Epic Information Session - ICTR · window for your rollout wave — Bayview, Wave 2 — JHH except Peds, Wave 3 — Peds and CRUs, Wave 4 • Most classes have several e-learning

Epic Information Session

Members of the Epic Clinical Research Team

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 Research1. Research Indicator

2. Flagging orders & encounters

3. Research reports

4. Streamlined scheduling

5. Preference lists for ordering

6. Research registries

7. MyChart for PROs

8. Temp logins for study monitors

9. Auto notifications for events

10. Recruitment alerts

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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 IMPROVEMENTView 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

Is this study active or IRB approved

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/rollout/index.html

Preparing For Epic: CRMS

CRMS and Epic: Short TitleShort Title

– Auto-populated based on first 100 characters of the Study Title

What the Study Team Needs To Do: 1) Edit the Short Title so that it makes sense when in Epic!

CRMS and Epic: Short Title

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 SectionAdmin 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 AbstractWhat the Study Team Needs To Do

— Complete the Information in the PurposeSection 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 [email protected]

• 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

INCOMPLETE! Don’t believe.

If you’re a clinician, your primary role

in Epic is NOT research-related.

A clinician’s research role is a subtemplate.

If you need additional subtemplates, enter

them in the comments.

Non-clinical personnel choose “Research”…

…and their primary template is research-

related.

If you’re not scheduling, no

subtemplate is needed.Still could be wrong!

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— Schegistrar 101— Referrals and Benefits Collection

• Register and take these classes NOW!

Other Training: If you are a…• Physician Researcher

— Physician 100— Physician 200— Research 200

• Research Nurse— Nurse 100— Nurse 200— Research 200

Other Training: If you are a…

• Non-clinical PI, Co-I, Study Coordinator, Research Manager— Research 100— Research 200

• Other study team members— Research 100

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

• 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 [email protected] and ask to be given the ability to enroll yourself in classes.

• E-Mail [email protected] to ask for help.

Final Notes, Training• There are still classes with seats available

in Baltimore, in February and March• You MAY have to travel to Keswick or

Bayview• Most roles/classes have e-learning

prerequisites, so plan ahead

THANK YOU

• Slide set will be on the ICTR website and Epic Training website by Friday

• Questions?