As aptly noted by the Medical Group Management Association, “Health systems leaders are challenged to ensure technology investments are integrated to support the best patient experience possible and aid administrative processes and optimize workflows, from improving care coordination, to streamlining clinical documentation processing and care team communication.”

It is a noble pursuit, yet obstacles to meeting the challenge are numerous— not the least of which is resistance to IT changes amongst clinical end users. Clinicians cannot be faulted for fearing that new healthcare IT measures or system changes equate to workflow disruption and added stress. Practitioner experiences with evolving technology have often been conflicted, to say the least.

However, there are strategies for managing healthcare IT change adeptly for all involved — and they don’t have to require costly, frustrating, and/or time-consuming initiatives.

One regional hospital system addressed change in a creative way when implementing optimized workflows in its Epic EHR. It is resulting in both increased clinician engagement and IT efficiency. Simple process ingenuity can sometimes produce terrific results.

The following use case highlights how an organization can benefit by rolling out available functionality to build clinician trust, and successfully accommodate advances in unique capabilities.

Adopting Epic EHR Service Optimization Modules

This particular healthcare organization comprises over 20 hospitals and care facilities spanning four states in the rural southeast. It is committed to value-based care and addressing health-related social needs to improve the well-being of close to a million people in its service area. In support of achieving this mission, enterprise-wide care planning tools including Healthy Planet and Compass Rose were rolled out.

Healthy Planet is Epic’s population management system module. It is designed to help “organizations keep track of how well they are serving their patients using real-time and predictive analytics, role-based daily metric dashboards, wellness registries, and chronic disease registries. The tool also benchmarks patients against national averages and incorporates home device data collection.”

Epic’s Compass Rose module is a comprehensive care coordination application used “to assess patient social determinants of health, enroll patients in community-based programs, and track patient outcomes” across the healthcare continuum.

When combined, these modules serve as powerful tools for proactive, enterprise-wide care planning which enhances care quality and patient service: two objectives near and dear to leadership, IT, clinicians, and the organization as a whole.

Leveraging Epic Functions to Build Clinician Trust

The organization is seasoned in its use of its EHR, but did not historically track and/or document configuration decisions and team approvals for clinical content. The Healthy Planet and Compass Rose implementation team wanted to change this in order to establish “build transparency” for the clinical end users who would be using the modules. In doing so, the IT team was hoping it would also build trust with the clinical care team members as they learned new workflows and received Healthy Planet and Compass Rose functionality at their fingertips.

The implementation team chose a creative use of the EHR’s metadata badge function to tag clinical content and supply build transparency to clinical end users. Here’s how the plan unfolded:

  • The implementation team was familiar with Epic metadata functionality, which was originally released for Epic’s Cogito analytics content (dashboards, components, dashboard metrics, and reports). After careful review and testing in collaboration with Epic, the team discovered that the metadata badge function could be applied to the new modules by assigning registry content ownership for registry metrics, as well as registry inclusion criteria.
  • The tracked fields to which the team applied this include: Reviewer(s), Record Approval Status, Review Date, Approval Notes (a free text field), Next Review Date, and content Owner(s) for each registry overall.
  • A process was created to support clinical end-user review and approval by using the import and export of CER and HCM records. CER are configurable rule logic records that are used all across Epic, and HCM are Epic’s metadata records.
  • The logic for registry metrics and registry inclusion criteria are stored as CER records in Epic. An export of the CER records was created, and then a list of new HCM (metadata) records linked to those CER records was imported into the system.
  • Clinical end users were provided with a report that contained the CER records for their review. This report is based on a Reporting Workbench Template with a base master file of CER. Clinical end users leveraged a print group that was displayed at the bottom of the report to view the exact logic used within the Rule Editor tool by the application team members for each CER record (limiting the need for security modifications and ensuring end users did not receive editing access unnecessarily).
  • Clinical end users used an export of this report to review (and modify if needed) the six fields including Reviewer(s), Record Approval Status, Review Date, Approval Notes (a free text field), Next Review Date, and content Owner(s) as their schedules allow.
  • Once the designated clinical end-user review was completed, the information was handed off to the Lead Cogito Manager for importing into the newly created HCM records.

Leveraging the metadata functionality in this new way enables the clinical content build approval information to be tracked in Epic directly and creates transparency for clinical build status across the organization. The process has been incorporated into the organization’s training and rollout standards, which supports its strategic change management and adoption objectives.

A Better Way of Building Together

Baking build transparency for clinical content into the implementation of Healthy Planet and Compass Rose made adopting the new modules a cooperative team effort that supplied clinical end users with a sense of ownership. This relatively simple process eliminated care team members questioning the configuration of metrics and validation efforts and created efficiencies for the Healthy Planet and Compass Rose implementation team. In short, it alleviated resistance to change and built trust.

The innovative approach leveraging the metadata badge for clinical content and build transparency can also be applied to any of the other Epic modules as well. For more information, please contact us.