caused us to reevaluate our implementation and support model, and one solution is that we’re building an enhanced clinical support team to support physicians who call the Help Desk with questions, anything from “I can’t figure this out” to “I need someone to come by my office and help me do something.”
How is Epic changing the practice of medicine?
For starters, it’s forcing YMG to have a number of discussions about the best way to deliver care. Our current system was built for a paper world, but having an EMR gives us the opportunity to do such things as reevaluate our staffing model, reanalyze our workflow, standardize practices, and think about whether we need to realign the organization of the health care system. The Epic implementation is a catalyst for talking about making changes that will be good for our patients and practices.
While this is an oversimplification, the real project begins after you get the software up and running. Optimization of the clinical workflow and the software allows clinicians to do such tasks as target specific patient populations and take advantage of the decision support features we’re building into the program. In addition, it helps providers improve the quality of care for patient benefit and meet regulatory requirements. And we’re now in the process of developing the tools, such as the clinical trials management system we installed last summer, to leverage the health care data that Epic can generate. We’re also beginning to think about creating a clinical research data repository that researchers will be able to use to discover the best ways of treating and curing diseases. Informatics may be a game changer.
With all this going on, do you have time to be a doctor?
I am just starting seeing a limited number of patients. My background is genitourinary reconstruction, and for now, I’m limiting my work to treating men with urethral strictures.
This schedule can’t leave much free time for outside interests.
I remain active as the health policy chair of the American Urological Association. I’ve also managed to reconnect with friends from my medical training days in New York City and family located in the greater metropolitan area. I have even played several rounds of golf on the Yale University course.