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!
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.
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.
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?
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:
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:
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:
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 can’t 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
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.
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.
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.
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!
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
I am amazed. First a few slides.
I want to emphasize how hard it is to be organized enough to go this fast.
And the outcomes: impressive.
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.
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!
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:
What is here and what is coming soon.
Thanks, guys. Can’t wait to see what the rest of the day is like.
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”
