Large PIG Annual Summary FY-2017-18: our successes, challenges, and plans for the coming year

Our Large PIG (actually JIG: Joint Informatics Group)

How do you give thanks and acknowledge your teams each year? I know WE don’t do it nearly enough. Here’s a partial list of our PIG achievements from 2017-18, now that we’re into 2019 (I know, I know, I can’t blog fast enough to keep up with smart amazing colleagues, a great problem to have).

Physician Informatics Group Annual Executive Summary
Submitted by CT Lin MD, August 20, 2018

Vision statement: We improve physician/APP and team wellness and effectiveness by building extraordinary relationships and innovative tools.

FY2017-18 Achievements

  • Go Lives: MANY Clinics, 2 Hospitals
  • Sprint: 17 Sprints in 2 years, 496 providers, 315 staff
  • PI’s conduct specialty-specific and general projects to improve provider and staff efficiency and effectiveness in patient care
  • PI’s create and educate via newsletters, tip sheets, videos, meetings
  • PI’s help review, test, educate and implement Epic upgrades
  • PI’s develop and lead service line governance for UCHealth
  • PI’s chair or co-chair or participate in at least 2 dozen UCHealth governance committees to guide both Epic EHR development as well as UCHealth provider leadership overall.

Examples of successful projects:

  • Conversion of OIC (infusion) orders from “referrals” to “Therapy Plans” for safety, efficiency
  • Creation of 5 new UCHealth-wide service lines to facilitate Epic EHR build, reduce unnecessary variation
  • Creation of an APP Epic Concierge meeting to improve effectiveness and training
  • Dragon Speech expansion and elimination of Partial Dictation
  • Creation of a PI onboarding document, training, getting-up-to-speed
  • Creation of an Opioid management steer and Epic customizations to support initiative
  • Implementation and expansion of innovation partner tools within Epic: AgileMD, RxREVU, APPRISS
  • Implementation of Radiology Indications software, phase I
  • Implementation of patient access to images via My Health Connection
  • Use of EHR, scheduling and billing data to improve clinic operation efficiency, effectiveness
  • Creation of an Universal APSO note to improve both standardization AND customization
  • Creation of an MA-smartform to dramatically improve consistency of data capture in Practice Transform
  • Connection of Epic data to ORIEN (oncology research network) with dramatic efficiencies
  • Implementation of iECG, physician informatics/organizational change support to change EKG capture platforms across all hospitals/clinics
  • EPCS: E-prescribe Controlled Substances deployment of 2-factor authentication
  • Support of Palliative Care and Spine Surgery smartforms, note templates, registry reporting tools
  • Standardization of UCHealth Order Sets, physician leadership, phase I
  • Support of AMC Neurology Practice Transformation, note templates, flowsheets
  • Book Club: Read books this year on Organizational Change, Communication, Connection: Design of Everyday Things, Good to Great, Great by Choice, Crucial Conversations, Leading Change, Nudge
  • Creation of Small PIG program to mentor newer PI’s

Opportunities for Improvement

  • Counseling and coaching of PI(s) to further improve internal and external communication and leadership skills in a rapidly growing organization
  • More emphasis on analytics, use of information in our PI role, beyond “go live” and “optimization”

Plans for Coming Year

  • Implementation of approved Sprint Team 2, improvements on process for Team 1
  • Implementation of expanded rollout of Practice Transformation (changing the MA:MD ratio to 2:1), and supporting EHR tools
  • Support of ongoing hospital go lives
  • Ongoing redesign of PI support of clinic go-lives and onboarding individual providers
  • Incorporate analytics into Sprint
  • Dragon speech QI/research project: Dragon in the exam room
  • Radiology imaging shown to patients QI/research project
  • Expansion of Innovation projects
  • Expansion of MHC questionnaires, possibly PROMIS questionnaires
  • Acceleration of the Order Set Synchronization project
  • Further reducing the EHR burden, improving patient care and human connection, in everything we do

CMIO’s take? What’s YOUR take? What do you plan for the coming year?

Willy Wonka and the Epic EHR: behind the scenes at the behemoth of Wisconsin (NYTimes)

This article speaks for itself. Having visited the Verona, Wisconsin campus of Epic’s Intergalactic Headquarters, with its dozens of campus buildings, its massive Voyager Training Hall, and its equally massive 11,000+ seat auditorium (the largest in the state), it is an impressive site. Equally impressive is the young talent that this company recruits out of college, how quickly they learn the necessary lingo and communication skills of health professionals, and dive into the constantly evolving code-base of the Epic EHR. Privately held, this company is NOT at the whim of the shareholder, which I think is a key success factor in its market dominance.

Yes, there are tons of criticisms for this and every EHR. Yes, there is a national outcry of physician burnout, directed at EHR’s in general.

Instead, you’ll read here, that the guiding vision of the reclusive CEO and founder, Judy Faulkner, holds true today; have fun, do good, recruit smart talent, improve patient care.

CMIO’s take? Having been part of the Epic community since 2010, I’ve seen lots of innovations and improvements and look forward to many more.