Epic Update: YIMA is reaping the benefits of the EMR

Staff reports data access, medication refills are getting easier

alt textMarie Follo (left) discusses the day’s progress with members of the Epic project team. 

Marie Follo (left) discusses the day’s progress with members of the Epic project team.

For the doctors and staff of Yale Internal Medicine Associates (YIMA), October 19 was anything but an ordinary day at the office. That rainy Wednesday marked the debut of a new era for Yale Medical Group as YIMA became the first practice—indeed, the first Yale New Haven Health System group—to begin using the Epic electronic medical record system.

In YIMA’s third-floor headquarters in the Yale Physician’s Building, things were festive, with a strong feeling of excitement in the early morning air. There were Yale blue and Epic purple balloons floating over the front desk, a smorgasbord of Starbucks coffee and pastries, and a small army of Epic administrators and purple-shirted application specialists standing shoulder to shoulder with Yale Medical Group and YIMA personnel to make the implementation as smooth as possible.

Returning to pre-go live pace

More than a month after the first patient was entered into the new system, the Epic team members have returned to their offices in Stratford, although they are still providing telephone support 24/7, and life at YIMA is slowly returning to its pre-go live pace, but in an electronic rather than a paper realm.

Practice director Matthew Ellman, MD, had considerable praise for their efforts. The Epic experts were “highly professional and responsive to our physicians and all the support staff during this intensive period of implementation,” he said. “They worked hard to understand our practice’s work flow and our staffing resources in order to show us the best options in Epic to meet our needs.”

One of the most difficult aspects of mastering the application, he explained, was the result of the new EMR’s remarkable flexibility. ”Epic is a complex and versatile system with a variety of ways of doing things, from entering office notes to communicating among staff, and this made it more challenging at first,” said Dr. Ellman.

Discussing best practices

But this also gave YIMA staffers the opportunity to discuss their various approaches to handling tasks such as phone encounters or closing their notes, and developing a standard practice. “Rather than have everyone do their own thing, they came together to make a conscious decision about the best way to do something in Epic,” said Marie Follo, who as YMG director of practice management helped oversee the implementation.

While it will take some time for everyone to get up to speed, YIMA practitioners and patients alike are “already reaping some benefits,” said Dr. Ellman. These include “easier access to clinical data in real time in the chart, and a more efficient and reliable process for providing medication refills and communicating with pharmacies.”

The physician, however, has experienced one unexpected casualty in his personal work flow. Dr. Ellman’s corkboard, a kind of nerve center that was always loaded with pinned-on notes, is now empty. Of course, his Epic in-basket is filling this void.