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What Epic Means to Me: Primary Care

What Epic Means to Me: Primary Care 2019-01-24T08:21:41-08:00

We continue our series titled What Epic Means to Me, in which we highlight individuals in various roles throughout SFDPH to find out what they are thinking about the Epic project, and share their insights with you. This month we interviewed representatives from our Primary Care team.

 

Ben Lui, MD, MPH
Chief of Community Primary Care, SF Dept of Public Health
Director of Community Integrated Health Care, SFHNMedical Director/Center Director, Chinatown Public Health Center
Assistant Clinical Professor, UCSF DGIM-SFGH

What do you think will be the biggest benefit of SFDPH having a system-wide EHR? The biggest benefit will be improved communication across DPH. It will not only facilitate communication for care providers across the continuum of care in our network, it will also facilitate communication and data sharing between SFHN and our Population Health Division, in support of DPH’s mission to protect and promote the health of all San Franciscans.

When fully implemented and supported over time, Epic will give us tools to support our system’s continued transformation from a coordinated health care system to a community integrated health care system. One which is population and community centered, partners with governmental agencies and community-based organizations to address health risk factors upstream, addresses social determinants of health across the life course, shares health information across health and human services organizations, and embodies a learning health system.

Based on your experience, what do you think our staff will be excited to know about Epic? Staff would be pleased to know that Epic Foundation has a number of features embedded in its Healthy Planet module to help us address our patients’ health related social needs. These features afford SFHN the opportunities to more intentionally and effectively design workflows which screen patients for their social needs (e.g. housing, transportation, food insecurity) and connect them to social services to meet those needs. SFHN is in the midst of creating and enabling an electronic community resource directory to support these new EHR functionalities.

In one word, how would you describe you feel about SFDPH implementing Epic? Hopeful

 

Hali Hammer, MD
Director of Ambulatory Care and Primary Care, SFHN
Clinical Professor, UCSF Family and Community Medicine

How will having a system-wide EHR benefit SFHN? Our Primary Care patients are folks who touch everywhere within our system. If I’m caring for 1,000 patients, those same patients will be going to the ER, the jail, could utilize specialty mental health, or be in long-term care at Laguna Honda. They are just everywhere. So, being able to coordinate care across sections and to be able to talk to each other no matter where our patients are seen is going to make a big impact on our patient care. Also, it is going to be so helpful to have all of our data in one place and be able to use that data to tell us how we’re doing and how we can improve. In Primary Care, we are the continuity providers. Our patients often touch the system everywhere – i.e. Jail, long-term care, etc., – and currently we can’t see those records. With Epic, both the jail provider and the Primary Care provider will be able to see the same data. Without that benefit, there are patient safety impacts and we lose continuity of care. Good sharing of records makes care more coordinated across our system.

What do you perceive as being your fellow primary care staff members’ view or opinion on how Epic will impact their jobs? They are really excited and positive about it, but are also nervous about all of the work that’s going to go into getting us to launch. I think that they worry that it’ll slow us down. We’ve had a lot of improvements in access, and people worry that we will backslide. But, the Epic team is pushing us to think about how we can maintain access. One thing we can do is make sure that we take training seriously and make sure that everyone is well trained before we start.

What do you think will be our biggest challenges as we go through implementation? Having enough at the elbow support for users because we are all going live at the same time. We have a tendency to prioritize where the most acute patients/highest risks patients are, but if we think about patient experience and what makes them come and see us and have confidence in us, that’s in Primary Care and Ambulatory Care. We have to make sure we don’t forget the patient experience in the ambulatory setting. For leadership, we have to make sure that a lot of support right in clinic when we go live. That’s really the best way to learn is by doing it with at the elbow support.

How do you think we can ensure our success as we go through this process? I think a secret to our success will be to engage as many people as possible. We need to make sure there are a lot of people at the table during all of the phases leading up to training so everyone feels invested and engaged with the system.

In one word, how would you describe you feel about SFDPH implementing Epic? Excited. Although I wish we could snap our fingers and be there. It’s honestly a lot of work right now!

 

Milagros Ramos
Practice Manager, Pediatrics Department at ZSFGH, Children’s Health Center

What do you think will be the biggest benefit of SFDPH having a system-wide EHR? I think it will allow our Department the ability to provide better health care coordination, our providers will have access to the complete patient records (records from other facilities, emergency room visits, medications, allergies, immunizations, test results, etc.) By providers being able to review the complete patient history, our patients should experience even better health care outcomes. Not only will all providers have easier access to complete patient records, but also allow for intra-network collaboration that allows for sharing of best practices and workflows.

How have you been involved in the implementation so far? I was chosen as a Subject Matter Expert (SME) due to my 22 years of service at various community clinics. So, I have had the chance to see and participate in the Epic build, which was pretty straightforward since DPH decided to go with Best Practices, which gives us the best features Epic has to offer.

In one word, how would you describe how you feel about SFDPH implementing Epic? Thrilled! I really think that the Department of Public Health has invested wisely. I truly believe Epic will benefit the staff and patients.

Care to read previous issues of this feature? They can all be found online on the Epic Communications Hub SharePoint site.