Epic Information Session Members of the Epic Clinical Research Team Updated, 6 March 2013
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.
What is Epic and Why Do I Care?
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
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
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 Evolving requirements for documentation
Benefits of Epic for Research 1. Research Indicator 6. Research registries APRIL 2013 2. Flagging orders & encounters 3. Research reports 4. Streamlined scheduling 5. Preference lists for ordering 7. MyChart for PROs 8. Temp logins for study monitors 9. Auto notifications for events 10. Recruitment alerts THE FUTURE
My Life on Epic
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
MAJOR IMPROVEMENT View Schedules Across Depts.
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
The Research Header
The Research Header
Study Details and Drilldown
Associate orders with a study
Flagged Orders in Chart Review
Flagged Encounters in Chart Review
Reporting on Study Subjects
Appointments at a Glance
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
Ordering: Preference Lists
Visit Documentation Signoff of completed orders Flowsheets allow for electronic documentation of research visits Standardized documentation of vitals, etc. No documentation requirements
Rollout: What Happens When?
The Thing to Remember Scheduling and Registration is SEPARATE from Ordering and Documentation for Rollout
Scheduling and Registration April 4, 2013 (Wave 1) FOR EVERYONE
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.
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 Clinical Research Units (including Bayview)
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 Paper
The OTHER Thing to Remember For the foreseeable future, special research requisitions (e.g., Pathology, Radiology) will remain PAPER BASED
Additional Information: Rollout http://www.hopkinsmedicine.org/epic/rollo ut/index.html
Preparing For Epic: CRMS
CRMS and Epic: Short Title Short Title Auto-populated based on first 100 characters of the Study Title
CRMS and Epic: Short Title What the Study Team Needs To Do: 1) Edit the Short Title so that it makes sense when in Epic!
CRMS and Epic: NCT Category NCT Category Added on General Tab Defines what type of Study you are running Consistent with Categories in Clinical Trials.gov
CRMS and Epic: NCT Category What the Study Team Needs to Do: Complete this information on the General Tab
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 Study Teams cannot modify this information
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.
CRMS and EPIC: Follow Up and Off Study Statuses What the Study Team Needs to Do: Update Study Participants to the Correct Enrollment Status
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 Description in Epic.
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)
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
Never Used CRMS? Questions? Contact the CRMS Team at CRMShelp@jhmi.edu There may be ways to import your subjects!
Epic Training
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
Access Request Manager (ARM)
Fields in ARM Role Type Wave Epic Template Epic Subtemplate Comments
Role Type Physician or Nurse: Ambulatory Clinical Other Study Team Members: Research
Wave If you need to schedule appointments Wave 1 If not Use the rollout wave for your location Use Wave 4 for the CRUs
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 Clinical Research Units (including Bayview)
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 T RESEARCH NON-CLINICAL1
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 Leave blank
If you re a clinician, your primary role in Epic is NOT research-related. A clinician s research role is a subtemplate. INCOMPLETE! Don t believe. If you need additional subtemplates, enter them in the comments.
Non-clinical personnel choose Research and their primary template is researchrelated. Still could be wrong! If you re not scheduling, no subtemplate is needed.
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
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 Register and take these classes NOW!
Complaints? Scheduling training 3 classes 24 hours Not counting e-learning pre-requisites Kelly Cavallio Administrator, Ambulatory Services kcaval@jhmi.edu (410) 502-5285
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
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
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
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 learning@jhu.edu and ask to be given the ability to enroll yourself in classes. E-Mail epictraining@jhmi.edu to ask for help.
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
THANK YOU Questions?