What Epic Means to Me – Pharmacy

What Epic Means to Me – Pharmacy 2018-12-05T09:57:45-08:00

We recently sat down with some of SFDPH’s Pharmacy leaders to talk about the Department’s implementation of the Epic Electronic Health Record. We hope you enjoy hearing their thoughts and learning from their perspectives.

Lenny L.S. Chan, PharmD, CDE; Clinical Pharmacist, Primary CareLenny L.S. Chan, PharmD, CDE; Clinical Pharmacist, Primary Care

Q: What do you think will be the biggest benefit of SFDPH having a system-wide EHR?
LC: The biggest benefit will be safety and efficiency. Providers and staff have tried looking for patient information they need but with the current EHR, they either spend a lot of time looking for that information, or they may not find it at all (think discharge information, ER visits, and medication dispensing record – everyone now is on a different system so even if we have LCR to centralize the information, it’s not easy to find the right information, and easy to interpret or transcribe the wrong information). This lack of organization or access to relevant information creates safety and efficiency problems for our staff and providers, and eventually our patients. Also, Epic is more intelligently designed, and provides relevant information at the time of decision making, allowing providers and staff to do what they are trained to do – to make the best decision in collaboration with patients.

Q: How do you anticipate that Epic will impact our patient care?
LC: Providers and staff can spend more time discussing treatment options with the patient, finding the relevant clinical information so we do not miss doing something or duplicate someone else’s work or treatment. As a pharmacist, more accurate allergies and medication history will greatly improve safety and the patient experience.

Q: In one word, how would you describe how you feel about SFDPH implementing Epic?
LC: Determined

Michelle Fouts, PharmD, BCPS; Director of Pharmacy; Associate Chief Health Information Officer:

Q: What do you think will be the biggest benefit of SFDPH having a system-wide EHR?
MF: With Epic as a single source of truth with discrete data elements, we will be able to measure our work and continually improve.

Q: What do you think will be our biggest challenges as we go through implementation?
MF: We have to remember that this is a marathon, not a sprint. It is important for all of our staff to take care of themselves during the challenging months ahead as we stretch our resources to be ready for go-live. For me and my staff, this has meant committing to eating healthy, making time for exercise, getting plenty of rest and being sure to get much needed downtime.

Q: In one word, how would you describe how you feel about SFDPH implementing Epic?
MF: Optimistic!

Tamara Lenhoff, PharmD, BCPS, Inpatient Family Medicine & Transitions of Care Clinical Pharmacist, Assistant Clinical Professor and PGY1 Residency Coordinator, UCSF

Q: What does Epic mean to you?
TL: Connection and open communication. We will finally have one system for clinics, inpatient stays, LHH, jail, ICU, ED, etc. I feel like much of my job is doing what I call “chart biopsy” on our patients: looking in the many different systems for when an allergy was developed and what their reaction may have been; identifying what outpatient medications they are taking so that I can continue them as an inpatient; knowing what medications did we start or change as an inpatient that I hope the PCP will continue as an outpatient. As a clinical pharmacist on the Family Medicine service, some of these transitions of care are eased by the emails my team sends to the PCP. With one system, these emails should become unnecessary!

Q: Since you’ve used Epic before, what do you think other staff would need or want to know about it?
TL: They will be surprised by the amount of information that is available to them immediately. For example, when validating an order for electrolyte repletion, the order will come along with the latest potassium level so that we can safely validate the order. Because validating orders becomes more intuitive and easier, we will now have time to do more clinical work such as dosing per pharmacy protocol. Also, we can write internal notes, secure chat, send messages through the inBasket making communication more seamless. Nurses can now send an inBasket message asking for a missing dose instead of calling down or text paging the pharmacy. The pharmacy can respond to the inBasket message telling them the status (eg. “tubing”, “making it”) and [the communication] is time stamped so everything is nicely tracked. This will mean fewer phone calls to the pharmacy and the phone calls that do happen from hospital staff usually become more clinically relevant (eg. IV compatibility or dosing recommendations).

Q: How will Epic make your job easier?
TL: Scoring systems! Currently we have to manually screen patients in for high-risk criteria to determine who should receive discharge med counseling from a pharmacy representative while inpatient. This can be quite subjective. With Epic, we will have an automated objective scoring system based on our current criteria, saving us time for more patient-centered care, such as discharge counseling. Also, Epic will be integrated with Meducation (a calendar building program). When the discharge medication list is finalized, a calendar can be produced in patient-friendly language. This will also save time for pharmacy staff who currently manually build these calendars.

Q: In one word, how would you describe how you feel about SFDPH implementing Epic?
TL: EXCITED. I joined SFGH 5 years ago hoping and praying for the day we would get Epic. And the time is finally here!

Check out what’s new for Inpatient Pharmacists in Epic 2018!