Working within the bustling imaging and diagnostics department at ZSFG is no simple feat. According to Dr. Mark Wilson, Chief of Interventional Radiology and Chief of Radiology Services, the Interventional Radiology team was mobilized to come into the hospital eight times over the extended Labor Day weekend – a near-record number. It is an extensive and complex process every time a patient is referred to the team for an IR procedure. “The closest comparison would be a well-conducted orchestra, which is ready to play Beethoven’s Fifth Symphony any time of the day or night and multiple times throughout,” said Wilson, “It is our True North Orchestra.”
Using this analogy, envision this orchestra trying to work without the real-time ability for each musician to know what notes the other members of the orchestra are playing. Our Imaging and Diagnostics work is currently completed via use of many disparate systems that don’t integrate, according to Andrea Turner, Administrative Director of Imaging & Interventional Services. “So, we can’t share information while we are supposed to work in tandem to provide the care our patients need.”
According to Turner, who has been a part of three Epic implementations in her career prior to joining DPH, “Epic is one of the most vibrant EHR systems there is.” She is most excited about the aspects of the EHR that will make her role as an administrator easier by enabling gathering of metrics and forecasting in ways that is nearly impossible today.
Turner feels that Epic will help us with our pillars of the True North by providing valuable information on quality and safety, as well as financial stewardship and equity. “All of the information I need will be at my fingertips,” she explained. “It is going to be invaluable.”
Focusing on these benefits helps this team get through the challenge involved in successfully implementing. “Change is certainly difficult for everyone,” acknowledges Turner. “Our challenge is that people continue to cling to their thinking processes of what used to be.”
“So, we have to focus on how this will make our lives so much easier,” she said. “Afterall, no one wants our lives to be harder!”
Turner stresses the importance of the role of leadership in helping everyone adopt and adapt to the change. To ensure this is happening within her department, Epic information is included in the departmental newsletter, highlighted on the DMS board, and staff meetings set aside time to update the team on the latest Epic developments.
Jimmy Ho, Diagnostic Medical Imaging Supervisor, agrees. “It’s all very new,” he explained, “for me we are learning a lot, and it is exciting, but we still have so much more to learn.”
RJ Merck, Radiology IT Supervisor, has been with SFDPH for more than 20 years, and began his career as a rad tech. In 1999 with Y2K coding issues at the top of all IT minds, RJ got interested in the technology piece of radiology work. Since that time, he has been involved in a variety of disaster preparedness projects for DPH, which in a way uniquely prepares him for what is ahead as we prepare for the change involved in implementing a system-wide EHR.
The challenge, according to Merck, is that “there are some things that we currently do that won’t need to be done anymore, and things we don’t know yet may come up later.” However, he is happy to be involved in this project to be able to use his wealth of DPH experience to help the project be successful. “There are things I’ve stubbed my toe on for the last 20 years, which I can then be aware of and try to do something about,” he explains.
All of this doesn’t come easy. Merck admits to working many late nights with a keen focus on making sure that every decision is made with deliberation, and that prioritizing the work is a critical component of success. Some improvements will have to wait while the most urgent ones are achieved first.
Merck observed that there are a lot of people throughout DPH doing multiple jobs at once to successfully implement Epic, and that the same resources are being tasked to do a lot of the heavy lifting. “The timeline we have is rigid and compressed, which is a challenge,” he explained. “I am impressed and proud of what IT leadership has done to get resources on board, but our go-live date is aggressive and if we don’t get it right we will feel the pain.”
When asked how he could summarize how he feels about the DPH Epic implementation, Merck said, “I’m a little overwhelmed, but also hopeful.”
“But no matter what, at the end of the day, [this is] the right way to go.”
Term to know: Radiant
Using the Epic application Radiant, imaging providers will actively add to patients’ medical records, encouraging widespread coordination among all providers. Clinicians in and out of imaging departments contribute to and learn from shared allergy and medication lists, and visual track boards keep technologists up to date on patients’ locations.