After implementing a good governance structure and clearing the issues backlog from the Epic EPR post-go-live phase, you will transition into the optimisation phase. There are several tools provided by Epic that can help you identify where your organisation may want to start. For example, you can use Epic Signal data, PEP data, and other utilisation reports to identify your organisation’s specific areas of focus. Signal data is largely grouped into four sections: Orders, In-basket, Chart Review, and Notes/Letters. In a recent Arch Collaborative report from KLAS Research, one Epic-based organisation used data to reduce the time providers spent at home charting by five hours each week, which adds up into large efficiency gains. Consider these found additional areas for potential benefit from a focused optimisation effort:
Workspace updates
- Snapshot reports: Ensure the snapshot reports available to doctors and end users have the pertinent information available in easily viewable sections that are readily accessible. Note that relevant sections may differ between users. For doctors, it could be sections that show their last progress note, results, etc.; however, nurses or healthcare assistants may need nursing notes, patient goals, or immunisation sections instead.
- Patient lists or Multi Provider Schedule: Patient lists or Multi Provider schedule are the primary activities doctors and end users access as soon as they enter the system. Hence, it is helpful to have all the columns and information available, relevant and actionable. During a go-live, a standard multi provider schedule or patient list is recommended, however an optimisation phase is an ideal time to revisit the patient list or multi provider schedule from a specialty-specific perspective. For example, Cardiac specialties might be interested in the last A1C and EKG to be visible on the multi provider schedule, however maternity services might prefer having pregnancy related data easily viewable.
- Chart Review filters: Standard filters for encounter department, specialty, cancelled orders, etc., are a great place to start; however, with new data flowing into the patient’s chart from various sources, it might be a good time to re-visit some of the filters in place. Validate with doctors and end users if their specialty filters work appropriately, especially if their provider record (SER) and log-in department have different specialties. This might also be a good time to reiterate the value of personal filters to help see relevant information more readily.
- Tool bars: The optimisation phase is a great time to review and hide or remove unused or infrequently used tools from all the tool bars. If a tool is not used frequently, consider whether the Epic menu or More Activities menu is better suited to home it. This phase is also a good time to remind users about the search function to easily access tools. User feedback and menu summary review will guide the cleanup of the workspace and remove clutter, streamlining workflows.
- Navigator/Activities: A good way to keep navigators and activities tidy is to group them and remove redundant sections, making an uncluttered workspace easier to look at and work in.
Specialty or Department Note-Writer templates:
- Macros: Note-Writer macros offer incredible functionality to quickly insert documentation into notes, and macros built for various patient conditions can greatly reduce documentation time during a patient visit. Epic-released macros are a great place to start, however during optimisation review and build, additional sharable macros are needed to speed up notes.
- Default SmartTexts/SmartPhrases: Default Smart Text buttons in the department build provide easy access to start a note. Users can also create their own SmartPhrase or SmartText buttons, which allows them to speed up the start of a note and customise it to their specific needs.
The optimisation phase, a dynamic period of refining workflows, presents an opportunity to enhance the user experience. Focused efforts in areas such as workspace updates, Notes and specialty-specific considerations contribute significantly to streamlining workflows. Snapshot reports, Multi Provider Schedules, Chart Review filters, toolbars, and navigators/activities all demand careful evaluation and customisation to align with the unique needs of different users and specialties.
