Epic XGM26 FOMO generator: AI-powered analysis?

AI getting into forms, reports, finding reporting workbench reports you need OR launching slicer and CHOOSING THE RIGHT DATA MODEL? Waat.

My frustration with reporting workbench has been: we have too many for me to figure out which is the right one to dig into to get my answer. Now, ask a question to the LLM-powered engine and it will search for you. Better yet, if there is not a reporting workbench report, it will FIND THE RIGHT DATA MODEL IN SLICER and run your first pass for you. OMG. Simplifying the complex.

 

Epic XGM26 FOMO generator: Draft Smartforms from an Image

OK, is this magic? Because, AI will now take a PDF or AN IMAGE YOU DREW ON A NAPKIN and make a smartform.

I will just leave this here. My brain is broken.

Oh, why don’t we just turn that into a registry? Sure…

 

Epic XGM26 FOMO generator: The Intelligent Visit

What the heck is an intelligent visit?

ClinAC01 Clinical Advisory Council Welcome

A smattering of innovations presented quickly:

Highlights: Rover Desktop: using Rover connected by cable to a display can drive the display to show and interact with HYPERSPACE. Waat.

Chart with ART for nursing. Able to capture voice conversation and fill in: Vitals, I/O, more than flowsheets: activity. Expressed education understanding. Planned discharge date. Whoooo.

Chart with Art inbasket reply will soon incorporate upcoming appointments, chart insight summary, and then re-draft a reply (version Nov 25). From narrative, be able to abstract SDOH into the circle.

Storyboard will soon be able to place Cologuard or FIT testing without leaving the storyboard (!)

DANbient, being trialed by Group Health, using Chart with ART will allow prompt customization of the note, resolving HCC alerts dynamically as diagnoses are captured in narrative in addition to capturing orders and diagnoses in the conversation.

Haiku will soon have Web hosted note editor: full Notewriter tools that is visible and editable on mobile (?!)

Too much to summarize. Thanks to our developer friends for another rush of new features.

The Intelligent Visit demo:

Emmie interviews the patient ahead of time

The MA/RN can review the patient’s med records and updates IN LINE

Visit topics get an intelligent problem-based summary in line

Orders, diagnosis generate dynamically, not needing to pause to do so. Progress notes flow in, based on diagnoses.

All the pieces work together.

Things are happening, people.

Epic XGM26 FOMO generator: Taiwan Little Eats

Madison little delights. I love having hometown food in Madison, specifically Taiwanese food. This tiny place has been in business for years and I’ve loved dropping in here; almost never busy, and the flavors are authentic. Thanks to Steve Rotholz for a nice informatics chat during dinner. Cheers!

Epic XGM26 FOMO generator: Danny Lee and Bala Kulandaivel, Johns Hopkins

A pediatric DKA risk score!

It was great to see Dr. Danny Lee and Bala Kulandaivel at their poster. They did the hard math to create a predictive model that detects pediatric diabetic ketoacidosis, and displayed it on the multi-provider schedule and on in patient trackboard units.

Congratulations to their achievement! This is hard work, difficult math, really hard tuning to make the alerts relevant to busy physicians/providers in an acute care setting.

Reflecting on our own journey with the Epic Sepsis model and other deterioration scores, we found:

  • Signal to noise ratio tends to be low (in our case about 9% initially, later improved to 30%, still low) even with the best mathematicians and models
  • Acute care clinicians are too busy to look at the scores, and don’t trust them “when my patient looks good right now. I have to go see the sicker patients down the hall, I will not act on your alert now”
  • Consider giving these alerts to a separate virtual team that can surveil ALL patients in the hospital and know what to do for these early warning alerts.
  • Be verrrry careful in the socio-political swoop in when you call a rapid response team to take over patient care from the primary team when you think a “true positive” is detected. This is where we stumbled a number of times.
  • It takes publicizing some “good saves” that might have gone against the primary team’s instincts of “that patient looked fine, and then they crumped for no reason” especially if the virtual team spotted the possibility hours before, but were rebuffed.

These are some details of our difficult journey to the acceptance of predictive alerts like this.

To Dr. Lee and team, great work on a new predictive model! and best wishes on avoiding some of the potholes on this really important journey toward a successful intervention! We will be eagerly watching!

Epic XGM26 FOMO generator: Scott Macdonald with Prospective Consent for AI Scribe

Dr. Macdonald meets the challenge of the California need to consent patients prior to using an AI scribe.

California is a “two party state” where both parties must consent to any recording. This applies to AI scribes in the exam room, and can be a bother to manage correctly with every visit with every patient. For some organizations this is millions of times per year.

Dr. Macdonald’s big idea?

Set a smart data element as part of the question for any clinician to ask the patient “OK if my AI scribe writes my note today? If ok for your visit with me, OK if all your future visits with UCDavis clinicians can do the same?” (my paraphrase, his wording is of course better). If the patient answers “yes” which they do the vast majority of time, then the EHR stores that and shows it to all subsequent clinicians throughout the organization, so no need to ask again. ONE consent, ONE time, revokable by patient if needed.

SO SIMPLE. Thanks, Scott, for this innovation.

Epic XGM26 FOMO generator: Modern Note Design and DAN

Eric Shelov and Margery Schonfeld from Childrens Hospital of Philadelphia tell us how Modern Notes are done. Listen up!

It is impressive what Drs. Shelov and Schonfeld have accomplished and also measured, in their efforts at improving progress notes, inpatient and out. They used disappearing help text, linking out just-in-time, Diagnosis Aware Notes, and have a plan to migrate to DANbient. Seriously, take a listen to this talk when it is published on userweb. Totally worth it. Some screenshots to whet your appetite.

Epic XGM26 FOMO generator: Inpatient events and draft hospital course

How are inpatient AI tools coming along? Inpatient insights and draft hospital course both with great adoption and satisfaction.

PAC04

Pretty well, it turns out. St. Lukes and Inova colleagues show us: the tools work well and their front line clinicians love them. Thanks to our smart colleagues!

Epic XGM26 FOMO generator: Agent Factory

Agent Factor within Epic. Imaging vibe coding your own agent to connect data and take actions. Is it a dream? Yes. Is it coming soon? Also, yes.

PAC Welcome post #2, this deserves its own observation

AGENT FACTORY.

For example, have a high risk evolving situation, a measles case unintentionally exposing a host of staff and patients in a hospital? Create an agent to assess the exposure, follow procedure, notify and act! Low or no-code assembly. Epic is developing a workspace for organizations deploy agents within Epic. Available soon.

It is possible that this will transform physician informatics from coding deep in the Epic code to becoming vibe coders, using their deep knowledge of clinical workflows and best practice design to interact with Epic more efficiently and build sophisticated tools.

The future is here.

Advances in Pharmacogenomics (PGx) — The Next Chapter of Personalized Medicine at UCHealth (guest bloggers Dr. James Martin and Dr. Nicole McDaniel)

Pharmacogenomics continues to accelerate: we are no longer just identifying patients with impactful genetic variants, we are embedding that information directly into care. What started as population screening has evolved into real-time, clinical-first decision support, from completely healthy biobank participants to patients with cancer about to start high-risk chemotherapy.

2025 Milestones at the Colorado Center for Personalized Medicine Biobank…

Our team (CCPM in partnership with UCHealth) has reached new heights.

  • Over 100,000 biobank participants now have PGx results
  • More than 1 million PGx results are available in Epic

These results are not just sitting in charts, they are fueling clinical decision support across the system, helping providers make safer, more appropriate prescribing decisions at the point of care.

And the impact?

  • >34,000 drug-gene interaction alerts delivered directly to clinicians
  • Coverage across 12 genes and 55 medications

Key high-impact drug–gene pairs supported by clinical decision support span a broad range of medications across multiple areas of medicine, including DPYD–fluoropyrimidines (5-FU, capecitabine); CYP2C19–clopidogrel/SSRIs/PPIs; CYP2D6–opioids (codeine, tramadol), antipsychotics, antidepressants (e.g., venlafaxine, vortioxetine), metoprolol, and ondansetron; TPMT/NUDT15–thiopurines; and SLCO1B1–statins.

 

Meanwhile, in Clinical Oncology…

The Clinical Oncology PGx program has rapidly scaled from pilot to systemwide implementation, reaching > 1,000 patients who had PGx results returned to Epic.

In just 5 weeks during the summer of 2025, PGx testing in GI Oncology expanded from 5 clinics to 11 clinics across UCHealth.

New clinics onboarded included:

  • North: GRMC, MCR, HRMNY
  • South: MHC, MHN
  • Yampa: YVMC

This marked a major milestone, the first clinical PGx initiative originating on the CU side to be successfully implemented systemwide at UCHealth.

Alerts tied to this initiative are actively informing care by delivering patient-specific chemotherapy and supportive care dosing recommendations, reducing toxicity risk, and optimizing treatment in real time.

 

And There’s More…

Building on this success, our teams have taken on their next challenge:

  • Expansion of clinical-first PGx testing into breast oncology went live February 2, 2026
  • Next Expansion: inclusion of all other solid cancer types; go-live date is to be determined

Using the same infrastructure, workflows, and CDS tools developed in GI Oncology, this expansion represents a major step toward scaling precision oncology across disease groups.

 Join us next time… 

As PGx continues to evolve from innovation to standard of care:

  • More patients will receive pre-treatment, actionable genomic insights
  • More clinicians will rely on real-time clinical decision support powered by discrete genetic data
  • And more lives will be impacted through safer, more precise medication use

CCPM and UCHealth are no longer just piloting pharmacogenomics; we are operationalizing it at scale.

Thank you for joining us for the next phase of our adventure.

[Blog Editor’s note: We cant wait! I love having smart, effective colleagues]

James Martin, PharmD, MPH
Clinical Pharmacist, Pharmacogenomics Instructor
University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences
Colorado Center for Personalized Medicine

Nicole McDaniel, PharmD, MPH
Clinical Pharmacist, Pharmacogenomics Instructor
University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences
Colorado Center for Personalized Medicine