Piedmont Athens shares lessons from an Epic installation

A Georgia facility, recovering from a difficult installation of a previous records system, sought to have a better experience with their most recent effort.

Piedmont Athens, formerly known as Athens Regional Medical Center, generally met with success in its installation of the Epic electronic health records system, but encountered some challenges that it had not expected.

The facility became part of Piedmont Healthcare System in October 2016; it was coming off a particularly difficult installation in 2014 that cost the jobs of several executives. In becoming part of the Piedmont delivery system, facility executives knew it would be migrating to the Epic electronic health record.

In August, Piedmont Athens did a big-bang inpatient and outpatient installation that met with more success, and learned some valuable lessons along the way, says Geoffrey Brown, chief information officer.

For starters, they learned to let the emergency department, physicians and nurses create their own workflows for the new system because they are more familiar with what they want, and afterwards will support the transition because of their ownership of workflows.

The overall nursing staff “totally drank the Epic Kool Aid” because other nurses coming to the organization raved about the vendor and its EHR, Brown recalls.

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Nursing staff strongly favored the shift to the Epic EHR, but physicians had a tougher time, as there were fits-and-starts of implementation. They had to train on an old Epic system in 2014 when it looked like the organization was going to Epic and then had to go through more training for the recent implementation. “That’s four hours not seeing patients along with the stress and trials of getting trained,” Brown acknowledges.

Overall, 80 percent of the Epic departmental implementations went well, says Charles Peck, MD, CEO at Piedmont Athens. “Much better was nursing and pharmacy, which had great leadership and preparation that made a big difference,” he says. “A newer chief nursing officer did a great job getting nurses ready as well as the pharmacy, and the central Piedmont IT team supplemented our team.”

However, installing the Epic Beaker laboratory information system was a challenge.

Any lab system is going to be challenging, Brown acknowledges, but the complexity of Beaker was not expected, with several different analyzers and problematic workflow issues. “We tried to over-stack the deck at go-live with Beaker,” Brown says. “Procedurally and operationally we had technical concerns that continue.”

That included differences between the new workflow in place for outreach labs and the organization is still working on some scheduling and registration issues. Work continues on bringing labs together with centralized workflows, according to Brown. “The challenge is doing thousands of tests and trying to get them all on the same page.”

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Change management also came in to play, as Epic has new modules that support patient movements, infection control, sports management and home health, among others; and real-time transcription through the Dragon Medical speech recognition system.

Despite the tribulations, CEO Peck views the implementation as a big success. “Other than the newness of Beaker, I’d say it was as good as could be hoped.”

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