Hospital Moves from Epic Go-Live to Optimization Phase
South Central Regional Medical Center, which went live with Epic on January 31, is now focusing on optimizing the EHR and expanding its features. Hospital leadership noted the new system removes limitations of their previous platform and that the focus has shifted from implementation to continuous improvement. The post-launch phase centers on refining workflows and enhancing clinical decision support tools.
- The American Nurses Credentialing Center (ANCC) offers the Nursing Informatics Certification (NI-BC), which requires practice hour minimums (1,000-2,000 hours in informatics) and continuing education to validate a nurse's expertise in the field. - ICU nurses transitioning to informatics can leverage their clinical experience to help develop and refine EHR interfaces and patient monitoring systems, bridging the gap between technology and real-world patient care. - A common complaint from ICU nurses about EHRs is the significant time spent on documentation, with issues like redundant data entry, poor workflow navigation, and excessive pop-up alerts contributing to the burden. One optimization project at UCHealth successfully cut documentation time for acute care nurses by 18 minutes per 12-hour shift by removing unnecessary flowsheet options. - Post-implementation optimization strategies often include 90 and 180-day reviews focusing on refining workflows, enhancing decision support, and improving reporting to realize the long-term return on investment from an EHR like Epic. Without a continuous optimization plan, user adoption can decline and the system's capabilities may be underutilized. - Epic is embedding AI and generative AI tools to augment clinical workflows; capabilities include automatically drafting clinical notes from patient conversations, summarizing chart entries, and using a vast de-identified patient database called Cosmos to offer diagnostic insights. - The ONC Cures Act Final Rule mandates that patients have secure, electronic access to their health information at no cost, driving the need for hospitals to adopt standardized APIs like HL7 FHIR to ensure interoperability between different systems and applications. - HL7 FHIR (Fast Healthcare Interoperability Resources) is a data standard that enables more flexible, real-time data exchange compared to older standards by treating information as discrete resources, which is particularly useful in critical care for accessing specific data points without needing a full document. - Common post-go-live challenges include a steep learning curve for new users, an overwhelming backlog of report requests, and the risk of cutting back on support staff too soon, which can lead to unresolved issues and clinician frustration.
