I see ACs, I see IDs!

Imagine being a patient and conducting your next primary care visit via video conferencing from your smartphone or tablet. This capability will soon be available at GBMC.

In order for that functionality to become available, your GBMC Application Coordinators (AC) and Instructional Designers (ID) are hard at work.

ACs address all issues that arise during the project for their application and are very knowledgeable of the organization policies, procedures and business operations. Their role is to provide primary support for a specific application.

IDs work with project leadership and ACs to develop the overall training program. IDs will provide end users with information about workflows and processes as well as how the system functions. In essence, although GBMC has purchased the Epic platform, it is up to our ACs and IDs that work tirelessly to customize the system based on feedback from physicians, managers and staff. Your input ensures that the system has the look and feel of GBMC, while meeting our internal needs.

A day in the life of an AC consists of regular communication with Epic representatives and working with physicians, managers and end users to ensure the system meets the organization's business needs. ACs and IDs must understand the choices involved in application configuration in order to ensure optimal functionality of the system. They investigate end users' preference while making build decisions. In addition, the team must also perform in-depth analysis of workflows, data collection, report details, and other technical issues associated with Epic software.This will take months and hundreds of hours!

So the next time you run into an AC or ID around GBMC, do not hesitate to ask them questions to learn more! Also, do not hesitate to ask questions or post comments in the comment section below! Remember that you, too, are participating in something GREAT and EPIC. This is your organizational project. Your time and efforts are not in vain.

Your Epic system implementation team is working hard each day to build a system that supports our vision...to every patient, every time, we will deliver the care we would want for our own loved ones.

Dione Harrison
Manager - HR Business Partner Services

Build Buckets

In our last blog, we mentioned something about "build buckets." So, what is a build bucket? That is a great question as we now start Phase 3 of the Epic project: System Design and Build!

We have just completed our third series of Workflow Adoption meetings with our Epic counterparts to understand how our GBMC workflows will be incorporated into the Epic software. (Thank you to all that attended to provide the needed input to the processes!) But our work does not stop there! The Epic analysts are now taking collected data to start building the system.

We will continue to collaborate with our SMEs (subject matter experts) on a regular basis to review our build and meet our aggressive timelines. We know this requires extra time and effort, but it contributes to making a better and safer healthcare information system for our patients. If you have any questions or comments along the way, don't hesitate to speak up. Also, don't forget that you can always leave comments below!

Back to the Build Buckets.

The build buckets are the heart of what the Epic team is working on right now. It will take four buckets to build the GBMC HealthCare Epic system before we test to see how the build is working. Each bucket has very defined tasks per application, but it is like building a house (or sandcastle).

Testing what was built starts in December!

Together, our buckets will build the system we want and need! It takes all of use to make this happen.

Kay Everett

Clinical Project Manager

Resolute

In a previous blog, we explained the origin of the names of various Epic applications. However, we forgot one: Resolute! We figured that this was such an important application that it warranted its very own blog post!

Resolute is the name given to Epic's hospital and professional billing systems. Truth is, I don’t know why the billing systems are called Resolute, so here are some findings from my research that may give us clues as to where the term possibly originated.

The Merriam-Webster dictionary defines resolute as “marked by firm determination” or “bold/steady,” derived from the Latin word resolutus, meaning “loosened, released and paid.” So Epic probably used this adjective-based word to show that with our billing systems, we will be adamant, firm and persistent!

Digging deeper, we can research further why Epic may have chosen the name Resolute.


Operation Resolute (Balkans) - British portion of the NATO-led, peacekeeping force in Bosnia and Herzegovina.

• Some insurance companies are rather fierce with their claim denials and rejections!
• Resolute can be seen as a "peacekeeping force!"

HMS Resolute 

Operation Resolute - The Australian Defense Force contribution to patrolling Australia's exclusive Economic Zone

• The billing office is like a force protecting GBMC's Economic Zone.

HMS Resolute (1805) - A British Hulk or Floating Prison

• I know this is a tough job, but this would be pushing it a bit far...

How about:

Resolute Desk - The Desk in the White House Oval Office

• The very desk that the President sat to write the Affordable Care Act! He hears and sees all the key words like: Insurance, rejections, denials, premiums, accessibility, less waste. Hmm, I may be onto something...

I was going to check with Alex, my Epic Hospital Billing Resolute Application Manager but we were too busy with our Build Bucket 1 tasks. And I knew you would ask: "What is a Build Bucket?" Good question! Keep reading our blog because we'll cover that another time.

Jonathan Schoemann

Epic Access and Revenue Project Manager

Timehop Tuesday

GBMC and Epic, Unite!

As we enter the summer months, I want to take time to reflect on a recent trip to Verona, Wisconsin. As part of its physician engagement program, Epic has developed a physician overview course intended to impart a deeper understanding of how to utilize their system.

In April, I was able to attend this class with Dr. Hmu Minn in Internal Medicine, Drs. Renu Thomas and Angela Yin with the Hospitalist group and William Zirkin in the Emergency Department. One of the first lessons learned when we arrived in blustery Verona was that one must pack and dress appropriately for a spring trip to Wisconsin! As we entered one of the classrooms, I was impressed by the number of physicians from various other healthcare organizations around the country. Here are some of the stats from the course.

The two-day course was packed with content and information that is new to all physicians using Epic. We were able to learn about many of Epic's functionalities and potential enhancements over our existing electronic medical record system, including Epic's user-friendly patient portal.

Getting Trampled by a Mammoth!

Despite the information-packed days, we were able to find time to tour Epic's sprawling, unique campus, as well as to interact with some of their distinctive artworks.

At the end of our visit while we waited for our departure at the Milwaukee airport, the group and I discussed over breakfast about what we learned and the endless possibilities of delivering care using Epic as our EMR. We came to the conclusion that Epic will be an excellent tool for us to provide the care we would want for our own loved ones, and we look forward to bringing its incredible potentials to GBMC.

Check out some of our other photos from our trip!

Dr. Zirkin Freezing

Epic, A-Z

Over the past few weeks, we have given you the names and definitions of several Epic applications that are coming to GBMC. You may have been wondering where in the world some of these names came from. To help you out, we have made a list of the ones most commonly associated with head-scratching and provided a brief explanation of origin.

ASAP (Emergency Department) – Things happen in the Emergency Department very quickly, which is how the application got its acronym, As Soon As Possible.

Beacon (Oncology) – A beacon is something or someone that guides or gives hope to others.  Cancer patients look for a “beacon” of hope after diagnosis.

Beaker (Lab) – Named after the common piece of lab equipment, not the Muppet.

Cadence (Scheduling and TeleTracker) – Much like its literal definition, (a rhythmic, steady beat of sound or words), this application keeps the beat of GBMC’s busy scheduling and patient movement.

Canto (Mobile Phone Access) – A canto is a “chapter” or primary division of a long, epic poem. This application is Epic’s smallest version of Hyperspace, the overall umbrella of all Epic applications and functionality.

Cogito (Encompasses Clarity, analytics, Reporting Workbench, Radar dashboards, registries and reporting content) – As Juan noted in his blog post last week, “cogito” is short for the Latin phrase, Cogito Ergo Sum…“I think, therefore I am.” This blanket term, Cogito, is used to describe everything related to reporting and analytics in Epic. The applications and functionality included under this blanket do a wide variety of thinking and analyzing for Epic.

Grand Central (Registration and Patient Movement) – Like Grand Central Station in New York City…it is the hub of patient movement at GBMC. As an additional FYI, this application will be replacing our current TeleTracking system.

Haiku (Tablet Access) – Much like Canto, this application’s name has a poetic origin. A haiku is a type of short, small poem. The application is a smaller version of Hyperspace.

Healthy Planet (Population Health) – Making the planet healthier, one patient population at a time.

Hyperspace – The overall umbrella of Epic applications and functionality. When someone logs onto Epic whether it be on their computer or a mobile device, they’re logging into hyperspace! (No Millennium Falcons included for you Star Wars folks, sorry!)

Kaleidoscope (Ophthalmology) – You may remember playing with a kaleidoscope as a child, seeing the colorful shapes and patterns as they change. The word kaleidoscope is derived from three Greek words: kalos (beautiful), eidos (form) and skopein (to view). Like the toy, your eyes function as a kaleidoscope for your body, allowing you to see beautiful things.

MyChart (Patient Portal) – When a patient refers to something that belongs to them, they say “my.”  This application grants patients access to their medical chart. GBMC patients will, however, continue to know this as “myGBMC.”

Optime (Surgery) – This is short for “operating time.”

Radiant (Radiology) – Various imaging and radiology departments work with different types of radiation, which is where this application gets its name.

Rover (Barcode Medication Scanning and MobiLab) – Rovers commonly refer to different modes of transportation, which allow movement. The Rover application assists with improved workflow by allowing clinicians to review information, document and perform other key workflows “on the go.”

Hippocrates

Stork (Labor and Delivery Clinical Documentation) – We have all heard the stories about a stork flying through the sky carrying a bundle of joy in a cloth and then dropping the baby off at the doorstep. The Labor and Delivery Department brings babies, just like storks.

Willow (Pharmacy) – Did you know the bark of a willow tree has therapeutic effects? The bark contains a chemical called salicin. When consumed, the body converts this to salicylic acid, which is the key ingredient in aspirin. This knowledge has been around so long that even Hippocrates, the Greek physician, noted its benefits!

We hope this gives your head some relief as you continue to increase your Epic knowledge!!

-Laura Jo Limmer
Instructional Designer

Embedded Analytics

René Descartes

If you got past that title and you are still reading this, thank you!  In all seriousness, we have lots of exciting developments to look forward to as part of the Epic implementation.

For starters, we get to say “Cogito.”  Ask any Epic colleague, and he or she will be happy to correct your pronunciation (KOH-gee-toh) and explain that it’s the name of the overall Epic analytics and reporting platform. It isn’t completely clear why this name was selected, although it was seemingly inspired by philosopher René Descartes’ famous phrase “ego cogito, ergo sum” (I think, therefore I am).

Speaking of caveats, as much as we will be able to do with Epic’s integrated electronic health record (EHR) and its embedded reporting tools, it is important to remember that these are still only tools. Lean processes aligned with our strategy and clearly defined metrics are still key drivers for any successful implementation. Therefore, in this post I would like to highlight a few items in two key areas.


1) Data Governance.  Organization-wide Lean efforts and projects such as the GBMC Integrated Data Warehouse have given us several opportunities to discuss and agree to standardized metric definitions. By necessity, the scope has been limited to the areas under consideration. With the broad-ranging Epic implementation, and the time and people dedicated to this effort, we have a unique opportunity to address key measure definitions right from the beginning of the process, communicate accordingly across all entities, standardize and provide ongoing governance. Although some of us might complain about what may be perceived as cumbersome and time-consuming steps, Epic brings to the table well-thought-out and comprehensive project tools for just about every step of the implementation.  We can leverage these tools to ensure that we are identifying and defining key metrics and priority reports. In the near term, steps include workflow adoption meetings and report content sessions.  Whether reviewing application workflows, reports embedded in the screens or back-end reports, our challenge is to maintain consistency in how we input, retrieve and interpret information.

2) Reporting Tools.  At GBMC, we can be proud of having access to state-of-the-art reporting tools such as our existing SAP Business Intelligence reporting platform. This platform, which provides us with tools such as Crystal reports, makes up the front end to our data warehouse and enables us to schedule and distribute reports organization-wide. With Epic, we will continue to leverage those tools. For example, we can use Crystal to author reports through Clarity and use the Web Intelligence query tool for the Cogito Data Warehouse. A huge new advantage to this is that we will now be able to embed a lot of that information up front in near real-time. Reports pulling more than 5,000 records over long periods of time will continue to be generated overnight with tools such as Clarity. But for data pertaining to shorter time frames and fewer records, Epic’s Reporting Workbench and Radar tools now provide us with the capability to display real-time information, for example as a dashboard chart or a table.

Clinical Metric Trends Screenshot

Additionally, Epic will give us the ability to benchmark against other Epic clients as well as against national goals. This opens up a whole array of exciting possibilities. Imagine being able to see key quality outcome metrics, as of today (as opposed to a month ago), on a unit dashboard along with a comparison to benchmarks. During the report content sessions, application report leads (ARLs) from each application team and report writers from the reporting team will begin reviewing the Epic-delivered standard reports with the subject matter experts (SMEs). ARLs will continue to focus on reporting workbench reports, while the centralized reporting staff focuses on Clarity and other report tools.

As Cogito project manager, I will coordinate those efforts. Our challenge will be to identify any critical gaps between the foundation reports and GBMC requirements and to ensure we deliver fully tested and accurate go-live critical reports on Day 1.

I look forward to working with the various stakeholders and helping to answer any questions you may have. And if you think this was an exciting topic, wait till my next post on statistics.

Juan Negrin
Reporting and Analytics Project Manager

What's That?

If you’ve been asking yourself that question in regard to Epic the past few weeks, then this post is for you! Now that the Epic implementation at GBMC is in full swing, you may be hearing a lot of “Epic speak” and unfamiliar terminology. We hope to clear up some of that confusion for you.

Below are some Epic words, applications and their definitions that you’ll want to understand as we move further with the Epic implementation!

• ASAP -- Emergency Room
• Beacon -- Oncology
• Beaker -- Lab
• Cadence -- Scheduling and TeleTracker
• Canto -- Mobile Phone Access
• Clin Doc -- Inpatient Nurse/Ancillary Staff Workflows
• Cogito/Clarity -- Executive Reports, Data Warehouse and Date Repositories
• Epic Everything -- Meaningful Use
• EpicCare Ambulatory -- Ambulatory Clinical Documentation
• EpicCare Everywhere -- Interoperability with other organizations, both Epic and non-Epic
• EpicCare Inpatient -- This is the umbrella over Clin Doc and Orders
• EpicCare Link -- Non-affiliated Web-Based Provider Access
• Haiku -- Tablet Access
• Healthy Planet -- Population Health
• HIM -- Medical Records, Health Information Management and Abstracting
• Kaleidoscope -- Ophthalmology
• MyChart -- Patient Portal
• Optime -- Surgery
• Orders -- Inpatient Physician Workflow
• Ortho -- Outpatient Ortho
• Prelude/ADT/Grand Central -- Registration and Patient Movement
• Radiant -- Radiology
• Resolute Hospital Billing (HB) -- Hospital and Technical Charging
• Resolute Professional Billing (PB) -- Professional Charges
• Rover -- Barcode Medication Scanning and MobiLab
• Stork -- Labor and Delivery Clinical Documentation
• Willow -- Pharmacy
• Workbench and Radar -- System Reports

Since you’re all a part of the Epic implementation, we hope you find this post helpful for when you start hearing these words used more!

Also, congratulations to Laura Hines for winning our Epic contest and answering the question correctly in Josh Von Reuden's blog post, Technically Epic!


Laura Jo Limmer
Instructional Designer