EPIC pushback

[JayWoz]

Hi everyone! My hospital just transitioned to EPIC. I have worked with EPIC and cerner before and love computer charting. At my current hospital I experienced something most unusual. My current hospital is allowing doctors to continue to place written orders and full admission telephone orders? I was under the impression that with the transition to EPIC there would be NO PAPER CHARTING. At my other hospital when we transitioned to EPIC paper orders were no longer allowed. All of the pushback is coming from the doctors. Just wondering if any other hospitals experienced this and how it was dealt with?

[canigraduate]

Most hospitals have penalties, up to and including losing privileges, for docs that won't adhere to computer-based physician order entry.

I have been in a few systems that switched to Cerner and Epic, and the docs were given extensive training and assistance for up to an entire year. Nurses got a 6-8 hour class.

Your administration probably has a stepped approach to getting the doctors on board. If this keeps happening, however, it's a sign of a weak administration.

[roser13, ASN, RN]

My facility continues to allow paper orders & H&P's, 2.5 years after introduction of EPIC. Our surgeons are spoiled brats.

[whichone'spink, BSN, RN]

I work in PACU, and currently the CRNAs and anesthesiologists (mostly the CRNAs since they do most of the work) chart their meds, vital signs and intake and output on paper. Next month, they will transition to using EPIC like the rest of us do, including surgeons of all people. It will be interesting to see how they adapt. I'm positive the CRNAs will manage well, but the anesthesiologists, at least half of them will struggle royally. Especially one doctor, who I've talked about before.

[RNperdiem, RN]

Never had any trouble with this. At an academic medical center, doctors are not a coddled and protected class. They had EPIC classes and superusers shadowing them for weeks until everyone adapted.

The doctors skew young here, probably because most of the MDs are residents under 35 and most of them are very comfortable using technology.

[canigraduate]

Never had any trouble with this. At an academic medical center, doctors are not a coddled and protected class. They had EPIC classes and superusers shadowing them for weeks until everyone adapted.

The doctors skew young here, probably because most of the MDs are residents under 35 and most of them are very comfortable using technology.

Well, you're by the Research Triangle. People are smarter there. BTW - I actually know where Apex is.

[Rose_Queen, BSN, MSN, RN]

My facility did a stepped approach to transitioning from paper charting to Epic. When the program first started, physicians were expected to complete H&Ps, notes, and any other narrative format documentation in the system. Paper orders, which for many clinical pathways involved set order sets with check boxes, were continued to be used for a year, with the unit secretaries entering the orders into the system with a sign off by the patient's nurse. Then, there was a cutoff date determined well in advance for when paper orders would no longer be accepted, and each physician would be expected to enter their own orders. Part of the lead up to this was developing updated order sets in the Epic system. Now, the only orders not entered by physicians are those entered as verbal orders, such as when the surgeon is scrubbed in the OR and truly isn't available to enter them or during emergent situations.