Epic Information Session

(1)

Epic Information Session

Members of the Epic Clinical Research Team

(2)

Topics Covered Today

• What is Epic, and why do I care?

• My life on Epic. How clinical research processes will change with Epic.

• Rollout Schedule: What happens when, and how it impacts you.

• How to prepare. Everything you need to know about training.

(3)

What is Epic and Why Do I

Care?

(4)

What is Epic?

• EMR (Electronic Medical Record) system • Also includes

— Scheduling and registration — Clinical documentation — Order entry — Pharmacy/Prescribing — Charge capture — Billing • A one-stop shop

(5)

What is Epic Replacing?

• Now (well, in April)

— Epic ’99

• By the end of 2013

— EPR

• Eventually

— Most clinical operations (Sunrise, ClinDoc, ORIS, OCIS, POE, Eclipsys, etc.) and billing (KEANE) systems

(6)

How Will Epic Affect Research?

• Scheduling and registration moves to Epic 2012

— New role for CRMS in feeding data to Epic

• Ordering for clinical research

— New processes and workflows for ordering

• Clinical documentation

(7)

Benefits of Epic for Research

1. Research Indicator 2. Flagging orders &

encounters

3. Research reports

4. Streamlined scheduling 5. Preference lists for

ordering

6. Research registries 7. MyChart for PROs 8. Temp logins for study

monitors

9. Auto notifications for events

10. Recruitment alerts

APRIL

2013

(8)

(9)

Scheduling

• Will work mostly the same way it does today

— If you use a scheduler, you’ll continue to do so.

— If you schedule, you can continue to do so. — If you have to call around, you’ll continue to

do so.

• Study staff will have the ability to view clinic schedules outside their department

(10)

MAJOR IMPROVEMENT

(11)

Increased Role for CRMS

• CRMS used to send information to Epic

— Study information

— Subjects enrolled on study

• If you’re not currently using CRMS, you’ll need to begin

(12)

(13)

(14)

(15)

(16)

Flagged Orders in Chart

Review

(17)

Flagged Encounters in Chart

Review

(18)

(19)

(20)

Ordering

• Will be required for most study visits in clinical areas, including the CRUs

• Orders entered before visit is scheduled • If you are not a licensed provider

(physician/nurse), orders will have to be

signed before visit is scheduled

• Shortcuts/workarounds will make order entry and signing less cumbersome

(21)

(22)

Visit Documentation

• Signoff of completed orders

• Flowsheets allow for electronic documentation of research visits

• Standardized documentation of vitals, etc. • No documentation requirements

(23)

(24)

The Thing to Remember

• Scheduling and Registration is SEPARATE from Ordering and Documentation for Rollout

(25)

Scheduling and Registration

• April 4, 2013 (Wave 1)

(26)

Scheduling Rollout

• If you know you need to schedule a visit past April 3, DO IT NOW!

• On March 17, you will no longer be able to schedule visits past April 3.

— Can still schedule visits BEFORE April 3

• After March 17, visits that need to be scheduled past April 3 will have to wait until April 4, and be scheduled in Epic 2012.

(27)

Ordering and Documentation

• May 16, 2013 (Wave 2)

— Green Spring, White Marsh, Bayview

• June 1, 2013

— Ambulatory (AND INPATIENT) at Howard County and Sibley

• June 27, 2013 (Wave 3)

— JHH, except Pediatrics

• August 15, 2013 (Wave 4)

— JHH Pediatrics

• Sometime after August 15

(28)

Between Wave 1 and Wave 4

• After April 4, all scheduling and

registration will take place in Epic 2012 • Ordering and documentation will use

existing systems and processes until rollout wave for that location

(29)

The OTHER Thing to

Remember

• For the foreseeable future, special

research requisitions (e.g., Pathology, Radiology) will remain PAPER BASED

(30)

Additional Information: Rollout

• http://www.hopkinsmedicine.org/epic/rollo ut/index.html

(31)

(32)

CRMS and Epic: Short Title

Short Title

– Auto-populated based on first 100 characters of the Study Title

(33)

What the Study Team Needs To Do:

1) Edit the Short Title so that it makes sense when in Epic!

(34)

CRMS and Epic: NCT Category

NCT Category Added on General Tab

– Defines what type of Study you are running

(35)

CRMS and Epic: NCT Category

• What the Study Team Needs to Do:

(36)

CRMS and Epic: Admin Section

Admin Section Added to the Regulatory Tab

— Identifies within CRMS if the Study and its participants will be sent to Epic

(37)

CRMS and Epic:

New Enrollment Statuses

New Enrollment Statuses on the Enrollment Tab

— Follow Up Status — Off Study Status

• In prior versions of CRMS, a participant enrolled in a study would remain in the Enrolled status. Now, the participant

should be moved to the Follow Up and/or Off Study Status for accurate enrollment tracking.

(38)

CRMS and EPIC:

Follow Up and Off Study Statuses

What the Study Team Needs to Do:

— Update Study Participants to the Correct Enrollment Status

(39)

CRMS and Epic: Lay Abstract

Lay Abstract on the Left Navigation Bar

— Information in the “Purpose” section of the Lay Abstract will be sent to Epic. This will be known as the Study

(40)

CRMS and Epic: Lay Abstract

What the Study Team Needs To Do

— Complete the Information in the Purpose

Section of the Lay Abstract (other sections can be left blank)

(41)

Sensitive Studies/Diagnoses

• Talk to the CRMS team.

• Epic is an operational/audited system. JHM monitors its use, like EPR.

• There are ways to identify study subjects in Epic, while keeping the nature of the study confidential

(42)

Never Used CRMS?

Questions?

• Contact the CRMS Team at

[email protected]

• There may be ways to import your subjects!

(43)

(44)

Getting access to Epic 2012

• Register for an Epic Role in the Epic Access Request Manager (ARM)

— http://cds.johnshopkins.edu/armepic

— ARM is how you request access to Epic. It does nothing else.

— The “Required Courses” that display in ARM are usually incorrect/incomplete.

• Complete the Required Training for Your Role

— Course Catalogs on the Epic Training site

http://restricted.hopkinsmedicine.org/epic/_training

— Register for classes in the Learning Management System (LMS) at http://my.johnshopkins.edu

(45)

Access Request Manager

(ARM)

(46)

Fields in ARM

• Role Type • Wave • Epic Template • Epic Subtemplate • Comments

(47)

Role Type

• Physician or Nurse: Ambulatory Clinical

(48)

Wave

• If you need to schedule appointments

— Wave 1

• If not

— Use the rollout wave for your location — Use Wave 4 for the CRUs

(49)

Rollout Waves:

Ordering and Documentation

• May 16, 2013 (Wave 2)

— Green Spring, White Marsh, Bayview

• June 1, 2013

— Ambulatory (AND INPATIENT) at Howard County and Sibley

• June 27, 2013 (Wave 3)

— JHH, except Pediatrics

• August 15, 2013 (Wave 4)

— JHH Pediatrics

• Sometime after August 15

(50)

Epic Template

• If you are a physician or nurse

— T AMBULATORY PHYSICIAN — T AMBULATORY NURSE

— (T AMBULATORY PHYS ASST) — (T AMBULATORY NP)

• If you are a non-clinical PI, Study

Coordinator, Co-Investigator, Study Manager

— T RESEARCH CRCOORD1

• Other study staff

(51)

Epic Subtemplate

• If you are a physician or nurse and DO NOT need to schedule

— ST RESEARCH CLINICAL1

• If you are a physicians or nurse and DO need to schedule

— ST RESEARCH CLINICAL1 — ST CADENCE, CLIN SCHEG

• Second subtemplate entered in Comments field

• Other study team members who DO need to schedule

— ST CADENCE, CLIN SCHEG

• Otherwise

(52)

INCOMPLETE! Don’t believe.

If you’re a clinician, your primary role

in Epic is NOT research-related.

A clinician’s research role is a subtemplate.

If you need additional subtemplates, enter them in the comments.

(53)

Non-clinical personnel choose “Research”…

…and their primary template is

research-related.

If you’re not scheduling, no subtemplate is needed.

(54)

Next….Training!

• http://restricted.hopkinsmedicine.org/epic/_training/

• If you need scheduling access, take your scheduling classes NOW!

• Take the rest of your classes during the training window for your rollout wave

— Bayview, Wave 2

— JHH except Peds, Wave 3 — Peds and CRUs, Wave 4

• Most classes have several e-learning prerequisites

— Automatically added to your learning plan in LMS when you register for the in-person class

(55)

Scheduling Training

• No matter what research role you have (PI, Nurse, Study Coordinator, etc.), if you need access to scheduling, take these classes

— Schegistrar 100 • https://lms4.learnshare.com/catalog/display.resource.aspx?Res ourceID=420074 — Schegistrar 101 • http://lms4.learnshare.com/catalog/display.resource.aspx?Reso urceID=420079

— Referrals and Benefits Collection

• http://lms4.learnshare.com/catalog/display.resource.aspx?Reso urceID=420100

(56)

Complaints?

• Scheduling training

— 3 classes — 24 hours

— Not counting e-learning pre-requisites

• Kelly Cavallio

Administrator, Ambulatory Services

[email protected]

(57)

Other Training: If you are a…

• Physician Researcher — Physician 100 • http://lms4.learnshare.com/catalog/display.resource.aspx?Reso urceID=420073 — Physician 200 • http://lms4.learnshare.com/catalog/display.resource.aspx?Reso urceID=420078 • Research Nurse — Nurse 100 • http://lms4.learnshare.com/catalog/display.resource.aspx?Reso urceID=420095 — Nurse 200 • http://lms4.learnshare.com/catalog/display.resource.aspx?Reso urceID=420068 — Research 200 • http://lms4.learnshare.com/catalog/display.resource.aspx?Reso urceID=425738

(58)

Other Training: If you are a…

• Non-clinical PI, Co-I, Study Coordinator, Research Manager — Research 100 • http://lms4.learnshare.com/catalog/display.resource.aspx?Reso urceID=425737 — Research 200 • http://lms4.learnshare.com/catalog/display.resource.aspx?Reso urceID=425738

• Other study team members

— Research 100

• http://lms4.learnshare.com/catalog/display.resource.aspx?Reso urceID=425737

(59)

How to Find The Classes?

• Easiest way: Use the hyperlinks in this slide set

— It’s not possible to search for most of these classes in LMS

— The class content is exactly the same, no matter which wave or role you have.

• TAKE YOUR CLASSES DURING THE TRAINING WINDOW FOR YOUR WAVE

(60)

(61)

Register for Training

• First: Try to register yourself

• Second: Ask your manager (or a friend) to register you

— Some people have the ability to enroll others in training.

• E-Mail [email protected] and ask to be given the ability to enroll yourself in classes.

(62)

Final Notes, Training

• There are still classes with seats available in Baltimore, in March

• You MAY have to travel to Keswick or Bayview

• Most roles/classes have e-learning prerequisites, so plan ahead

(63)

Epic Information Session