Epic is Everywhere

Discover how Mary Greeley Medical Center’s new electronic medical records system is impacting care.

Kendra Gustafson was naturally concerned when her daughter was taken to the Emergency Department (ED) at Mary Greeley Medical Center with a broken wrist. But while the young girl was being treated, Gustafson couldn't help directing some of her attention to Epic, the medical center's cutting edge electronic medical records system.

Epic provides a fast, efficient way to access and share health care information. While patients may not realize it, Epic is already impacting how Mary Greeley Medical Center maintains records and provides services. Gustafson's excitement over Epic is understandable. As director of clinical applications systems at Mary Greeley Medical Center, she's worked almost two years overseeing the implementation of the system.

Staff access electronic medical recordsEpic puts the retrieval of a patient’s medical records into a healthy hyperspeed. Getting records used to take anywhere from 15 to 45 minutes. With Epic, it takes seconds, and that means a lot to patient care, especially in an emergency. A few strokes on a keyboard, and Epic provided ED staff with Gustafson's daughter's medical history. Shortly after X-rays were taken, mother, daughter and doctor were able to view them on a computer screen.

"The process was so easy and smooth, and then, at her follow-up appointment when she had new X-rays done, we were able to view before and after pictures to see how the healing was going," says Gustafson.

A Successful Launch

"The staff at Epic was amazed at how operationally involved our Mary
Greeley Medical Center management team was," says Gustafson. "Our
leadership had a vision of what this could be, and they've helped make it a
success. We had 100 percent participation in the training from our medical
staff too. That's 11 hours' worth of training, so it's a real commitment."

Epic provides a patient's pharmaceutical history, past surgeries and other important medical information in an organized, easy-to-access format. It has been implemented in steps by Gustafson, Clinical Applications Manager Amber Deardorff and a staff of applications analysts. Epic launched in March 2009 in the ED. By July 2010, Epic's use had expanded to hospital billings, patient registration, patient scheduling, medical records, clinical documentation, medical and nursing orders, pharmaceuticals, obstetrics and surgery.

One of the biggest benefits of Epic is that records from McFarland Clinic, which started implementing the Epic system in October 2008, and those from Mary Greeley Medical Center, are now instantly accessible to providers at both organizations.

"I was at the grocery store, and the checkout person asked me what I did, and I told her I work with electronic health records at the hospital. She got all excited and talked about how wonderful it was going to be that we'd be able to share with McFarland Clinic," Gustafson says.

Top Concern: Security

The most frequent comments Gustafson and Deardorff hear about Epic have to do with security. Stories about medical records of celebrities and college athletes being leaked are often in the media, which prompts privacy concerns for everyone. Deardorff notes that the system is actually more secure that previous recordkeeping methods—primarily documents on charts kept in or near patient rooms.

Epic records are available only to the people who need to see them. And, while Epic-connected hospitals can share information, one hospital can't "see into" another hospital’s system without a patient's consent. Finally, Epic tracks every access.

"There's a trail of who touched records and when they touched them," says Deardorff.

A Wealth of Applications

Before Epic, some Mary Greeley Medical Center patients may have seen nurses dragging a heavy and noisy cart with a computer into their room. Now the medical center has more than 800 Epic workstations, including one in each patient room. This gives health care providers the opportunity to immediately enter notes and orders in a patient's record.

Deardorff points out that "our physicians are entering more than 80 percent of their orders electronically. That level of order management by physicians is awesome."

"The best thing about Epic is the near instant access to all modes of information needed to practice medicine—labs, X-rays, nursing notes, historical chart, patient's pictures and phone numbers—all on one screen," says surgeon Mark Taylor, M.D.

Epic's effectiveness is built on the prompt entry of data, a responsibility that falls primarily on medical service providers, including physicians and nurses. Juggling this important clerical duty with the goal of providing personal patient care is one of the challenges that come with the benefits of Epic, Dr. Taylor notes.

And those benefits are many. Fast records retrieval enhances patient care, but it's just the beginning of Epic's applications. Here are just a few ways Epic is being used at Mary Greeley Medical Center:

  • A physician considering prescribing a new drug for a patient can quickly learn how the drug could interact with other medications the patient is taking, or if the patient might be allergic to ingredients in the drug.
  • Organizations that use Epic can share information. For example, what if someone from Texas moved from central Iowa and needed the services of Mary Greeley Medical Center? If their former health care system in Texas was connected to Epic, that patient's records could instantly provided to Mary Greeley Medical Center.
  • You can keep track of a family member who is having surgery. Sitting in a waiting room while you await word of the patient's status can be frustrating. With Epic, the patient is assigned a number and family members can "follow" them from surgical prep, surgery to recovery via a monitor in the waiting area.
  • Obstetrics can simultaneously view a mother's and infant's records.
  • Patient wristbands are scanned before drugs are administered to ensure the patient is getting the correct medicines and dosages.
  • Specialized reports can help doctors view important patient information over a span of time, not just on a particular day.
    Physicians can have these reports tailored to meet their
    patients’ needs.

All these functions almost make Epic sound like a smartphone loaded with applications, which prompts the question: Is there an Epic smartphone application? The answer: Yes. Many Mary Greeley Medical Center doctors have already asked when it will be available to them. "Soon," says Deardorff. "Soon."