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

Epic XGM26 FOMO generator: Outside the Ivory Room Piano Bar

Sometimes, the meeting outside the meeting is where the magic happens. Thanks for the hangout, friends!

Due to the talks I’ve given and my bad ukulele playing, I have fooled some into thinking that I am an extrovert. They would be wrong. I am an introvert, who has learned to put on the Suit.

I intentionally put on my Extrovert Suit for UGM, XGM, and other meetings, and push myself to go meet people. The introvert avoids large crowds, but also recognizes that meeting people and building relationships with friends always pays off in the long run. Research proves this viewpoint right among train riders.

This evening, as in past years, I agreed to meet friends outside the Ivory Room Piano Bar. The introvert in me insisted I return to my hotel room. I’m glad I did not listen.

Above, my new besties: Deborah Russo, Emily Webber, Sue Chang, (me), Penny Fu, Eugenia McPeek-Hinz, Dirk Stanley. Thank you to Ken Angle, photographer.

I am reminded and amazed at the brainpower, skills and accomplishments of my peers at XGM. Our generation of informaticists have been at ground zero for many EHR implementations in the past 2 decades, have shared their lessons, stories and cautionary tales so that we are all better. There are no signs that EHR work is slowing down, as health system consolidations, EHR swaps and optimizations continue in our industry. Informaticists who understand “It’s Not About the Tech” will be needed for quite a long time to come.

We happy few, we band of sisters and brothers, love to hang out and swap stories. (Sorry, late nite posts lead to hyperlink madness) Many of us are introverts, and end up pushing ourselves to come to public events, and end up enjoying ourselves most, just OUTSIDE of the venue, as we did this evening, where we can hear ourselves think and chat, while our colleagues are inside singing their hearts out.

For years, I went to conferences, optimized the sequence of presentations I’d attend, studied the slides and take home notes. It took a long time for me to understand that equally important, if not more so, was to meet and make new friends, re-connect with existing ones, and nurture relationships. You never know who might have the insight that unlocks a problem you’re trying to solve. “Phone a friend” is always a good option in our work. Phone a friend also works great for commiseration.

More new besties pictured: Menaka Prakasam, informaticist; John Tate, application manager, Angad Singh, ACMIO, University of Washington, Jason Hill former ACMIO and now Vice Chair Hospital Medicine at Ochner, Gunjan Dalal, informaticist; (me).

“Just outside the piano bar” has been one of the best places at XGM, for me. Thank you for sharing your journeys, your struggles, your joys.

In the Age of AI Acceleration and Fear Of Missing Out on the latest news and the greatest technologies, it is so great to take a breath, shake hands, hug, and be ourselves. I am grateful to be among such wonderful humans.

Thank you.

Epic XGM26 FOMO generator: ClinAC024: 40% use of Inbasket ART drafts at John Muir

Please tell us the secret sauce. John Muir lays out how they did it: their physicians and nurses use In Basket draft reply more than 40% of the time and growing, and their residents are part of the AI governance.

This talk is a must-watch when it comes out on userweb.

  1. In Basket Art is a dedicated project to tune and continuously improve
  2. Residents involved in AI governance is fantastic and useful idea. Not the least of which: when should students/residents have access, and to which tools? Have them part of the conversation re: skills, timing, graduated learning. Well-thought-out.

Epic XGM26 FOMO generator: Deep Space and the Epic learning center. Take a breath

Just a reminder to take a breath during the craziness. Or to send FOMO your way (sorry) for non-attendees at XGM.

It occurs to me that I’ve been coming here since 2009. That would be … 17 years. Either XGM or UGM or sometimes both. It is always great to spot friends in the crowd. In the last few days: Tom Wessel, Dirk Stanley, David Bar Shain, Aram Alexanian, Chris Alban, Gwen Kerby, the scroll is gratifyingly (terrifyingly?) long.

Epic has built a tradition and community that is stronger for the individuals and organizations that come here repeatedly to learn from each other and share best practices unselfishly. See my MMOLC post from a few years back.

Sometimes the introvert has to sit in the corner when the big sessions start just to be quiet and recharge before diving back in.

Or go for a quick Cow Bike ride.

To all, thank you. Instead of FOMO, I am profoundly grateful to all of you.

 

Epic XGM26 FOMO generator: RAC15 Epic Cosmos Data-thon (and ukulele)

RAC15. From adoption to acceleration: Building scalable research pipelines with Cosmos. Don’t be fooled! Excellent session about the Epic Cosmos Datathon done right! (and a ukulele song summary)

Brilliant colleagues Jennifer Goldman MD and Claudia Masihy from Memorial Healthcare System in Florida, and James Gray MD, Kacey Appel PhD and Stephanie Hotze from Cincinnati Childrens Hospital spoke about taking Cosmos to the next level with the Datathon in their organization.

Dr. Goldman explained the nuances of building a sustaining community. Crucial point: Get your IRB chair to be comfortable that the entirety of COSMOS is deidentified. Then ALL projects via Cosmos are already IRB Exempt! Am I dreaming? 

Then, bring your Epic experts, your statisticians, your research experts, get the competitive juices flowing between your clinical departments, and the race is on to write the best paper IN ONE DAY. This is the way to hold an Epic Cosmos Datathon.

More community building.

The results speak for themselves. One-day datathon. So much output.

Cincinnati Children’s built similar cultural bridges.  

Then some dude came up with lyrics. “Epic Cosmos Datathon” has the same number of syllables as “Carry On My Wayward Son.” Did a recording of the song survive the session? Time will tell.

Thank you to brilliant colleagues, 300 million patients in the Epic Cosmos database is available to researchers and quality specialists using Epic. A rising tide raises all boats.

Bonus: lyrics by CT Lin and Jennifer Goldman. “Epic Cosmos Datathon”

Epic Cosmos Datathon
via the original:  Carry On My Wayward Son. Kansas

Epic Cosmos Datathon
Write your paper when the day is done
Ask a question, Slicer does the rest
Don’t you cry no more

I was mired in the noise and confusion
Needed data from beyond my institution
I was asking all my questions, but I got no reply
300 million patients, now I see a pattern
Got my question answered, this is what matters
IRB exempt? am I dreaming?
Now I hear the voices say 

Epic Cosmos Datathon
Write your paper when the day is done
Ask a question, Slicer does the rest
Don’t you cry no more!

Epic XGM26 FOMO generator: Mark Mabus with “TURN IT ALL ON”

Mark knows how to rock out. He and his outstanding panelists from PAC08 (Parkview and Northeast Georgia Health System) showed us how to move fast on the suite of AI product deployments

XGM PAC08: Scaling up generative AI rapidly

I am amazed. First a few slides.

NEHS Georgia. Great way to lay out the challenge and principles.

I want to emphasize how hard it is to be organized enough to go this fast.

And the outcomes: impressive.

Dr. Mabus says some prophetic things

Physician Builders are evolving, especially with AI tools, vibe coding and the coming Agent Factory.

Get your microscope out. If you can read this, it could unlock your future. A governance grid on how worried to be, how fast to go, who to involve in AI governance for fast adoption.

Dr. Mabus gets it. Just-in-time education, explaining WHY so that docs are grounded in their new tools.

Dr. Mabus rocks out

And then, the coup-de-grace: Mark with an original rock song: TURN IT ALL ON. Thanks for letting us glimpse greatness, Mark.

Rock on, Garth!

Epic XGM26 FOMO generator: PAC Welcome, PAC mentorship and more

The XGM Epic PAC01 Welcome is a banger, as always. Hanging out with our Epic Physician besties, including CMO Jackie Gerhart. Amazing.

Firstly the PAC mentorship program is going strong. Thanks to Christina Jung, Esther Hyelim Park and David Bar Shain, the program is going strong with over 200 members. Come join as either mentor or mentee or both. See bar code.

Sam Butler, Karen Wong, Louis Kazaglis led our PAC welcome. Too much going on to jot it all down.

With 1000 of our best PAC friends

Some notes:

  • Prior Auth AI extracts data from the chart to support documentation
  • 23 organizations live on Chart with ART ambient notes
  • Diagnosis aware notes and ambient coming along. AND custom prompts like “make my after visit summary rec’s rhyme”. Really? Really?

  • Unlocking SDOH codified data out of narrative to promote taking action
  • An antibiogram to treat the patient with results of local urine cultures

What is here and what is coming soon.

Thanks, guys. Can’t wait to see what the rest of the day is like.

Return of the XGM26 FOMO generator: Ukulele: Epic Cosmos Datathon

Wanted to come to Epic XGM but could not? Or just want to see it through my eyes? FIRSTLY, I’m not on the agenda, but RAC15 COSMOS research is gonna have a secret presenter at the end: ME.

Memorial Health in Florida, and Cincinnati Childrens will present on Cosmos and their organization taking advantage of this 300 million patient database to promote research in an organization even with little investment. Amazing what smart, dedicated colleagues can do.

And a ukulele song! It turns out “Epic Cosmos Datathon” is the same number of syllables as “Carry on my wayward son!”

Will I see you there?
RAC15 at 430pm TODAY 4/27,
Location: “A Classic Episode”

Valley View Health go live on Epic

UCHealth is excited to welcome Valley View Health in Glenwood Springs, CO to our community connect partnership on Epic. Go lives are a pressure cooker and also a joyful experience for newbie informaticists.

I had the privilege of visiting Valley View Hospital, a terrific health system in Glenwood Springs. Their go live on the Epic EHR last week went very smoothly.

Thanks to the hard work of Foster ‘Fiji’ Goss MD, CMIO and Heather Gardner MD, ACMIO, the organization’s physicians were well prepared and met the challenge of go live day with philosophical calm. That is rare, and a testament to their planning.

Thanks also to Jon Pell MD and Heather Holmstrom MD from the UCHealth Senior PIG team (physician informatics group) for coaching and guiding our newest partners into the Epic EHR community.

It truly takes a village. We have taken over the local hotels and have many dozens (probably over a hundred) staff on site providing at-the-elbow support.

The weather also cooperated, it is a balmy 60s in the canyon and in the springs. A soak in the mineral hot springs nearby is the perfect balm for a 10,000 step day supporting docs, hospital units and busy clinics.

Lessons learned?

  • Listening is a superpower. Every go live we learn something new about providing care to patients. Shutting up and listening unlocks the possibilities. Sometimes listening means spotting a workflow improvement not related to the EHR! Win-win!
  • Waiting is also a superpower. Don’t overconfigure EHR tools in the first month. Wait until users get the hang of how personalizable the tools are before overdesigning and creating more work for everybody.
  • Managing transitions: Read the Book. In short, let people grieve their ending of the old ways, let people wander in the neutral zone exploring possibilities. Don’t slam them with new beginnings, everyone goes through transition at their own pace. Of course go live forces the issue … let’s hope you gave enough lead time to let these emotions surface and pass.
  • Rounding is a joy: you get to see amazing people at work, and the entire spectrum of care in hospital and in clinics— the variety is humbling.
  • Colleagues are what make this job a joy: smart technologists, trainers, clinicians, are all great people. Solving problems in the moment as they arise, what a rush.

Thanks also to my Epic IT colleagues and informaticists who sat around the campfire last weekday evening to listen to an impromptu ukulele EHR parody unplugged concert. The potential audience for ‘ukulele EHR parody song’ is limited to a few hundred people worldwide, so I don’t take it for granted. I am grateful to my besties for singing with me last week.

Songs we sang?

  • Valley View Rocky Mountain High (world premiere)
  • ChatGPT (to Sweet Caroline)
  • Hospital of the Rising Sun
  • Epic Man

Valley View Rocky Mountain High lyrics

She went [D]live in the [Em]summer, of her [C]twenty seventh [A]year;

Coming [D]home to a [Em]system she’d never [G]used before

She [D]left Meditech behind her, You might [Em]say she was [C]trained [A]again

You might [D]say she found a [Em]use for her [G]keyboard.

When she [D]first put down her [Em]script pads, her [C]life was [A]far away;

In [D]Hyperspace, [Em]hanging by a [G]thread

But [D]Epic was really [Em]tough for her, and she [C]found it hard to [A]care;

It keeps [D]changing fast, and it’s [Em]hard to stay [G]ahead

[G]Valley View [A]Rocky Mountain [D]high

We’re [G]saving patients and [A]we’re improving [D]lives.

[G]Friends around the [A]keyboard, [D]keeping our quality [G]high.

[A]Rocky Mntn [D]high, [Em]Colorado [G]

[A]Rocky Mntn [D]high, [Em]Colorado [G] [A7]

She [D]mastered Epic [Em]chart review, she saw [C]morning vitals[A] flow;

She saw [D]lab results as [Em]far as you can [G]see

And they [D]say that she got crazy once, and hit [Em]control [C]alt [A]delete

She thought she [D]lost her note, but it was [Em]saved in [C]memory [A]

Now she [D]works in quiet [Em]solitude, with a [C]keyboard and a [A]screen;

Making [D]sense of [Em]complex patient [G]history

Her [D]sight has turned [Em]inside herself to [C]try and [A]understand;

The [D]serenity of a [Em]collaborative [C]discharge [A]plan

[G] Valley View [A]Rocky Mountain [D]high

We’re [G]saving patients and [A]we’re improving [D]lives.

[G]Friends around the [A]keyboard [D]keeping our quality [G]high

[A] Rocky Mntn [D]high, [Em]Colorado [G]

[A] Rocky Mntn [D]high, [Em]Colorado [G] [A7]

New songs?!

And a couple of new songs I’m working on: ‘Something in the way she computes’ (Something by the Beatles) and ‘A Bridge to Nirvana’ (Stairway to Heaven). Perhaps these will show up at future talks.

Some of these songs are on my YouTube channel

YouTube.com/@ctlin1

NEWS FLASH: Epic Cosmos Datathon

Tomorrow 4/27 I’m at XGM and RAC15 Monday afternoon 4:30pm in room: ‘A Classic Episode’ Memorial and Cincinnati Childrens’ session on Epic Cosmos Datathon might have a guest appearance by me and my uke. Did you know that ‘Carry On My Wayward Son’ and ‘Epic Cosmos Datathon’ have the same number of syllables? Hmm. And they rhyme.