Epic_UGM2014_FinalTripReport

USERS’ GROUP MEETING 2014 TRIP REPORT

TABLE OF CONTENTSIntroduction .................................................................................................................................................. 3List of UCLA Presentations............................................................................................................................ 4Top Takeaways.............................................................................................................................................. 8Ambulatory ................................................................................................................................................. 18Clinical Informatics (MD & RN) ................................................................................................................... 54Communication........................................................................................................................................... 77Emergency (ASAP)....................................................................................................................................... 82Executive Leadership .................................................................................................................................. 86Financial ...................................................................................................................................................... 92Inpatient...................................................................................................................................................... 97Lab............................................................................................................................................................. 128MyChart & Mobile Apps ........................................................................................................................... 129Pharmacy .................................................................................................................................................. 144Reporting .................................................................................................................................................. 148Research.................................................................................................................................................... 154Training ..................................................................................................................................................... 155Other ......................................................................................................................................................... 159Photos ....................................................................................................................................................... 188Index.......................................................................................................................................................... 193 2|Page

INTRODUCTIONThe Users’ Group Meeting is an annual gathering of Epic customers from all over the world,where they present topics of interest and complexity to the Epic community, learn about newfeatures and updates to current and future Epic versions, and to discuss enhancement requestswith Epic development teams. The shared knowledge from these meetings provided tips,advice with industry peers, creative approaches, establishes priorities with future plans and isessential in the EHR improvement process. Our goals from attending UGM is to share ourknowledge about CareConnect with the Epic community of users and to continue to improveour EHR to provide the best tools for excellent patient care and provider usability.UCLA sent over 56 attendees to UGM 2014 and presented 19 presentations, consisting of 36speakers during September 15 - 18, 2014. This trip report captures the high level learning’sfrom the conference. All UCLA attendees were asked to provide the sessions they participatedin, key points from the session and their top two take-a ways from the UGM conference. TheEpic session provided by the UCLA attendees where categorized in 14 departments;Ambulatory, Clinical Informatics (MD & RN), Communication, Emergency (ASAP), ExecutiveLeadership, Financial, Inpatient, Lab, MyChart & Mobile Apps, Pharmacy, Reporting, Research,Training and Other. 3|Page

UCLA PRESENTATIONSANIMAL FARM: GOVERNANCE THROUGH GO-LIVEMichael Pfeffer, MD, FACP, CMIO, Interim CIOJeanne MarklandReview an approach to governance that played a key role in a successful Epic implementation, helping to bringthe project in on time, under budget, and meeting all enterprise-wide strategic objectives.AVOID FLYING COW PATTIES FROM PROBLEM PROVIDERSJohn Luo, MD, DFAPA, DFAAPHawkin Woo, MD, MPH, FACPMuch as the Incredible Dr. Pol television veterinarian has dealt with a plethora of veterinary situations,providing support and dealing with difficult providers takes talent. Learn how many of the toughest issues arerooted in psychology, where personalities and defense mechanisms are involved. Dr. Luo and Dr. Woo share howunderstanding the why helps shape the right strategy for go-live and ongoing support success.BUILDING AN ENTERPRISE ANALYTICS ORGANIZATIONMohammed Mahbouba, MD, MSThis organization decided to establish a new department in charge of data, reporting, and analytics to supportthe Health Sciences Enterprise across the organization's three missions: patient care, research, and training. Thisunique approach resulted in the consolidation of existing analytical “silos of excellence” and the creation of ananalytics powerhouse of more than 80 multidisciplinary professionals. 4|Page

BUILDING BARNS, NOT SILOS: AMBULATORY PRODUCTION SUPPORTJeanne MarklandScott ShermanGet a review of a clinic-centric, end-user focused ambulatory production support model. Discussion includesstrategy, issues, factors, and lessons learned. Additional review outlines how the support model fits into anoverall ongoing implementation/optimization strategy.CARE OBJECTIVE ORDERS: HOW MUCH TO PLOWDarryl Hiyama, MDJason WilliamsLearn how to set up a new order type to communicate ICU care objectives to physicians, nurses, and otherproviders.DRAGON’S LAIRMichael Pfeffer, MD, FACP, CMIO, Interim CIOAn opportunity for CMOs and CMIOs to exchange the best approaches to using Epic for improved safety, quality,and productivity.GROWING YOUR EHR INTO A FIELD OF DREAMSFrancisco JordanCherie Neil, RN, NSN, CNS, GNPIf you build it, they will come. Learn how to build your EMR into a Field of Dreams for your organization.Presenters show a real-time report used by nursing to quickly indicate completion of quality indicators such asfall, skin, pain, flu, and pneumonia assessments. They also share how they maintained regulatory complianceand increased patient perception of safety & quality, ensuring greener acres.HARVESTING A USEFUL PREFERENCE LISTEric Cheng, MD, MS, FAANAshwin BuchipudiIn an ideal world, users should use SmartSets to cue up their orders. In reality, many users go straight to OrderEntry. Find out how preference lists can save those users from unnecessarily entering database look-up.HARVESTING THE FRUITS: OPERATIONAL HANDOFFCzarina OfallaScott ShermanLearn the value of establishing an operational handoff strategy as a defined part of your Epic implementationstrategy – with a focus on creating ongoing opportunities for staff development. Hear how the investment paysoff through lower attrition rates, higher staff satisfaction numbers, and an implementation plan that meetsstrategic goals and deadlines.HERDING DOCUMENTATION: NO-FUSS NOTE ROUTINGMaria Alizondo, MA, RHITKathleen CrowThis organization's Epic implementation resulted in the development and implementation of a system-wideworkflow to ensure timely and accurate communication with referring providers. Physician Informaticists, the 5|Page

transcription vendor, and build & technical teams collaborated to create a viable method that ensurescommunication to internal and external referring providers within minutes, with an average error rate of .01%.NEEDLE IN A HAYSTACK: A SOLUTION FOR DIAGNOSTIC HODSAlyssa Doyle BSN, RNNina EmersonAllan Wu, MDComplex departments like neurophysiology, fetal diagnostics, and PFT labs present unique challenges andtypically don't fit into a Radiant or Cupid install – but they can still be successful and paperless. Get a demo of aworkflow that uses scheduling, system lists, In Basket routing, and shared note functionality to support thesedepartments, including specific build tips & tricks.PARTIAL HOSPITALIZATION PSYCHIATRY PROGRAM BUILDDaniel NollJames RosserLearn how you can build a partial hospitalization psychiatry program using EpicCare Ambulatory tools. Tips andlessons learned are shared.PEARLS: WORK LISTJeff Banting, MBAMeg Furukawa, RN, MNHerding Tasks to the Work List Using Order Transmittal This session presents an overview of how the work listwas implemented and optimized, starting with nursing decisions on its content and use through using ordertransmittal to get tasks to appear on the work list. Time for Chores: Making the Work List Work for YouPresenters describe their work list journey, from initial development through final adoption. Learn why you needan integrated approach from orders, clin doc, training, and operations teams to make this tool work for yourstaff. Hear their successes and challenges.PREPARING PHYSICIANS FOR GO-LIVE WITH A PERSONALIZATION LAB AND SUPPORT STRUCTUREChristine Alanes, RNDeidre Keeves, PTSee how to prepare for go-live by providing your physicians a place where they can review go-live-critical points,set up their preferences in the system, and customize their settings. Learn how to use the personalization lab toeffectively and efficiently provide go-live and post-go-live support to ensure they are using the system accuratelyand to its full capacity.RAPID DOCUMENTATION WITH AN AMBULATORY INJECTION SMARTSETDavid GomezDaniel Vigil, MDSee how an ambulatory injection SmartSet allows rapid documentation of commonly performed procedures byallowing the user to document a diagnosis, order an injectable medication, submit the corresponding CPT code,and enter a Level of Service with minimal clicks.SOWING WHAT YOU REAP: REDESIGNING AND OPTIMIZING L&DTina Nguyen, MD, FACOG 6|Page

Jason WilliamsLearn about one organization's experience of optimizing Foundation System elements to streamline L&Dworkflows.SUCCESSFUL APPOINTMENT CONVERSIONLaxmi KumarJosi MillerHear lessons learned during a successful conversion of future appointments for a Cadence go-live.WEEDING OUT SEPSIS: EARLY ID AND INTERVENTIONFrank Day, MDLynne McCullough, MDKaty ChungPresenters from two health systems discuss the design and implementation of QI projects focusing on pediatricand adult sepsis reduction. They share the screening and decision support tools (both passive and active) used toidentify patients with abnormal vital signs, and the lessons learned for collaborative creation of order sets andBPAs that can achieve measurable improvements in sepsis outcomes.WINNOWING THE CHAFF: DYNAMIC ADMISSION SMARTGROUPSMichael Pfeffer, MD, FACP, CMIO, Interim CIODavid MuiHear how to use Best Practice advisory (LGI.) records to create dynamic admission SmartGroups which include orexclude ADT orders based on current orders. 7|Page

TOP TAKEAWAYSCHRISTINE ALANES, RN • There is much work that remains to be done with bringing up Epic's 2014 Blood Product Admin Module (BPAM). Networking with other sites and attending the blood admin unsession would have to be my most valuable experience of attending UGM. After coming back from UGM, I was able to bring up to the team and business owners what other sites encountered as issues and cause of delay. For example, l learned about the regulatory requirement to testing to all barcode scanners used in blood admin, interface testing scenarios and outcomes. Since UGM we have a contact on 2014 using BPAM in the inpatient setting. It was nice to also know that UCLA is the only site that has been able to effectively use the worklist, especially for blood orders. • Learned when creating a new EAP or adding a new order to be added to a preference list and/or in the order set that as the application team will need to ask more questions around the \"lifecycle\" of that order. 1) Is an order necessary and why? 2) What should the clinician do with this order and is it clear enough for them 3) How should this order display in application reports as well RWB reports.MARIA ALIZONDO, MA, RHIT • 2014 Upgrade is going to bring much needed functionality for HIMS workflows, including ROI, Identity and Deficiency Tracking applications. Some updated functionality can be implemented in v. 2010 as well. • Networking with other Epic HIM users is an invaluable experience. Sharing information and best practices adds to the user experience and benefits not only HIMS but UCLA as a whole.ANGELA AMUCHA, BSN, RN • Population Health is the future of healthcare. Hospitals need to begin to work on strategies to manage large groups of patients with chronic diseases and proactively encouraging preventative health more efficiently. • Patient Engagement is imperative to the health of patients. Actively engaging patients in their healthcare using tools like MyChart will greatly enhance the patient experience. Also virtual care thru e- Visits will also change the way patients receive their healthcare.SCOTT BAILEY • Epic has significantly increased the scope of their intended reach - both in terms of international expansion and the significant and aggressive direction towards enhanced analytics and derived operational efficiencies. • Our significant feedback, feature requests, and engagement with Epic appears to be directly driving new product features, improvements - and even some of the major use cases we saw presented in the General Session. 8|Page

JEFF BANTING, MBA • I was able to see what new and creative functionality other hospitals built. This was important for me since it gave me a different perspective. • I was also able to share my experiences and gather feedback from other hospitals. I believe sharing information and networking better prepares us for the challenges we'll be facing.ANDREW BEER • Tools which foster engagement with the patient are a larger part of the focus of upcoming development by Epic, and implementation by health systems. The emphasis is on allowing the patient to remain in touch with their medical record at all times, while allowing physicians greater flexibility in when and where to engage the patient. So many features are decentralizing tasks away from Hyperspace into mobile devices and the web, that it will be a challenge to implement these features competitively while providing appropriate levels of security and privacy. • Meaningful Use requirements need to be met with coordinated workflow revisions. As requirement metrics pile up, it is important to avoid simply adding new hoops for physicians to jump through, and instead press forward with optimizing workflows while also incorporating new metrics, to strive for increased usability and enhanced metrics at the same time.ASHWIN BUCHIPUDI • This is my first experience. This is a very productive experience for sharing knowledge between organizations. Learnt lot of interesting points on flowsheets, registries,… • Also learnt some very cool features coming in next versions of Epic.SAMANTHA CAO • Progress in implementing telemedicine tools and programs such as e-visits, video visits, remote monitoring, etc must be part of the organization’s strategy and business model. Directional leadership, coordination of efforts, and support needs to be provided by executive leaders. • CC leadership needs to have a long term build plan in coordination with ambulatory operational and revenue cycle leadership in order to take advantage of all the MyChart features in Epic 2014 and coming Epic 2015. What is the vision for what the office visit and specialty visits will look like? Virtual? The extent of build within CareConnect directly reflects accuracy and use of MyChart features. * MyChart online bill pay for copays and self-pay services * Tapestry build for insurance and referrals and bill pay * Cadence build for open scheduling, fast track, etc. * Telemedicine use cases, business and reimbursement models * Questionnaires and flowsheets to collect clinical data and patient satisfaction data * Developer resources for patient entered data and tracking/management features connectivity with monitoring devices, etc. and use of open.epic and extensibility 9|Page

DIANE CARTER • My trip was based on understanding the needs of the UCLA travelers and to secure hotel rooms with shuttle access in close proximity to EPIC when 10,300 users attend the UGM conference in Verona, Wisconsin.BUKEKA CHANDLER • The key to a successful launch of MyChart across the board is having the “buy-in” and overall support of leadership. There were several organizations represented that made it clear that this was their most important requirement before training anyone else internally and externally on MyChart. • Paperless is the way to go! Taking advantage of new technology by purchasing tablets for patients to use in a clinical/hospital setting to sign up for MyChart and to learn all of the functionality available and teaching staff the same will improve productivity, Meaningful Use numbers, and overall patient/customer satisfaction.ERIC CHENG, MD, MS, FAAN • CareConnect contains many of the features presented during sessions. I was struck by how often a presentation described a feature that we already had. • End-user usability was a theme emphasized during main presentations, usability sessions, and the most memorable sessions that I attended.TONY CHOE • Epic Systems - world domination in Healthcare EHR. During the initial general session, Judy Faulkner presented a slide deck with a plotted map depicting Epic patient records covering over 51% of the entire United States with expansion to global market including Netherlands, Dubai, and Singapore. Just a year ago, Medical Economics published an article by Brandon Glen on April 25, 2013 stating \"About 40% of the U.S. population has its medical information stored in an Epic EHR\". • Many Epic customers are showing more interest in Cogito Data Warehouse than previously. Following are few benefits of implementing Cogito Data Warehouse: Standard Healthcare data models that include clinical, revenue cycle, cost, and patient survey while conforming and linking patients and providers across the different data models within CDW. Epic data flows out of Clarity directly into Cogito Data Warehouse. Non-Epic data integration into the data model using Epic provided ETL (Extract Transform Load) framework and management tools. Version upgrades are developed and vetted out by vendor (Epic data).MELISSA CHUN, OD, FAAO • Ready for optimization and full utilization of the functions within Epic CareConnect. Looking forward to upcoming Master Class for Kaleidoscope. • Availability of Physician builder can significantly streamline workflow, automate clinical data collection and auto populate form letters and reports. Individual providers do not have the know-how; departmental physician builders with clinical and workflow knowledge can be instrumental in consistency of documentation and output. 10 | P a g e

KATHLEEN CROW • HIM Roundtable provides key upcoming enhancement information which could be even more accessible if a webinar was offered for non-attendees. • As the number of Epic clients increase, it's clear that from one installation to the next there are vastly different build interpretations of Epic functionality. It will be important to utilize the Epic Newsfeeds to query other Epic users rather than relying just on Epic staff for ideas and suggestions.FRANK DAY, MD • Web services for data exchange with Chronicles are mature in 2014, and 2015 support for HL7 FHIR holds huge potential for increasing interoperability, optimizing mobile device based healthcare workflow, and increasing patient engagement. • Epic's foundation Patient Education activity is a long way away from enabling coordinated multidisciplinary longitudinal efforts to educate/engage patients and family across the continuum of care (among home, ambulatory and inpatient contexts). Extra-Epic application development will be necessary to meaningfully advance education coordination as a method to reduce readmissions and achieve Stage 3 MU.LORENA DOUILLE • My Chart will be very important to our operations in order to give the power to the patient to schedule appointments, pay their bills. • Reporting--excited to see that it will be easier to run reports.ALYSSA DOYLE BSN, RN • Epic is paying a lot of attention to the development of Rover and will be including a lot more functionality in the future to allow RN's to be truly mobile users of Epic. • In addition to central clinical surveillance - Epic Monitor is being utilized by health systems to assist in electronically documented trauma's and in RT command stations for real time monitoring of patient vents and trends. Additional development for L&D will make this a great tool for MD rooms in OB.NINA EMERSON • We could really benefit from an improved prioritization process, so that each project is scored against our organization's objectives and to ensure we have a balanced project portfolio of improving base system build/maintenance, optimizing existing features, and implementing new features/modules. • The customers that seemed to put more time on fewer projects seemed to have greater success. For example, customers that dedicated a large amount of resources to just physician sidebar reports were able to achieve great outcomes. I talked to several people and went to several sessions where a lesson learned was projects with a large scope led to a lot of minor improvements but not transformation of a problematic workflow. 11 | P a g e

DEBORAH FERGUSON • This is my third UGM and this one seemed to have most positive energy than previous UGM's I attended. Focus on My Chart usage and patient privacy protection. • Future enhancements to Haiku, Canto, and Rover, to name just a few were welcomed by the crowd. Telemedicine and Epic Monitor will be exciting. Center is around patient care, ease of use, efficiency, meaningful use.MEG FURUKAWA, RN, MN • Leverage the EHR to guide providers into proper medication reconciliation. Support the physician's workflow and make it easy to manage the medication list and do the right thing. • Change from a reactive to a proactive approach to optimizing the system.DAVID GOMEZ • A future module in Epic will focus on genometics and the study of genes. This module will be called \"Eagle\" and will integrate with various other Epic modules such as Patient History, My Chart, etc. The goal will be to provide better preventative care via genetics. • As Epic moves away from a system that does pure documentation, to a system more involved with preventative care there will be a big push on analytics of big data. Epic is now responsible for over 50% of all EHR data in the United States which results in massive amounts of patient data that can be used to find trends that can help with preventative care for patients.DARRYL HIYAMA, MD • We will need more server capacity to upgrade past 2014FRANCISCO JORDAN • Many new features coming with 2014 that will improve our reporting and analytic abilities. Overall sessions were nice but did not necessarily provide solutions we can use since many organizations are on versions beyond 2010 while we are still on 2010.BERNARD KATZ, MD • The 2014 upgrade will enable some features that will make users more facile with CareConnect. • UCLA’s initiatives are already excellent. Many of the things I saw showed that we were ahead of the curve in implementing new processes.DEIDRE KEEVES, PT • Organizations that have implemented the MyChart bedside patient engagement module including Ohio State University and Mercy West (formerly Catholic Health Partners) have seen a dramatic improvement in HCAPS scores for each of the following domains: Overall Score, Would Recommend, Doctor Communication, Nurse Communication, Staff Responsiveness, Medication Communication, and Discharge. 12 | P a g e

• Epic More and more epic customers are using web services to extend their epic platform to include integration with organizational mobile and web applications. Examples include: an iPad rounding tool for patients and staff, extending Haiku to launch clinical apps from within the provider workflow, and integrating voice recognition solutions within patient call centers.LAXMI KUMAR • We are in the Right direction as it relates to the PCC Project. The build is similar/better than some of the presentations. • We could improve our Scheduling and Registration process.THERESA KYLES • The importants of collaborating with other departments in which you support to define metrics and establish benchmarks to discuss, review and fine tone the work flow process. • Other important takeaway points made were the importants of Socialization (internal and external physicians), Education and Roll-outs to ensure everyone trained and kept abreast of updates, Registration Errors monitoring, identifying trends and addressing denials, Process Monitoring is required to ensure that we're meeting the standards and expectation of the department.GRACE LEE • For any program to thrive within an organization, leadership will need to recognize the key attributes of that program and stand behind it to implement system wide recognition. Currently UCLA Health is not able to utilize all functionality of MyChart, it will be nice if we had more programmers/developers on board so that we can take advantage of all that MyChart is able to offer for our patients. <And for the hospital/ambulatory> • Epic's visionary goal described during Executive Address was truly inspiring. I am in awe of the way they were able to handle such large group (11,000+) with such grace and planning, I feel grateful to be part of healthcare industry that is technology forward.MOHAMMED MAHBOUBA, MD, MS • Epic's development roadmap is aggressive and comprehensive particularly with regards to reporting and analytics which highlight the fact that we (OHIA) need to thoroughly understand this roadmap and stay alert and actively involved to take advantage of new capabilities as early as possible and adjust strategy and approach accordingly particularly with regards to investment in home grown and third party solutions.LORRAINE MALDEN, RN, BSN • Learned and connected with other Perinatal Units across the country to discuss issues related to Stork, particularly phases of care in L&D, BOA (birth out of asepsis), OpTime and Perinatal HOD namely FDU workflow with PACS.. 13 | P a g e

AUDREY MCCLENAGHAN • Interaction with other types of organizations and how they use and implemented EPIC is educational. Their success stories, challenges, and experiences can be very valuable to help us with our Optimization. • Upgrades and new versions of EPIC enhancements are inspirational and motivations to see where the long term goals are going in this Electronic Health Record System. It makes me excited to see the future of health care.DAVID MCCLOSKEY • The ability (in 2015) to allow the same patient in 2 different beds (dual admission) will be a great benefit to NPH when their inpatients have procedures performed at Ronald Reagan. The current discharge readmits process cause orders to be reentered. • The ability (in2015) to create a claim for the entire inpatient stay that have been interim billed without having to undo/canceling the interim claims will save the Hospital Business Office time and headaches (moving payment and adjustments) caused by the canceled claims.LYNNE MCCULLOUGH, MD • Very valuable, want to go every year to learn about new innovations & opportunities, so already working on submissions! • Great potential with the upcoming ASAP advancements; particularly with mobile access via Haiku.JOSI MILLER • Research was a key area of focus in the general session, but there were very few customer driven research sessions throughout the week. There is a big opportunity there. • Clear that governance was a large topic - it was discussed even as a subset of nearly every session I attended. Interesting strategies but key is always a strong champion from operations.YVONNE MUGFORD, RN • Sites that have moved from Teletracking to Epic EVS/Transport had a very smooth transition and UCLA was able to contribute to future enhancements for EVS/Transport. • All sites talked about the issues they are having with Phases of Care.DAVID MUI • With regards to Optimization, we need to maintain a strong connection between the strategic goals of the organization + optimization projects. We also need to close the \"inside channel\" to the Application Coordinators so that no projects are bypassing the standard review process.BRUCE NGUYEN • Understanding the logics and reason why an EPIC client would use a different build than UCLA. The benefits and disadvantages of the build. • Previewing upcoming EPIC build and focus. 14 | P a g e

TINA NGUYEN, MD, FACOG • There are many different ways to address the same problem within CareConnect. The methods are often complicated and require difficult builds. UCLA’s approach is more straightforward and user friendly. • Buy in from physicians is very important. Many smaller organizations that are live on Epic have great difficulty with physician buy-in and just find ways to go around them by putting more work onto the nurses and techs.DANIEL NOLL • Presenting UCLA's unique Partial Hospitalization Psychiatry Build to other organizations was and AMAZING experience. The attendees were extremely engaged and very thankful for sharing the build. Users from other organizations are already reaching out to me to get more information. • There are some amazing changes coming with the new version of Epic. The Focus Group session was the most beneficial session I attended. I can’t wait to start working with users to implement the new features and updates.CZARINA OFALLA • Project Prioritization strategies used by other organizations. • Networking with other academic institutions on best practices, resource management and project prioritization processes.MASON PAKNEJAD • The Tapestry application will have the ability to offer HMO patient's portable electronic cards. The cards will have near real-time eligibility information. • Member-level Claim Repricing functionality will be made available for Tapestry in 2015JULIO PIEDRASANTA • Epic is focusing on improving the patient experience by allowing medical records to be shared across platforms and place of service. They are also innovating the experience using mobil technology through the use of smart phones. • Through the use of smart technology, Epic is helping providers focus on better care for their patients. The use smart reminders allow providers provide better service and proactively managed appointments, refills and follow ups.MICHAEL J. SAUK • There is no better organized software vendor conference anywhere. Does anyone have white umbrellas ready to use if it rains during their conference? Even though over 8 conferences it has grown for me by 8 fold in attendance, someone Epic still makes it seem personal. • I attending the Tuesday the opening conference presentation by Judy Faulkner and although I think she is one of the best CEO's of any company, I thought her presentation on future plans was very disorganized and without \"meat.\" I believe Epic is on the right track strategically but I thought her 15 | P a g e

presentation lacked structure. Maybe it was the coveralls and bib cap that did it. :) I also attended a futures session on Radiant with good futures but all in 2015. My other walkarounds were at some of the snap presentations which were a great idea and well done. One good connect was made when we were talking to Children's of Cincinnati and we have their Epic application director's contact information to setup in early January a \"lessons learned\" on their 2014 upgrade which they will do in December, 2014.SHEHZAD SHEIKH • It was very insightful to see Epic's road map and things we can expect in future. This would help me to align the strategy for providing analytical solutions in conjunction with Epic's framework. The announcement of AppXchange by Epic is a perfect example with that aspect, where we can share our apps with Epic's community. This also means before starting to develop a new solution, we could look up a shared solution by other organizations in Epic's community that could fit our need and potentially leverage it. • OpenEpic is another important announcement. It would allow new and easy ways to integrate vendors and third parties as well as our internal custom applications/Solutions to integrate well with Epic and would open new doors to innovation. FHIR is an example of such set of APIs that would become available in EPIC 2015. I will keep OpenEpic on our radar to see how we can continue to innovate with in UCLA while implementing analytical solutions for the organization.SCOTT SHERMAN • New project requests should utilize an objective methodology that evaluates all projects against enterprise strategic goals. • Many other organizations are looking at a non-silo approach to supporting their end users; there was a lot of positive feedback and interest in the UCLA production support model.CINDY SWAIN • There is an Epic-wide focus on improving ambulatory workflows and supporting interconnectivity between larger hospitals, clinics, and small community specialties as well as personalizing healthcare for the patient and involving the patient more directly in their own care. • There is a lot of development centered around allowing physicians to analyze larger data sets and patient populations so they can manage their problem patients at once and come up with big picture solutions.HANNA TAMERU • A lot of enhancements coming for MyChart in the 2015 and future versions of epic. • Will be able to use mobile devices and tablets for a lot more in future versions of epic. 16 | P a g e

DANIEL VIGIL, MD • Of all large scale implementations, UCLA's has been among the fastest, most efficient and error-free. As one of the junior Physician Informaticists, I was flattered and impressed by the number of questions I received about our UCLA PI group from physician attendees at UGM. • Other enterprises with similarly complex workflows (e.g. Cleveland Clinic, Duke) have created Epic functionalities that could have applicability at UCLA. Similarly, I believe UCLA has much to offer these similar/competing enterprises. I think collaboration and sharing of ideas would benefit us all.JASON WILLIAMS • While discussing with other groups, learned that Inpatient encounters are considered complete with the signing of a discharge order, however they will not (close / require addendum) until a batch is created. This is good for most inpatient encounters; however those types that do not require a discharge order (Hosp/Surg, Orders only) will still float. • The team I work with is very bright and a good team. Inspired by innovation and discussion of ideas, would be great for any team to experience and be inspired by.ALLAN WU, MD • Training and reaching out to providers needs more individualized approach; reaching limits of our “classroom” reach. • Need to improve integrated DASHBOARD and SNAPSHOT reports for Providers right from the start.RICARDO ZEFERINO • The UCLA Health organization utilization rate can improve dramatically once Haiku and Canto are implemented. Any open slots can be filled in with an e-visit to improve the practices operational efficiency. The applications will allow us to provide more convenience to our patients, while increasing the systems revenue. • Engaging patients during our build is vital to our organizations success. For example, Nebraska Medical Center redesigned an AVS report with customer feedback to identify important topics and criteria on the summary report. Patient complaints decreased dramatically, while customer satisfaction increased. 17 | P a g e

TOPICS AAMMBBUULLAATTOORRYYSession 15OPTIMIZING ORAL CHEMOTHERAPY MANAGEMENT―Andrew BeerA presentation by NorthShore and University of Wisconsin Health about how to track oral chemotherapytaken in an outpatient context. Also discusses how to ensure pharmacist verification of the oralchemotherapy, to keep to the same standards as are followed with supervised chemotherapyKey Points:1) The solution used to track oral chemotherapy was to build multi-step order transmittal rules to captureoral chemo orders from treatment plans and prevent them from being prescribed until a pharmacistcompletes an InBasket message approving the prescription2) InBasket messages were also set up to trigger reminders to pharmacists to review at intervals how welloral chemo patients were complying with the medication regimen. Flowsheet rows were built to allow themto document their trackingSession 18AN AMBULATORY NAVIGATOR SO SIMPLE, EVEN A SURGEON CAN USE IT―Tina Nguyen, MD, FACOGThey simplified the look of the navigator but made it optional for the urology providers’ to use so got pooruptake.Key Points:1) Simplifying navigators.2) Don’t give too many options to providersSession 21A PATIENT-FRIENDLY AVS: THE ULTIMATE TRACTOR PULL―Ashwin BuchipudiThis session helped me in what problems they faced while creating paper AVS in the system and what theydid to overcome thoseKey Points:1) I learnt how to customize the information in AVS using rules.2) How to create paper format of AVS in the system―Lorena DouilleIt was great to see how other groups were using the AVS to help communicate to patients. They made surethat they moved important orders to the top of the AVS. They kept the patient as the focus of the build,however, they did not forget about the providers. They also added patient friendly diagnosisKey Points:1) Consistency2) Clutter free3) Clear instructions for patients―Lorraine Malden, RN, BSNUse patient centered language i.e. \"your medications are listed below. You have just had a cesarean sectionand you should be cautious about….\" In newborn documentation refer to your babies. Define specialties, 18 | P a g e

don’t assume pts understand terms like neurology, urology. Gave MDs a picklist of reasons the pt should call. AMBULATORYAVE has a tear off medication sheetKey Points:1) Good suggestions on altering the language in AVSSession 23DON’T HAVE A COW, MAN: WEB SERVICE WAIT TIME APPLICATION―Frank Day, MDLearn how to use Epic's web services and create a mobile app that displays estimated wait time and patientcount in a given waiting room across all your express care centers. Presenter discusses analysis and buildstrategy, includes high level web services overview.Key Points:1) Cache globals (eg ^SAP-MCS) are accessible that contain nodes with data of interest (ApptDat, DeptID)2) Set up target variable definitions based on available masterfile item contact values (eg wait time=EPT 75443-2)3) 2014 includes many generic web services (GetData, SetSmartDataValues) that will obviate need for newweb services buildSession 30MYCHART ACTIVATION VIA TEXT MESSAGE―Grace LeePresented by Bon Secours Health Systems as they shared their trials and tribulations as they 8implementedthe text messaging system to increase their MyChart Activation rate. Based on their data, 70% of their patienthad smart phones, in order to engage those patients, during the check in process, they offered their patientsto text them an encrypted link with patient’s activation code. “Nexmo gateway” was used to send out thesetext messages at a cost of 7/10th a cent per text. Compared to 10% activation rate with printed activationcode, the text messages resulted in 80% activation rate. Privacy & compliance requested for the staffmember offering the text option to click on “consent” button on behalf of patient and for it to bedocumented under “Documents” navigator. Heavy internal marketing was done throughout the system andmade this process part of their workflow.Key Points:1) Highest percentage of MyChart activation was achieved via SMS text. It was also an easy process toimplement as workflow, since it only required few additional clicks for our front desk staff2) No chance of \"losing\" the activation code and compliance was met since patient had to put in additionaldemographic information to identify themselves3) Look into different Vendors that we may be able to work with <e.g. Nexmo gateway and ExperidianSession 41THE PATH TO 100% BARCODE COMPLIANCE―Bruce NguyenDeveloping new pharmacy workflow, redesign med & NDC build, and successfully train end users to achieveover 95% scanning compliance within the first week of implementation.Key Points:1) Designing reason why the bar code was not scanned to make it easier for the IS staff to trouble shoot2) Training the end users to meet 95% of scanning compliance 19 | P a g e

Session 44 AMBULATORYPATIENT ENGAGEMENT VIA MYCHART AND WELCOME QUESTIONNAIRES―Bernard Katz, MDUse of My Chart to engage patients with questionnaires and obtain information from patients convenientlyahead of appointments.Key Points:1) Active MyChart engagement2) Reward participation3) Multiple areas of signing up―Samantha CaoReview process and considerations for rollout of questionnaires (HPI & ROS) in MyChart and Welcome.Organization waited to pilot after upgrade to Epic 2012 to take advantage of advanced functionality. Pilot incancer centers due to several factors: (1) buy-in and support from doctors and leadership; (2) demand frompatients who are used to filling out lengthy questionnaires and wanted an online resource; (3) highpercentage of patients who are already active on MyChart. Encouraged patient sign-up at first visit byutilizing Welcome on tablets (started planning in late 2012 but have not yet gone live). Tablets were set up toauto log-in and auto launch questionnaires.Key Points:1) Add patient instructions in questionnaire to guide patients and simplify their process so they don't have toclick for every question. Ex: Please click \"Yes\" for all that apply. Helps create a clean summary for review byproviders.2) Patients really love that Epic pulls in data from within the system to populate the questionnaire3) Staff and physicians should be re-trained and followed up with after go-live to ensure correct workflow isfollowed. Functionality also needs to be integrated into training for onboarding new staff. Split training tofocus on Office Staff, MA, and physiciansSession 51STRATEGIC DESIGN GROUP: TELEMEDICINE―Bernard Katz, MDUse of telemedicine demonstrated with required software and hardware and challenges in reaching patients.Key Points:1) Fat vs thin client platform2) Coding and billing for time3) Use of support staff to assistSession 52FOCUS GROUP: HEALTHY PLANET―Deidre Keeves, PTEpic presented development on healthy planet development. Currently 4 organizations are live, another 31are actively implementing and 85 organizations have trained their teams to build HP features. Key featuresinclude: Collecting data using CareEverywhere & Cogito Data Warehouse; Analyzing data with registries,creating predictive risk scores, and custom interactive radar dashboards; Engaging patients for follow upactions using bulk ordering and bulk outreach communications workflows.Key Points:1) In 2015 version Healthy Planet and Cogito data warehouse will have improved ability to handle externaldata 20 | P a g e

2) Clinicians will be able to reconcile in external procedures from claims data and the information will be AMBULATORYdisplayed within the clinical workflow so there is a complete view of the patient3) Epic is building in a modified LACE tool into their 2014 model systemSession 56THE BIG CHEESE: PROVIDER BASED BILLING―John Luo, MD, DFAPA, DFAAPPatients left cardiology clinics due to higher co-pays, so accurate E&M and Technical charge billing isnecessary to reduce frustration. Depending on the insurance payor, a cloned charge from professional billingis sent for technical charge. This methodology ensured accurate co-pays for the patient, and decreased userconfusion on what charges to file. Handout is essential as it details how they accomplished this.Key Points:1) For device fee, they added cloned charge with dummy modifier to facilitate bundling in claims processing2) CPT cloning only when the dame for both professional fee and technical charge3) Service area helped determine which rule to applySession 58HATCHING VIDEO VISITS―Scott ShermanReview of E-Visits by Stanford; lessons learned, challenges, and items to consider if an organization isconsidering to implementKey Points:1) Use of video functionality currently requires fat client installation on the hardware2) Technology can be hit or miss for patients since they need to have a working video feed of some type3) E-Visits are only allowed for certain insurances do to reimbursement considerations―Samantha CaoStarted video visits last year with support from the CEO. Longitudinal care and care coordination are in Epicso keeping video visits within the Epic application to have everything at their fingertips streamlines physicianworkflow made the best sense (offered the most benefits). Identify market segment and patient populationto target (18-50 yr olds, women). Compliance, privacy, billing (compensation model), patient ID verification,scheduling, remote enrollment workflows all need to be figured out. MA workflow if patient/provider isrunning late and if there's technical issues. Started with commercially insured patients for business modeland billing (limited availability of MyChart scheduling by payor; didn't qualify for CMS reimbursement); alsonegotiated with ACO and employer contracts. Getting reimbursed 75% of the time for video but found verylow reimbursement for telephone visits. Physicians are compensated via RVU at in-person rates for video toengage physician use. Video visits must be conducted with patients within the state to avoid legal concernsof practicing out of scope.Key Points:1) Streamline care for patients and providers through one system (Epic) for consistent documentationworkflow, immediate access to patient information, and minimal \"accounts\" patients have to log-in to accesstheir care and info2) Need to focus on digitizing patient forms (NPP, T&C). Stanford added checkbox consents as standard forpatient activation of their MyChart account. ***Look at PPT for screenshots of patient digitized consentsafter account creation***3) Video visit workflow took 1.5 years to rollout. Conduct extensive user testing to make sure it all worksbefore rolling out to larger patient population. Rollout after developing an implementation toolkit to scaleup 21 | P a g e

―Grace Lee AMBULATORYStanford has been live with video visits for their ambulatory operations for the past 6 month. They kicked offwith a Primary Care office that just opened and all the physicians were \"salaried\", hence they did not have toworry about the reimbursement rate. Physician's schedule was managed to see both in-person patients andvideo visits, however, one was allocated for video visits only. Some of the kinks that had to be worked out:What if the physician is running late, what if the patient was running late, how many monitors should thephysician use for the video and the EMR, who will test out the connection prior to the video visits and etc.They started off with 30 minutes for return visits and 60 minutes for new patients. To ensure 'identify' of thepatient, they were asked to hold up their ID card in the beginning of the visit. At this time, patients are notable to use their cell phone or tablet for video visits; hence, it made it difficult for those who work in open orcubical setting.Key Points:1) Certain personality traits are required for the MD to be successful in Video Visits2) Video Visits work best for post op or post discharge follow up visits3) 6am to 7pm visits were offered for patients and the highest requested time frame was during 7-9AMSession 59EXPANDING HOSPITAL SERVICES USING EPICCARE LINK―Andrew BeerA presentation by Lancaster General regarding their implementation of EpicCare Link. Discusses how they setup providers who work in external nursing homes to be able to order labs directly through Link while on site.Link is the preferred solution for allowing the lab orders to be received electronically in Epic while stillallowing the providers to follow the specific nursing homes' order procedures, as the nursing homes areexternal organizations and not built out in their Epic system.Key Points:1) Used EpicCare Link to give providers working in external sites a means to enter lab orders electronicallyand remotely, without requiring the external sites to be built out in Epic, which they could not be as theywere external to the health system2) Preference list size could be a challenge in doing this setup3) Have to anticipate the ordering needs of a range of external facilitiesSession 67HERDING RECORDS: CONTENT MANAGEMENT FOR MIGRATION―David MuiA presentation by Lancaster General regarding their implementation of EpicCare Link. Discusses how they setup providers who work in external nursing homes to be able to order labs directly through Link while on site.Link is the preferred solution for allowing the lab orders to be received electronically in Epic while stillallowing the providers to follow the specific nursing homes' order procedures, as the nursing homes areexternal organizations and not built out in their Epic system.Key Points:1) Used EpicCare Link to give providers working in external sites a means to enter lab orders electronicallyand remotely, without requiring the external sites to be built out in Epic, which they could not be as theywere external to the health system2) Preference list size could be a challenge in doing this setup3) Have to anticipate the ordering needs of a range of external 22 | P a g e

Session 75 AMBULATORYFOCUS GROUP: CADENCE―Laxmi KumarThe Cadence Focus Group discussed Upcoming features related to cadence.Session 85AVOID FLYING COW PATTIES FROM PROBLEM PROVIDERS―Jody GasparHow to engage providers in using Epic.Key Points:1) Identify problem providers early2) Customize the support strategy for each individually3) Train super users in the area where the provider works (NPs, etc.) who they are comfortable with to helpthem―Bernard Katz, MDUCLA session. How to engage problem providers in solving issues with Go Live and adoption of initiatives.Session 90MILK THE MOST OUT OF YOUR FLOWSHEETS―Ashwin BuchipudiLearnt how to use custom formula in flowsheet and also how to pull patients information into the flowsheetusing rules and properties. How to create new properties using rules.Key Points:1) Create flowsheet rows using custom formula2) How to use rules in the flowsheet3) How to find some inbuilt cache code to use in the rulesSession 95IMPLEMENTING ICD-10-CM IN A MULTI-SITE PEDIATRIC EMERGENCY DEPARTMENT―Andrew BeerA presentation by Cincinnati Children's on their implementation of a clinical ICD-10 go-live. Discusses theirdecision making in choosing how to present ICD-10 to the end users, and also their preparations for dualcoding. Key Points:1) The setup they finally settled on matches UCLA's clinical ICD-10 strategy closely. For example, they areallowing more general diagnosis terms to be used on the problem list, and requiring more specific codes inVisit Diagnosis field only2) They found issues with performance when general terms were searched for (searching on \"fracture\" forexample) as the volume of codes in ICD-10 is much larger. They found a solution through an SU which bringsan enROL setting to system definitions which allows the lookup time for search windows to be limited,preventing the system from hanging during searchesSession 96PARTIAL HOSPITALIZATION PSYCHIATRY PROGRAM BUILD―Daniel Noll 23 | P a g e

I presented Partial Hospitalization Psychiatry Program Build this year at UGM. I showed other organizations AMBULATORYour attempt and successful PHP build. Most users use a HOD build while we used pure ambulatory build. Thepresentation was very well received. Users have been extremely engaged and have already started contactingme.Key Points:1) Instead of holding questions to the end, let questions flow in during the presentation. I believe this wasone of the key reasons why our audience was so engaged2) The attendees stressed that there were few to no presentations directly relating to psych. I'm glad I wasinvited to speak and spread our build knowledge3) I'm glad I avoided a live demo and instead included plenty of screenshots in my presentation. The Epicnetwork was extremely taxed and I doubt I would have been able to show anythingSession 105INCREASING EFFICIENCY WITH KEYBOARD SHORTCUTS―Ashwin BuchipudiLearnt how to increase the efficiency for users by using keyboard shortcuts.Key Points:1) Found a lot of shortcut keywords that helps users to increase the efficiency―Melissa Chun, OD, FAAOPresented Hot Keys and keyboard combinations to navigate through Epic. Presenter has detailed list ofkeyboard shortcuts and Epic keys to essential replace function of mouse.Key Points:1) Keyboard shortcuts require another learning curve but select use of keyboard shortcuts could aid inefficient documentation in Epic―Lorena DouilleI was very impressed to see this presentation on how MD's can reduce clicks. I'm looking forward to reachingout to the presenter so that we can see how we can use some of her tricks in our Department. I'm hoping tocreate a pilot within our Department to see if we can really reduce clicks.Key Points:1) Systematic approach to create keyboard commands2) Great way of reducing clicks―Bernard Katz, MDUse of keyboard vs mouse for shortcuts with documentation and notes in Epic.Key Points:1) Alt Key2) Control Key3) Dictionary for phrases and word completion with space barSession 109PLANTING SEEDS: ANALYTICS FOR EVERYONE―Jody GasparHow analytics team supports the skill development and engagement of clinicians in decision making.Key Points:1) Create a team to prioritize reports 24 | P a g e

2) Create a reports library with criteria for each and who should use AMBULATORY3) Use radar dashboard for users linked to EMB record for security purposes―Kathie HaleHow analytics team supports the skill development and engagement of clinicians in data-driven decisionmaking.Key Points:1) Prioritize reports2) Create reports with definitions and the users of the reports3) Use dashboards to consistently report and distribute timelySession 114TRAINING AND OPTIMIZATION FOR BEACON―Czarina OfallaOptimization recommendations on how to enhance protocol build and how to increase end user efficiency.Key Points:1) Creating custom ERX and EAP codes to drop auth requests & home infusion start times2) Updating navigator sections and adding tabs in the WE rule to facilitate more efficient workflows3) Optimizations with Oncology History and SnapshotSession 119OLD MACDONALD HAD AN EPISODE: BENEFITS OF USING EPIC EPISODES―Tina Nguyen, MD, FACOGThis session focused on linking episodes of care. This is especially relevant to the IVF providers in OB/GYN.The presenter was quite poor and vague but I will contact her further.Key Points:1) Linked Episodes can be used to streamline IVF cycles and monitoringSession 130WHERE’S THE BEEF? IT’S IN THE SMARTFORMS―Ashwin BuchipudiI learnt how to use smartforms in notewriter and also attach smartform in a navigator. Link a flowsheet to asmartform using smartdata element in smartform that helps in reporting.Key Points:1) Create a custom smartform2) Attach smartform to the navigator section3) Link flowsheet rows to the smartform components and display in navigator sectionsSession 135BEACON PROTOCOLS: STANDARDIZATION & ADHERENCE REPORTING―Bruce NguyenThis discussion is about the importance of standardizing components of Beacon protocol build. Thisdiscussion also includes an introduction to Advance Order Groups (AOGs). The benefits to use Advance OrderGroups (AOGs). Finally using clarity functionality to build a protocol adherence report within EPIC.Key Points:1) The benefits of AOGS 25 | P a g e

2) A beacon protocol adherence report in EPIC AMBULATORYSession 144ED TO L&D WORKFLOW―Tina Nguyen, MD, FACOGOne center's ED triage to L&D transfer.Key Point:1) Not relevant to UCLA as we do triage and labor admissions in one placeSession 151MATERNAL FETAL MEDICINE ULTRASOUND REPORTING―Lorraine Malden, RN, BSNLearned about using PACS to document findings for obstetric ultrasounds to include fetal anatomic survey &maternal findings. Measurements of fetal anatomy then created the growth percentile related to gestationalage.Key Point:1) Using smartforms, information is charted in the form to create the body of the report for general resultsand fetal anatomy―Tina Nguyen, MD, FACOGHow one center was able to bring their ultrasound data into EPIC.Key Point:1) Need to get centralization of data in one system (PACS) and then can build out the formsSession 153SOWING SEEDS FOR MYCHART SUCCESS―Andrew BeerA presentation on promoting and increasing MyChart metrics by the Ohio State University Wexner MedicalCenter. The focus is on how to promote patient usage as patient messaging (both in and outbound) aremeaningful use metrics. There is a good deal of discussion on promoting internal adoption of MyChartfunctions by providers, as they are a key link in engaging patients.Key Points:1) Releasing results to patients' MyChart accounts early and often (one-day delay) is one suggestion forincreasing patient involvement2) Promoting prompt physician office responses to MyChart advice request messages was another lesson.Patients were more likely to engage with MyChart when the replies were kept within a 24 hour turnaround(OSU mandated this response time from their users)3) Including patient pre-visit questionnaires in MyChart was a big step for them, as it not only engagespatients, but a submitted questionnaire counts toward Meaningful Use messaging metrics as well―Grace LeeOne of the difficult MU objective for many hospitals is to meet the 50% or greater Mychart activation rateand having population greater than 5% route messages via Mychart. Ohio State University was able tomitigate this issue by doing the following: 1>Engage Leadership 2> Establish Imperative adoption of Mychart3>Set clear metrics and goals 4>Provide Education 5> Define Best practice 6>Build necessary changes intoEMR 7>Strong marketing plan. During monthly meetings, they called out the exceptional and the low 26 | P a g e

performance clinics, which encouraged low performer to up their activation rate. Also, mychart message AMBULATORYturnaround time was monitored to ensure patient satisfaction.Key Points:1) Monitor physician and office staff's mychart message turnaround time2) Promoted Mychart during local news channel's \"healthy minute\"3) Signed up patients in the room, so that they can register using the computer in the room―Samantha CaoThe Ohio State University Wexner Medical Center presented on how they engaged users and patients tomeet MU Stage 2 and utilized a faster workflow for granting proxy access to MyChart. They formed aMyChart workgroup to identify 7 actions to improve sign-up rates to address patient and staff awareness,marketing, training, and tracking progress towards goals. The workgroup relied on the executive director ofambulatory services and medical director of ambulatory services for engagement and support.Key Points:1) Highlight importance of MyChart adoption as it relates to financial impact (meeting MU objectives) andmaking it part of the EPs performance goals/evaluation. Utilize hyperspace physician dashboard to let eachphysician know how they are doing with meeting MU (patient messaging and turnaround time). Turning onhistory questionnaires greatly increased ability of EPs to meet 5% messaging objective2) Ambulatory leadership made MyChart e-learning required for all staff including physicians. 15 minutes e-learning showing the patient's perspective and cc user's workflow. Included in New Hire training too3) Success was attributed to executive leaders understanding the definitions of objectives and goals andbeing able to discuss this with their colleagues and direct reports when encouraging action to meet MU.Everyone in the organization was talking about MyChart because it's integrated into each department's goalsSession 165IRRIGATING THE AMBULATORY SPECIALTY USERS―Allen Wu, MDReport from Lancaster General Health South in Pennsylvania. Described an effort that went BACK to clinicsthat had gone live and had never really been optimized, frequently specialist groups that had particularworkflows that had never been optimized. Their biggest problem was to get buy-in that they could actuallyhelp and felt that Epic TS as part of the team was essential (!). Approach was systematic by specialty levelusing the Epic Specialty Optimization Toolkit which they expanded from 3 weeks to 12 week timeline.Key Points:1) Will review the Specialty Optimization Toolkit from Epic for guidance when optimizing specialty workflows2) Had a very nice presentation of build hours available in dynamic spreadsheet to give to manager and havethem prioritize which things to build for their optimization. It will help each clinic understand the timerequired for any requests made3) Keep monthly meetings with each specialty going forward with NO commitment to build, but opportunityfor them to be heard. Good ideaSession 170MILKING WIDESCREEN TO MOO-VE FASTER―Bruce NguyenDemonstrated how widescreen will benefit Oncology workflow. Improve provider’s efficiency andeliminating workflow snags.Key Points:1) Improved user workflow by minimizing scrolling 27 | P a g e

2) Improve the display to give users the information they need AMBULATORY3) Customization the display to the userSession 178WORKFLOWS AND TOOLS FOR TRANSPLANT COORDINATORS―Andrew BeerPresentation by University of Iowa about the workflow they built to facilitate transplant coordinatorworkflows. Especially discusses Cadence scheduling build for transplant scheduling as well as using Beacontools for treatment plans.Key Points:1) Iowa uses MA's to schedule patients, draw labs, and gather historical information. Because of the largescope of responsibility they gave their transplant MA's, they created work list tasks for the MA's to use totrack all their duties per patient2) For post-transplant treatment and care, they used Beacon treatment plans and built them out withtransplant monitoring lab orders instead, to ensure the patient was consistently getting the right labs at theright time after transplantSession 179ROUNDUP: LAB RESULTING AGENCIES, PROCEDURES, AND RESULTS―Bruce NguyenThis session shows how to integrate EpicCare Ambulatory and tend distrinct Labs. They reviewed obstaclesto ideal workflow and see solution implemented to improve lab ordering. Maintaining the ASP logic forfuture state.Key Points:1) Using ASP logic to automatically input patient LABS2) Extensive training to provider to set resulting agency3) The relationship with the clinics to keep insurance up to dateSession 185AS YOU SOW DATA, SO SHALL YOUR REGISTRIES REAP―Daniel NollPark Nicollet from Minnesota was utilizing Epic tools for their diabetes registries prior to Healthy Planet.They were using Reporting workbench, epic crystal reports, crystal reports, and Excel for their registry needs.Most of the information they gave was unique facts about their organization. The best part was the PatientPartner program they have. They identified a few patients to act as partners in the development of the care.They invite these patients to their meetings and valued their input.Key Points:1) Patient Partners can be a valuable tool to help get patients the quality care they are looking for. I wouldlove to see this happen at UCLA2) The more users utilize patient population tools, the more they feel a part of the patient's continuing care3) It seems that organizations are always in the process of fine tuning their registries and their inclusionrules. We will likely have to do the sameSession 200SAVING CLICKS IN EPICCARE AMBULATORY―Eric Cheng, MD, MS, FAAN 28 | P a g e

Quick wins defined as easy to set up, high end-user satisfaction, yet settings are turned off by default. So AMBULATORYmany features that I have not seen before!!!Key Points:1) My favorite session at UGM2) Should be mandatory viewing by ambulatory Informaticists3) I will discuss with ambulatory team―Kathie HaleSharing system configurations to minimize clicks by the physicians.Key Points:1) \"Quick\" reports - mini chart review in the inbasket which includes visit info, meds, vitals, MD's last note2) Filters - check provider notes & hide deleted. Same with labs & imaging - hide canceled3) Smartlink information - bring in 1-2 labs (not all) & create hyperlinks to add to results4) Add \"wrench\" button so users can customize―Darryl Hiyama, MDSimilar to above, a number of changes both in 2012 and 2014 are available now. Definite improvements toexisting shortcomings. Suspect that users will find them very useful.―Hawkin Woo, MD, MPH, FACPEpic enabled functionality overview. Hyperspace 2010 System Chart Review Filters now available, previouslyneeded TXT. Smartlink Info in Chart Review to find Base names quicker, avoid note bloat when users pull ineverything in a time period, more targeted pull.Session 205MAMA GOAT CHECKS ON HER HOSPITALIZED KIDS―Tina Nguyen, MD, FACOGHow one cenger allows parents to enter their neonates mycharts as a proxy to see their progress in the NICU.Key Point:1) Proxy MyChartSession 208FRONT DESK USER FOOTPRINT―Jody GasparMeasure user touches for developing a front desk scorecard.Key Points:1) Need budget, standardization, productivity measurements, but be mindful of varying job duties2) Include daily average No of patients checked in, scheduled, and arrived3) Add patient satisfaction scores and denial information―Kathie HaleTrack/measure user touches for developing a front desk user scorecard.Key Points:1) Need budget, standardization, productivity measurements. Challenges: job duties vary, specialties can beunique2) Include daily ave # of patients checked in; daily ave of patients scheduled; completed/arrived; high volumeusers 29 | P a g e

3) Add patient satisfaction from QDM; denials (insurance not on account; incorrect insurance, etc.) AMBULATORY―Theresa KylesThey discussed the needs to customize reports used to describe the front desk work flow process. Theyutilized dashboards to standardize the work by job title at the front desk. Thou they were challenged withbudget cuts, this allow them an opportunity to look at patient volume and expand staffing needs accordantlyas physician availability varied from front desk to desk. Some of their employees were reclassified to meetthe work expectations.Key Points:1) Daily average patient checking in by user and daily average patient scheduled by user.2) Determine high volume users.3) Using a position control number (PCN) file from HR to match use and appropriate work areas―Ricardo ZeferinoThe front desk user footprint was mainly coded to manage UPMC's front desk employees. Also, the tool wasused to prioritize float pool requests by assessing patient volume at each practice. The main reasoning forbuilding the footprint was to allow for supervisors to assess employees' productivity.Key Points:1) A report card measuring specific criteria could assist the float team in benchmarking everyone’sperformance2) Managers will be able to measure departmental inefficiencies with new reportsSession 214A HEALTHY HARVEST: POPULATION HEALTH LAUNCH―Daniel NollNovant health was one of the first organizations to work with Epic on developing population managementtools. They were the first in the country to go live on advance population management dashboards. Theyutilized PODS (Patient Oriented Delivery System) to break apart health service areas across geographic areas.They have an integrated team of providers who coordinate care across multiple care settings.Key Points:1) They spent a lot of time developing the dashboards for users. Focusing time in the area where users oftengo to find information is key. Quality of data and ease of access should be our focus2) They also created quite a few panel metrics which show how providers are doing across the entireorganization. It resulted in competition among MDs to get a good score since each provider's score waspublic knowledge3) Since they were an early adopter, they will be implementing healthy planet tools like Slicer Dicer later on.They look forward to using these new tools. This is a good sign that healthy planet is a useful tool since theyare so engaged to use new functionalitySession 215LEAVIN’ THE FARM: MYCHART & WELCOME FROM TOTS TO TEENS―Samantha CaoUsing combination of MyChart and Welcome to collect pediatric data such as developmental and behaviorscreening data. Questionnaires are assigned based on scheduled appointments (rule-based). Process is well-received by providers and staff and encourages them to get their patients signed-up on MyChart. Otherstrategies used to promote MyChart in the pediatric population include the following: questionnaire-onlyaccess to upcoming appointments and questionnaires via proxy when parent is making the appointment and 30 | P a g e

promote to teens that they have access to their doctor for sound medical advice. Sutter has rolled out access AMBULATORYto teens and their parental proxy. Has special access class for parents who need full access. Confidentialmessaging is not available on the mobile app (must communicate this). Build: batch jobs --> ***look at pptsolution slides***; custom web smartform for online proxy request.Key Points:1) SWYC Milestone questionnaires - The Children's Hospital of Philadelphia is willing to share their build withother organizations2) Need build for users to tag \"sensitive\" information so it can be filtered out of MyChart to improve proxyaccess to useful features3) Sutter rolled out teen access to MyChart today. ***Look at slidedeck with summary of teen access andproxy access*** Utilize existing online proxy tool!!! Parental permission for teen to have online access isonline (required by law)? Parental approval shows up in the teen's visit navigator for staff to sign them up inthe clinic (not allowed to activate online)―Grace LeeSutter Health really took advantage of the 'Questionnaires' within Mychart. They made the questionnairebecome available 7 days prior to the patient's appointment and if it wasn't filled out, sent a reminder 2 daysprior again. For those who did not have the questionnaires complete, were provided with tablets during thecheck in process. Online Proxy Set up is available by patient entering child's name and if they share the same'address' was granted. Sutter also allowed proxy of teen to email teen's PCP. Parents of teen were givenchoice to let their teen activate their Mychart account.Key Points:1) Sutter's had a great promo video made for teen’s mychart access: video was simple, yet entertaining andwas able to grab its audience2) Sutter allows the parents to decide if teen should have access to Mychart vs. UCLA no consent is required3) Strong leadership engagement was needed for implementation of mychart. <budget>Session 222PLANTING THE SEEDS OF ELECTRONIC SURVIVORSHIP CARE PLANS―Bruce NguyenDeveloping and using Survivorship Care Plan in Epic. Also a discussion included EPIC's future plan forsurvivorship functionality and content.Key Points:1) Survivorship report for end users and patients2) Creating and maintaining template for easy use for clinicians3) 2015 smartlink, chemo treatment planSession 229STRATEGIC DESIGN GROUP- CASE MANAGEMENT―Audrey McClenaghanThis new enhanced model of case management was very detailed. This is for the 2014 upgrade and it wasbeing presented by EPIC for user feedback on the current proposed enhancements. The Model started withthe Registration process and evolved to discharge placement. The Dashboard Metrics included but notlimited to: Approval Rates, Discharge Rates, SNF days, and avoidable days. A case manager would not haveto call SNF'S, the system could automatically reach out to the current contracted vendors. Right Fax interfacehas been completedKey Points: 31 | P a g e

1) Wonderful tool for Disease management AMBULATORY2) Who would build and maintained these scoring systemsSession 245GROWING INTO NOTEWRITER FOR TRAUMA―Ashwin BuchipudiI learnt powerful utilization of notewriter to improve patient care.Key Points:1) I learnt how to customize the notewriter2) How to use notewriter in order to satisfy quality measuresSession 252OLD MACDONALD’S CO-OP FOR CHRONIC DISEASE―Bukeka ChandlerLancaster General Health presented their challenges and successes with their new cancer center, whichopened on July 8, 2013 and located in south central Pennsylvania with 631 best, 37, 166 inpatient discharges,more than 7,000 employees, and over 900 physicians. Their challenge was integrating their many servicesand programs (i.e, Genetic Counseling, Nurse Navigator, Symptoms Clinic, Dietician, Pastoral Services, SocialWork, Financial Counseling and Image Recovery Center) in EPIC. After implementing their solutions (i.e.,extraordinary customer service, concierge service upon arrival, improved registration workflows, no patientwaiting, peaceful and pleasing facility design, and a collaborative approach between physicians and staff),the results showed improvement in on-time appointments from 45% to 85%, activation of MyChart improvedfrom 30% to 50%, and patient appointments increased from 1.5 to 3.5 per day.Key Points:1) Becoming more patient/customer focus will improve overall numbers2) New centers/clinics should consider conducting mini-orientation to the center/clinic for all patients3) Strategically place kiosk(s) in the clinic for those technically savvy patients―Ricardo ZeferinoLancaster General Health in south central Pennsylvania implemented a seamless workflow process for theirchronic care patients. They incorporated key technologies such as IPADs and Kiosks to assist with check-inand questionnaires. Also, they made sure key data was being collected upon initial scheduling. For example,patient information, insurance, guarantor, hospital account (if applicable) and set PB visit account andcoverage (if applicable). This led to short wait times and high patient satisfaction scores.Key Points:1) Technology is key to improving workflows such as Kiosks and IPADs2) On-time appointments in the clinic improved from 45% to 85%3) IT needs to build the infrastructure to implement webcams, so staff can identify patients by viewingphotos (removes the announcement of names in waiting room; HIPPA Violation)Session 255FOCUS GROUP: STORK OBSTETRICS―Tina Nguyen, MD, FACOGNew options in upcoming versions of EPIC/Stork.Key Point:1) Overall nice options 32 | P a g e

Session 256 AMBULATORYFOCUS GROUP: EPICCARE AMBULATORY―Daniel NollThis was probably the most useful presentation I attended. Epic staff demoed future state EpicCareAmbulatory. There are some amazing changes coming down the pike. There is also a lot of brand newfunctionality in the new version as well. I have attached a summary, sorry but I don't have pictures.Key Points:1) The Visit Task bar is an amazing feature that will allow users to enter orders, LOS, Dx, and sign encountersfrom anywhere in the patient's encounter2) The new Card system looks very promising. It organizes tasks for users and gives them the most criticalfirst so users can take action on them. This looks to help streamline workflow3) The new 2015 build beefs up existing functionality and makes workflows and functionality much better. Isat in and tried some of the Chart Review changes at one of their user engagement sessionsSession 266HOME GROWN: BUILDING A TIER 2 SUPPORT CENTER―Scott ShermanChallenges with setting up a Helpdesk call center that can also act in the capacity of a Tier 2 support center.Approach and lessons learned reviewed.Key Points:1) Staff selection is key; need people with the right background, skill set and motivation2) Training and retention is an ongoing challenge due to the economics of certification3) There are advantages in cross training and working in multiple knowledge areas/modulesSession 268DUCKS IN A ROW: REPORTING WORKBENCH FOR BETTER BUILD―Ashwin BuchipudiI learnt how to create custom templates. What is the use of creating reporting workbench reports? Differencebetween SQL reports and RWB reports.Key Points:1) How to index columns for faster searching2) How to create action pack to take bulk actions on patients3) Using Cache code to develop complex criteria or columnsSession 271ALIGNING DOCUMENTATION AND WORKFLOW IN THE PCMH―Ricardo ZeferinoCone Health System serving the Piedmont, North Carolina presented their goal to integrate documentationand data capture into a seamless workflow. The ambulatory team implemented PCMH doc flow sheet, whichthey integrated into the visit navigator. The information from the visit navigator was then transferred to theAVS and A & P (assessment and plan) Notes via smartlinks reducing duplicate work for clinical staff members.Key Points:1) Clinical staff should work closely with ambulatory build team to collaborate on departmental needs.Adding physician builders to team improves likelihood of success2) Pulling SmartTexsts and SmartLists from other forms into AVS summaries are the key to simplifying andstreamlining clinical documentation 33 | P a g e

Session 277 AMBULATORYSUCCESS AT 7: BENEFITS OF MYCHART MEGA-ADAPTION―Grace LeeNovant Healthcare really took advantage of 'Mychart' to meet Meaningful Use and to meet ACO model.Offering Bill pay via Mychart app was a true turn-around for the organization as whole. In short amount oftime(6 month), they collected over 4.3 million dollars with mychart bill pay. By using the openscheduling(direct scheduling) 2,411 new patients were brought into the system, generating over 4.1 milliondollars in revenue. No show rate via open scheduling was only 4%, much less than average no show rate.Video visit and E-visits were also offered to patients via mychart.Key Points:1) Between E-visit vs. Video visit, patient preferred e-visits for follow ups2) Billing had to work closely with various insurance companies to make sure that e-visits and video visits canbe reimbursed. <work out the correct CPT codes.3) After Mychart bill pay went live, they were able to reduce their billing department call center staff by 50%and average hold time went down to 120 secondsSession 282FOCUS GROUP: WELCOME PATIENT KIOSK―Angela Amucha, BSN, RNReview of existing and future functionality of Welcome with customers currently using Welcome and thoseplanning to use this product in the future. 2015 features: patient and encounter level smartforms, patientdriven account assignment (ie..Worker’s compensation), and remote support for e-visits.Key Points:1) Tablets can be utilized for check-in, visit payments, and completion of questionnaires2) Allowing patients to pre-register thru MyChart to decrease wait times in the clinic3) Allowing patients to see the average wait times from the patient login screen in WelcomeSession 283FOCUS GROUP: BEACON ONCOLOGY―Bruce NguyenMeeting developers to see what is in future Beacon Build. They summarized their top items to fix and build.Top items were BMT Transplant, Scheduling Request, Radiology Oncology, and Oral Chemo.Key Points:1) Epic Consulting Services2) BMT - Transplant date no more negative days3) Managing Scheduling Request. EAP for scheduling that will drop into the order work queue―Czarina OfallaVoting on prioritization and future enhancements for 2015.Key Points:1) Oral chemotherapy workflows still being enhanced2) Using weight and height specific to Oncology for dosing chemo3) Med replacer utilities will extend to therapy plans and looking at extending to include mixturesSession 287PREDICTING & PREVENTING CLINIC NO-SHOWS 34 | P a g e

―Kathie Hale AMBULATORYHow to build & fine-tune the predictability model.Key Points:1) Providence Health and Services created a model to predict the % of no-shows using patient demographics:age, sex, ethnicity, email, whether they live in an apartment; Added encounter detail for prior 24 months:no-show, total arrivals, late arrivals, early cancellation, late cancellation, first visit, # of providers seen, # oftimes seen, hospitalization; Added DX crawler (i.e., drug use has highest no show rate); HCC demographics;Add duration of time from home to clinic; Add median income based on 2010 census & zip code2) They are willing to share their model3) This was about the calculation not what to do to reduce the no-show rateSession 289NEW FRONTIERS IN E-PRESCRIBING OF CONTROLLED SUBSTANCES―Andrew BeerA presentation by Rady Children's about their adoption of a workflow for e-prescribing controlled substances,which is a first in California. Discusses the legal and operational challenges of this approach.Key Points:1) Adopting e-prescribing for controlled substances requires implementing two-factor authentication, per theDEA. In their case, they chose passwords combined with biometric scanners2) This workflow requires SureScripts version 10.63) It was a struggle for them to get pharmacies to accept the e-prescriptions, after the technical work wasdone, due to misconceptions that the e-prescriptions for the controlled medications were not legal. Theyreceived support in overcoming this from the California HealthCare FoundationSession 298FERTILIZING THE GROWTH OF PATIENT ENGAGEMENT TOOLS―Samantha CaoNovant Health's use of MyChart from a revenue service perspective by focusing on patient experience inscheduling, billing, and updating demographics. Direct appointments made online through MyChart and openscheduling greatly decreases no show rates and saved the organization $600,000+, including same dayappointments. $5+ million collected through MyChart online bill pay in 6 months (major satisfier for self-paycollection). eCheck-Ins since July 2014 (no marketing or promotion and already 3400 check-ins). Novant madesure patients who did not have a MyChart account still have the option to pay online but really encouragedpatients to sign up for an account. Outcomes: increased efficiency (lower customer service support needs),higher collection rates, higher patient satisfaction and lower contractuals.Key Points:1) Centralize all patient services into one seamless patient experience --> MyChart clinicals, billing,appointments, and demographics. Must have very strong operational and technical partnership2) Direct appointments made online through MyChart and open scheduling greatly decreases no show rates,including same day appointments. Emphasis that the clinic is still in control3) Very important to integrate the bill pay functionality with the clinical portal because patients are alreadygoing there to view their clinical information―Kathie HalePatient Engagement is the # 1 key for true patient satisfaction, MyChart is THE best tool to help organizationachieve that. Patients were offered online Pre registration, which simplified their office visit and allow themto take care of their co-pay prior to the visit. Using one patient portal system to manage their health and take 35 | P a g e

care of bills increased efficiency, resulted in higher collection rate and increased overall satisfaction for our AMBULATORYpatients. Key Points:1) Ensure patient engagement tools are built to be intuitive and simple2) Make MyChart part of the organizational culture, including revenue cycle3) Continue to increase adoption of technology, don't be afraid of the newSession 308FEEDING THE PAPER TO THE GOATS―Ricardo ZeferinoThe University of Mississippi Medical Center redesigned their documentation process from paper to Epicwithin their Transplant Department. The individuals who were resistant to change did not feel comfortableusing an EMR system because they lacked basic computer skills such as typing. Leadership stressed toemployees with a formal letter indicating clear expectations to use EMR instead of paper to document patientencounters because they were creating multiple workarounds. As a result, the high inefficiencies were causedin staff work flows and delays in patient care and access.Key Points:1) Make sure staff have basic computer knowledge before training them on Epic2) We should consider offering basic computer courses (i.e. typing) within CareConnect for individuals lackingcomputer skillsSession 315PHYSICIAN-TO-PHYSICIAN EPIC OPTIMIZATION TRAINING―Allan Wu, MDJacqueline Leavitt at Rush, substantial effort as physician informaticists, essentially provided a 1:1 by apptphysician-visiting the physician in office to help personalize workflow. Took care of nearly 200 physician visitsin 1 year with a 0.5 FTE. Suggests splitting a FTE by 3 physicians. We might be able to offer this, but it’s a bigstep and takes a lot of time, but obviously very personalized and directed toward physicians. Typical sessionis 1.5 to 2.5 hours. We already do this with a rare few providers who really need it.Key Points:1) Must schedule non-patient non-clinic time for personalization in the physician's office2) Schedule time to observe physician throughout workflow with patients before personalization. Collect thepain points3) Emphasize pretty extensive personalization (a lot!!!) of filters, smartphrases, keyboard shortcuts,dictionary - stuff we do, but not directly personalizedSession 335FOCUS GROUP: MYCHART PART 1 OR 2―Grace LeeNew features coming for Proxy access: Suggested proxy by pulling information from Emergency contact andguarantors. Epic will be getting rid of \"Enable for Proxy Use\" bar. Patient's will be able to 'soft-register' viaMyChart and schedule their first appointment using open scheduling. If an earlier appointment becomesavailable, patients are sent alerts via MyChart App. Epic 2015 will allow us to brand our own MyChart app.Key Points:1) Physicians will be able to assign flow sheets to patients via MyChart, having them keep track ofweight/glucose level/ blood pressure and etc. Physician will be alerted if value out of range is added bypatient, hence, able to keep a close eye on patient's status 36 | P a g e

2) Using MyChart, organizations will be able to bring in \"new\" patients, who seeking quick access to AMBULATORYhealthcare via web or video visits3) During initial consent signing, include verbiage for \"care everywhere\" pre-authorizationSession 342BEACON AND SCHEDULING: WHERE NO MAN HAS GONE BEFORE―Andrew BeerA presentation by CentraCare about their implementation of a complex Beacon infusion visit schedulingworkflow, designed to reduce wait times and use nursing resources more efficiently.Key Points:1) Their main achievement was the development of an acuity scale, to assess the complexity of care neededby scheduled patients. This allowed them to assign workloads at the beginning of the day with an eye towardbalance, so that one nurse was not ending up with all the most difficult patients2) The acuity scale was reflected in Cadence by building multiple visit types (for complex, simple, etc.patients), and leaving appointment notes to indicate each patient's particular issues3) The acuity scale was extended into Beacon by rating each treatment plan with an acuity score, so that theacuity of patients could be judged by the front desk simply by checking which treatment plan they were onSession 356REVENUE CYCLE SUPPORT ACROSS MULTIPLE SILOS―Ricardo ZeferinoNovant streamlined the billing workflow by utilizing Epic's billing system. They went from using twenty ninebilling platforms to one platform with Epic. Overall, the organization was extremely successful illustrated byreducing 66 % of accounts with 121 days aging to only 5 % of accounts aging more than 121 days.Key Points:1) Create a dedicated team for ICD coding working denials2) Practices should measure patient’s propensity to pay with Experian to see if they qualify for charity3) 85 FTEs were removed due to improved efficienciesSession 359BUILDING BARNS, NOT SILOS: AMBULATORY PRODUCTION SUPPORT―Samantha CaoReview production support structure evolution to better support ambulatory operations as a whole by crosstraining support staff and partnering with other team managers. Cross training provides additional internalresources for new project support in all applications. Focus on long-term benefits instead of short turnaroundtimes by investing in the right people and providing opportunities to learn about other applications/areassuch as operations, other IT departments, building relationships outside of their team.Key Points:1) Production support staff needs to have a strong understanding of the operational aspects of the system -how end users utilize the system to provide patient care2) Have a structured ticket submission process to capture and track all issues. Must enforce business owner’suse of the system instead of email/phone3) Production support is a different kind of work that requires different type of people from implementationsupportSession 394 37 | P a g e

DICOM SR INTEGRATION FOR ULTRASOUND IMAGING AMBULATORY―Tina Nguyen, MD, FACOGTips on how to get data from DICOM to EPIC.Key Point:1) Need images to be in one central hubSession 400PATIENT-REPORTED DATA INTEGRATION―Samantha CaoGeisinger collects patient reported data in the form of questionnaires through a variety of collection points:MyChart, ipad in waiting rooms, touchscreen in exam room. Questionnaires are built in DatStat and arelaunched through DatStat then files back to Epic via the web service into flowsheet rows which can be pulledinto print groups for nicer display in Epic. Decision support is set up to alert provider of results using BPAs(with acknowledgement buttons and smartsets and IB messages. Examples of questionnaires being used:depression PHQ2 (MyChart) PHQ9 (in-clinic) with adult and modified teen versions; asthma control test (ACT)in primary care, pulmonary, and asthma clinics; pediatric wellness screens for nutrition, activity level andsleep apnea triggered by BMI; medication reconciliation prior to visit; sleep apnea risk assessment triggeredby diagnosis and/or BMI (STOP questionnaire). Standardize format of questionnaires for ease of patientcompletion.Key Points:1) Integrate into workflow so when screening is due, activity automatically launches/prompts in MyChartand in Epic for the clinician to act on and is available to launch ad hoc within the navigator. For Providers,\"review flowsheets\" section to see results over time. Created Encounter type \"patient survey department\" todisplay in Chart Review2) Eligibility for specific screenings are pulled from the patient problem list3) Regular screening of patients have generated a higher volume of referralsSession 422PICTURING A BETTER EHR: HAIKU & CANTO PHOTO CAPTURE―Andrew BeerA presentation of how Sutter Health and Stanford have implemented the photo capture feature of Haiku andCanto to improve communication and documentation in their systems.Key Points:1) Haiku and Canto include a photo capture feature that can add both ID pictures and clinical images topatient charts with a simple click. No image is stored on the mobile device, but rather it loads directly intoHyperspace via the blob server, reducing PHI concerns2) Clinical images taken this way can be attached to notes in Hyperspace and viewed by anyone in thesystem. This can facilitate e-consults, as a physician can take an image of a symptom he would like a secondopinion on and it will be viewable immediately to the consulting physician, without the need to send thepatient over3) The ID photo feature can be used to capture patient portraits which can display throughout Hyperspace aswell as MyChart. This has been promoted as an effective tool against medical identity theft―Ricardo ZeferinoStanford and Sutter described their experience using the Haiku and Canto applications. Sutter piloted theprogram with only 500 physician users in 2012, which has grown to over 3500 physician users at the presenttime. Administration was resistant to using the image function due to computer storage space, but they were 38 | P a g e

pleasantly surprised that photo images only used 100 kilobytes of storage space. Capturing photos and AMBULATORYsharing them within patient care teams has allowed for improved patient care and turnaround time.Key Points:1) UCLA Health should develop the IT storage infrastructure to rollout both applications2) The use of photos in the clinical setting allowed for improved patient throughput by physicians becausethey were dictating less (photos can capture a thousand words)Session 450NO BULL: TOOLS TO IMPROVE WOMAN’S HEALTHCARE―Tina Nguyen, MD, FACOGUsing third party apps or building your own to improve contraception care to women.Key Point:1) Linked Episodes can be used to streamline IVF cycles and monitoringSession CAC03ENGAGING ALL USERS FOR SUCCESSFUL EPIC ADOPTION―Daniel NollI was hoping this session would go into detail about Epic adoption beyond implementation. It was gearedmore towards organizations who are first starting off with Epic. I was still able to find value in this session.Staff from Catholic Health Initiatives reviewed their process towards getting users up and live on epic with anopen mind towards the new system.Key Point:1) Expose your users to Epic workflows, terms, and ideas as early as possible. The same can be said aboutimplementing new clinics that have been recently acquired.2) Under promise and over deliver3) Utilize \"Adoption Office Hours\" where users can come in and review specific focus areas. Offer thisprogram on a mobile platform. Bring WOWs to the floors to help those who can’t make the office hoursSession DAC04INCREASING YOUR YIELD: PROGRAMS TO LEVERAGE THE EPIC COMMUNITY―Scott BaileyDiscussed various Epic programs including Emeritus, Stars, and Benchmarking and how to leverage them.Epic's Benchmarking program publishes to academic and pediatric peer groups monthly and requires at least10 unique submissions before metrics are published (to protect identities). In 2015 they will expand toadditional peer groups.Key Points:1) Benchmarks published monthly2) Free functionality, requires operational engagement (free) to validate data3) As of August, 49 clinical benchmarks and 14 financialSession DAC05CROSS-POLLINATING TO IMPROVE YIELD: PAIRING ANALYSTS WITH PRACTICING CLINICIANS―Scott ShermanReview of approach where physicians are paired with a build analyst to help the physician become a builderwithin Epic.Key Points: 39 | P a g e

1) Approach of close pairing of physicians to build analyst a worthwhile approach AMBULATORY2) Physician engagement is key3) UCLA has a similar model already in placeSession FAC18REFERRAL AND AUTHORIZATIONS WORKQUEUE OPTIMIZATION―Allan Wu, MDHow UCSF created an aggressive 4 week program to fix and re-do all ambulatory clinic workqueue build in anindividual clinic way. They started with just 1 workqueue per DEP?!?! Ran 4 week cycles including build, 2week offsets, 4 projects running concurrently. Big project. Week 1: kickoff, intro, expectations, Week 2:validation of WQ spec document, signoff start build, Week 3: testing and signoff (validate in PRD), Week 4:train end users, cut-over. 6 months.Key Points:1) Referral builds must test in PRD2) KEY - obtain a pre-visit QUESTIONNAIRE - that asks what the pain points are for referral WQ for that clinic -what current WQ used, missing DEP, Visit Types, relative volumes, pain points, staff available; start 2 weeksahead of kickoff; review with manager 1-2 days before3) Created many tweaks and strategies -- 2221 rules; 522 unique rules in DEP's with 332 referral WQ, 98 authWQ, build Visit Types, identified different workflow types (which we can and probably should do)Session FAC19PEARLS: WELCOME PATIENT KIOSK―Deidre Keeves, PTCHOA and KP discussed use of welcome kiosks in clinics. CHOA discussed a pilot process used prior to fullscale deployment while KP took on a different approach and employed wide scale aggressive timeline for arapid roll out.Key Points:1) Thoroughly test welcome with upgrades! One organization had a significant challenge with welcomefollowing their double upgrade which caused the welcome kiosks to be down for 4 weeks while the issueswere being resolved2) Organizations achieved a 30% registration utilization rate using the kiosks and were able to reduce frontend staff3) Welcome is not currently compatible with ipadsSession General SessionCOOL STUFF AHEAD―Darryl Hiyama, MDMajor design change in Ambulatory workspace. Heightened mobile connectivity and functionality. Push forpatient engagement and ease of navigation. Interoperability with both Epic and non-Epic providers has beenimproved.Key Points:1) Interoperability is improving. Both Care Everywhere and Connect will likely be major improvementsespecially in our market2) Mobile platforms are improving in functionality though more so on the patient side vs. the provider3) The Ambulatory change is a major one. Looks different from the Inpatient workspace so may not be awelcome change for users―Tina Nguyen, MD, FACOG 40 | P a g e

New research areas and population based data collection AMBULATORYKey Points:1) 2015 version―Bernard Katz, MDIntegration by Epic with multiple vendorsKey Points:1) 2015 screen actually looks more confusing although they say it is \"cleaner\"Session General SessionEXECUTIVE ADDRESS―Tina Nguyen, MD, FACOGLots of new Ambulatory and research stuff coming in 2015.Key Points:1) Care Everywhere2) Express Lane workflows3) The Ambulatory change is a major one. Looks different from the Inpatient workspace so may not be aSession HIM03HERDING DOCUMENTATION: NO-FUSS NOTE ROUTING―Allan Wu, MDReview of go-live problems with routing of notes at UCLA. Solution has put research of provider addressesand recommendations for updating SER records on HIMS. No complaints but may not be frequent HIMSfunction. A lot of work behind the scenes had to happen between M-modal and CareConnect get this systemto work, indicating when a provider was not in the system (using a P and asterix to manually indicate whensuch research is needed). Transcription rates have gone down but not as much as other places.Key Points:1) Auto-routing background better understood; consequences on resident/fellow workflow require Epic TSinput2) How can we make Communications more efficient for providers from here? (Question raised in my mind,not yet addressed)3) How can we decrease Transcription rates? (Question raised in my mind, not yet addressed)Session NAC04WRANGLIN’ THE CATTLE: PATIENT TRACKING IN THE CLINIC―Angela Amucha, BSN, RNUniversity of Iowa implemented smartforms and custom columns to help track patients in the clinic.Key Points:1) Using custom columns in the multi provider schedule indicating wait time, check in status, rooming timeand duration of entire visit creates visibility for clinic staff and providers to efficiently manage patients2) Importance of visual indicators to assist clinic staff in tracking patients in the clinic3) Consider turning a column red if a patient on the schedule has had no activity in 15minsSession NAC09IN PURSUIT OF A NOVEL PATIENT CENTERED GALAXY FOR CHRONIC CARE―Deidre Keeves, PT 41 | P a g e

Stanford Children's health (pediatric multispecialty ambulatory providers) created a patient flag of \"Complex AMBULATORYCare Patient\" that drives a Shared Goals Activity that is seen across all encounters. They used care teamcomments to determine if a provider was part of the core care team or an advisor. This drove messaging logicwith a new messaging type called \"status chat\" to facilitate communications across the team.Key Points:1) Patient level flags can drive specific custom activities that cross multiple encounters (complex care patient)2) Integrated a custom built \"shared goals\" section across multiple encounters and made this viewable inmychart3) The program greatly improved coordination of care across specialty pediatric populationsSession NLF05FOXES WATCHING THE HEN HOUSE? NON-PROVIDER ORDER ENTRY AND SCOPE OF PRACTICE―Angela Amucha, BSN, RNJohn Hopkins Medicine created a protocol and policy group to help examine and execute a methodology tofacilitate orders placed by clinic support staff.Key Points:1) Implement using the comment field in the Verbal Order Mode screen for protocol orders to document theprotocol referenced to monitor and track protocol orders2) Integrated a custom built \"shared goals\" section across multiple encounters and made this viewable inmychart3) The program greatly improved coordination of care across specialty pediatric populations―Allan Wu, MDSummary of process by which Johns Hopkins developed a method for non-providers to enter orders inattempted compliance with regulations and internal compliance offices. Extension of ability for MA (andLVN, RN) to place orders per protocol for immediate action. codifies how to make sure orders are ensured tobe strictly within a protocol with build options in orders and reports and a workgroup. Has potential forUCLA, but first need to clarify security and scope issues with UCLA before going forward.Key Points:1) Important points to consider -- UCLA may need a more clear method for establishing protocols for per-protocol orders which we allow in scope, but do not regularly audit or have method to audit2) SHOULD DO - add • Print group – Order Mode Info – IMPLEMENT THIS print group. Need to research whichencounters/reports to put this in • States Order Mode and signed on says action, order mode, communicator, comment, responsible provider, signed by, when signed • Complements “Order Provider Info” (default report re orders)3) Monthly workgroup for non-provider ordering – includes with P&T, Medical, lab, radiology, nursing,pharmacy, regulatory, billing, medical staff, Epic; Runs a regular Rogue Orders Report―Hawkin Woo, MD, MPH, FACPProtocols that were old, unwritten, physician initiated, nurse initiated, non-provider initiated (admin callingin bowel preps) Ambulatory may be less technologically complex than inpatient, but it is more often complexlogistically. JCHO and CMS and Nursing Boards and Hospitals have definitions of protocols. Nice gridcomparing different regulatory body. Nursing leadership compliance legal, billing, MD leadership, Radiology,pharmacy, medical stapp, Epic, Lab, P&T, medical Board part of team. Challenges - Clarify reporting impliedthat \"Verbal Order taken by RN\" instead of stating protocol . Epic equated Order Mode and Verbal OrderMode. Redid Printgroup to show Order mode , ordering user changed to Communicator, Comments for NIPOKey Points: 42 | P a g e

1) Monthly meeting with leadership from multidisciplines. \"Improper\" Clarity Reporting AMBULATORYSession PAC01PHYSICIAN ADVISORY COUNCIL GENERAL SESSION―Darryl Hiyama, MDSignificant upgrades to appearance and functionality of both the inpatient, ambulatory, and mobileworkspaces. Much higher degree of functionality based upon Chart Search (but working in the background).Significant iOS based functionality by appearance.Session PAC05PEARLS: E-VISITS―Darryl Hiyama, MDExperience of two physician groups from Chicago and Northern Kentucky who both have implementedeVisits. Key Points:1) Very little reimbursement in their situations2) Don't announce rollout3) High degree of provider and patient satisfaction―Bernard Katz, MDOverview of implementation of e-Visits and how they can be used to offer alternatives for patient care.Key Points:1) Compliance issues2) IT issues3) Training―Deidre Keeves, PTRich Kelly, DO & Michael Radtke MD from Dryer Medical Clinics presented multispecialty groupimplementation of eVisits. Key justification of eVisits was improved access, improved patient experience,build infrastructure for future telehealth endeavors. They launched a pilot that was free to patients whofocused on use of questionnaires to address 4 simple PCP conditions such as: back pain, sinusitis, red eye,and cough. They since have scaled the program to eVisits for 28 conditions.Key Points:1) Key ROI of eVisits is providing a better patient experience, not improving revenue. The organizationsbelieve the service is a huge patient satisfier and it is allowing them to see the sicker patients in the clinic andmanage the less acute needs in a more streamlined manner2) Physicians were concerned about this impacting their workflows but both presenting organizations foundthat after a short pilot, their providers were fully onboard and appreciated the benefits of the eVisit programas a significant patient satisfier3) Lesson learned: 1) don't drastically change your call in oreing practices when you first implement eVisit.Messaging from front office to patients calling for a telephone consult should appropriately direct toquestionnaire based eVisits when appropriate to better meet patients care needs. 2) Lesson learned: it’simportant to include specialists in development of content even if the eVisit workflow is primarily used byPCP's―Tina Nguyen, MD, FACOGE-visits being used for specific conditions. Minimal to no reimbursements, can require copay. Algorithm todetermine what can be an e-visit and what needs to be seen. Patients can manipulate the system.Key Points: 43 | P a g e

1) E-visits (email not video) may be viable way to decrease urgent care visits AMBULATORY2) Need strict algorithms―Daniel Vigil, MDE-visits will soon become part of the routine physician-patient interaction landscape. Technologies areadvancing rapidly enough that we can expect sufficiently reliable platforms to be widely available within thenext several months/year or 2. All major enterprises should begin planning to incorporate e-visits into theirservices.Key Points:1) UCLA is well-positioned to consider offering e-visits―Hawkin Woo, MD, MPH, FACPAdvocate Dreyer. .5 WRVU. Questionnaire needs input from users. Pilot phase staffed by UC doctors. Noexternal advertising campaign. Marketed by bulk message in My Chart. Patient calls were re-directed to E-visit, global policy for no more phone treatments which was new for some patients with long history withsystem. Initial conditions Back pain, red eye, cough, sinusitis. Branched questionnaires mostly based onFoundation with SME refinement. Patient feedback, generally very positive, except for patient who did notget Antibiotics. Questionnaire has hard stops to redirect patient to schedule appointment instead of e-visit.2nd phase, began charging $30 to patient’s non-HMO, currently no insurers cover in Illinois. Expanded to 28conditions. Physicians do not like checking IB all the time, needs push notification. Not a revenue generator.No adverse outcomes yet. Sometimes patients will submit multiple e-visits to game and get ABX. St Elizabeth6 month roll-out. Access issues, many patients seen in ER for sinus problems. .48 WRVU for providers. PCPwere told not to change usual practice, ok to continue calling in meds if they want to. Problems, desktoporiented, no mobile.Key Points:1) Patient satisfaction largely determined if they got antibiotics or not2) No payor reimbursementSession PAC08USING EPICCARE AMBULATORY TO SUPPORT PRECISION MEDICINE QI AND RESEARCH―Melissa Chun, OD, FAAOPresenter built doc-flowsheet based navigator, Epilog, to collect point of care data (discrete data anddiagnosis collection) in Epic and MyChart for outcomes surveys (Eq-5D, SF-36), data extraction andincorporate data into provides' documentation. Reported 50% utilization Beta MD use to enter key diagnosticinformation at every patient encounter and engagement of front desk, letters to patients through MyChart toinvite and encourage patients to fill out surveys. Accomplished without workflow changes.Key Points:1) Well built discrete data collection enabled effort to serve multiple purposes: data extraction for reporting,QI, national registries etc.; electronic communication that is highly automated and required no workflowchanges for clinical trials―Bernard Katz, MDDemonstrated the use of Ambulatory for various components in addition to patient careKey Points:1) Ability to flex system as needed―Tina Nguyen, MD, FACOG 44 | P a g e

Upenn Neurosurgery designed a very detailed and in-depth navigator that would allow their providers to AMBULATORYhave discrete data for research. The build was intense and the navigator is very wordy and clunky but theygot buy in from physicians by telling them the navigator would allow for research at a later time. Key Points:1) Discrete data elements are easier to track in EPIC for research. The problem is that they are tedious to fillout―Darryl Hiyama, MDNeurosurgery group from U Penn which organized a workflow by which patient centered data is collected avarious points in the registration, evaluation, preop, postop process. This data in turn can be used for bothindividual and aggregate uses. Did not add to existing workload. Benefit of real time reporting for things likecomplications. Also ability to add predictive analysis of risk for individuals. Also assessment of patientsatisfaction and QOLKey Points:1) Data consent with HIPAA consent2) Use validated metrics to evaluateSession PAC11ADDRESSING TOXIC IN BASKETS―Mark Grossman, MD, MBA, FAAP, FACPTest Pending at discharge folder in basket for inpatients…do we have that turned on? Routing of same type ofmessage to a single folder…roll up cc charts and put reports into one folder. Consolidate clinically similarmessages. Overdue escalation notifications…not a good option. Inbasket aging report…when is ours ready forroll out?Key Points:1) % unviewed messages at 30 days by dept./division, mandate six folders within 30 days for results, cosign,refills, etc...2) Exiting providers must clear out Inbasket prior to departure or getting last paycheck3) Purge messages older than 90 days in nonessential folders―Bernard Katz, MDDemonstrated suggestions on how to deal with physician in basketsKey Points:1) Try to limit Inbaskets to key points that MDs need to review2) Penalties (withhold final paycheck) for in baskets that aren't completed prior to departure of MD3) Publish for \"peer pressure\" large in baskets―Daniel Vigil, MDEpic In-basket has potential to demand several hours of a physician's time per day. In-basket managementshould be a central component of training when on-boarding a new physician. When a toxic In-basket isencountered, efforts to assist that physician in clearing the In-basket are helpful while training and resourcesare offered to assist the physician in acquiring skills to maintain a healthy in-basket.Key Points:1) UCLA Care Connect Master classes are an excellent tool in helping to prevent the development of toxic In-baskets2) UCLA Care Connect Master classes are an excellent tool in helping to address the problem of toxic In-baskets―Hawkin Woo, MD, MPH, FACP 45 | P a g e

Parkland Texas: Departing MD (residents, etc.) and staff are med center employees. HIM checkout process AMBULATORYconfirms 0 messages at start and none when leaving institution with escalation process. Last paycheck is heldback pending completion IB. For Faculty, employed by University have to complete an HR checklist. IT candelay signing pending IB completion. Condense CC'd Charts, Pt Reports and Preview Reports into one folder,Epic is rolling out. Turned off \"Addendum Notification\". Push notification to Outlook for providers who arepart time, currently not possible. Request of an Escalation Notification for automated message to leadershipfor unanswered messages. Voted for new policy for providers to have 30 day policy for 6 key folders (Results,Cosign, ), the other 24 folders are auto-purged every 90 days to maintain system performance and reportedto leadership.Key Points:1) Look at Epic consolidation of folders2) Created report / snapshot of IB status Unviewed Messages and presented at MEC3) HIM IB checkout process for IBSession PAC13HACKING HAIKU: WHEN YOU JUST CAN’T LEAVE WELL ENOUGH ALONE―John Luo, MD, DFAPA, DFAAPHaiku/Canto doesn't always have content needed for users. There is a way to customize an iOS app, whereHaiku/Canto passes information to the app for a calculator such as a billirubin tool. Print groups can bemodified to work for Haiku/Canto. Custom department lists for Haiku/Canto can be modified to decreasechoices for users.Key Points:1) Modified print groups can pull data from Epic into URL to execute specific code, such as decision support2) Create UCLA web custom app using this source code - https://github.com/dukemedicine/Duke-Medicine-Mobile-Companion3) Print groups can be modified for Haiku by looking in Epic Data HandbookSession PAC17PEARLS: POPULATION MANAGEMENT―Deidre Keeves, PTGrant Greenberg MD &Cheryl Dehmlow (University of Michigan) - presented how they used outreachencounters with bulk orders and bulk communications called \"Birthday Letters.\" In patient’s birth month theysend a communication via portal or mail that says what preventive services or tests are due based on healthmaintenance, it gives patient instructions on how to schedule and it’s signed from their PCP. Anita Ung from(Atrius Health) presented in clinic standard work with health maintenance strategies to improve populationhealth.Key Points:1) Patients who received messages by my chart portal had a higher response to outreach encounters thanthose who got paper letters.2) Presenter made the point that you can implement population health tools but they are only as strong asthe operational infrastructure that uses those tools.3) Atreus publishes their report comparing compliance with health maintenance screening results betweentheir various clinics and PCP's and they call out high performing clinics and low performing clinics. Theysurvey the high performers and publish their operational best practices that led them to get the good results.They believe transparency and healthy competition amongst the providers was key to success.Session PAC18 46 | P a g e

PLOWING THE FERTILE GROUND OF CARE TEAMS AMBULATORY―John Luo, MD, DFAPA, DFAAPUse of care teams is essential for coordinating care. To facilitate frequent updates, the Kaiser system put thecare team report and activity in various locations. They pre-populated the system with care team membersbased on encounter data in clarity reports, and then had them edited by providers for accuracy. The new2015 build of Epic will address attribution with a new 'measure group'.Key Points:1) Care teams are important for coordinating care, especially accurate information with regards to non-UCLAproviders2) Having the 'Care Team' navigator be available in multiple locations ensures that providers will update thecare team assignment because there are no clicks away from their current activity3) Automating the care team using background processing from Chronicles will decrease need for user inputSession PAC21PEARLS: AVS―Angela Amucha, BSN, RNDecreasing variability in design and distribution of the AVS. Reorganizing the AVS to make it more patientfriendly while still meeting departmental or clinic needs and Meaningful Use.Key Points:1) Patient and family feedback is essential to the usability of the AVS. Consider creating a council that includespatients and their families to improve the AVS2) Consider implementing a banner to remind providers not to print AVS's for proxy patients3) Add upcoming immunizations for pediatric patients on the AVS―Daniel Vigil, MDAfter Visit Summary (AVS) is a component of Meaningful Use (MU). AVS can be a valuable tool in helpingpatients to be active participants in their medical care.Key Points:1) AVS at UCLA has not been well standardized yet. Many physicians still do not believe in the value of theAVS. A handful of physicians are outright opposed to having AVS given to patients2) Tools in Epic exist allowing the customization of the AVS3) UCLA has the expertise to take advantage of the Epic AVS tools to make our AVS more informative―Bernard Katz, MDAbility to utilize the AVS to provide as much streamlined information as possible to the patientKey Points:1) Challenges with inpatient AVS information with medications, instructions, etcSession PAC24LEVERAGING THE HIDDEN POTENTIAL OF SMARTFORMS―John Luo, MD, DFAPA, DFAAPThe session covered how to use a smartform to create a guideline based system of post-polypectomydocumentation. This standardized process improved and automated follow-up recommendations. Inaddition, the logic in the smartform was used to generate the follow-up procedure and period. Quality ofresults communication improved significantly.Key Points:1) Single standardized letter template makes generation of follow-up letter easier to generate versus free text 47 | P a g e

2) It incorporates evidence based guidelines into the generation of time and follow-up procedure AMBULATORYrecommendations3) Using smart data elements enabled reporting on reportsSession PAC25ENHANCING THE PROBLEM LIST EXPERIENCE FOR PHYSICIANS―Hawkin Woo, MD, MPH, FACPOakwood Michigan: Create LPF for Problem List to improve efficiency and load times. Rand Crystal Report onall Problem List records in 1 year. Display name may be unfamiliar with clinicians. Create Crystal, take subsetin Chronicles, and then export to Excel. Specialty specific vs Faculty List shared. Eventually chose Facility list -estimated 4700 diagnoses in past 1 year, which was shorter than the search results for diabetes (5000) pre-intervention. Now diabetes returns 85 results. Did not change Problem Use usage by simplifying PL.Key Points:1) 99 end users stayed within the new Preference List, only 1% went to Data Base Look up2) It incorporates evidence based guidelines into the generation of time and follow-up procedurerecommendations3) Problem List usage did not changeSession PAC29A COMMUNITY COLLABORATIVE APPROACH TO OPENNOTES―Hawkin Woo, MD, MPH, FACPExcellent and articulate discussion by panelists in favoring OpenNote. Able to state reasons for and againstthis initiative. Most common concerns addressed including ability to hide certain notes at certain times bycertain providers. Most concerns materialize rather rarely.Key Points:1) OHSU was not aware of concerns with resident/fellow notes being potentially send out by auto routingwithout being signed by attending. Has never been an issue apparently (but we should take seriously atUCLA)2) Most concerns do not materialize, but need to be planned for (i.e. situations of spousal or geriatric abuse,pediatric access, rollout); Make sure have policy in place and can be implemented. Need to have policytransparent on how to handle requests for amendment to records to HIMS―Bernard Katz, MDHow several institutions approached Open Notes and the challenges they faced.Key Points:1) Provider buy in2) Need to limit accessing of note if patient safety concerns present (i.e. abused patient)3) Positive patient experienceSession PharmAC02WHAT’S NEW IN WILLOW―Andrew BeerProvides an introduction to Willow Ambulatory and an overview of new features. Highlights functionalitywhich is complete in Epic version 2015, and of which most has been or will be SU'd to 2014. Also provides a\"sneak peek\" of upcoming development ideas beyond 2015.Key Points:1) Ability to view previously scanned documents is being added to Willow Ambulatory. If we trainregistration staff to scan such documents as prescription benefits cards, then Willow Amb. staff will be able to 48 | P a g e

get started earlier on pre-authorizations for prescription coverage, enhancing patient experience upon pick- AMBULATORYYup2) In 2015 Willow Ambulatory will gain the ability to customize medication label warnings per language. Forexample, we would be able to add custom language to only the Spanish version of a medication's label, ifneeded3) In 2015 the ability to bill to research accounts will be addedSession PharmAC04WILLOW AMBULATORY AND INVENTORY FIRSTS―Andrew BeerDescribes Parkview's experiences implementing Willow Ambulatory and Inventory. Discusses their setup ofdifferent methods for alerting patients when prescriptions are ready for pick-up. Also discusses strategies forutilizing the Inventory module, and lessons learned from implementing it together with Willow Ambulatory.Key Points:1) While MyChart build can be done to alert patients via e-mail that prescriptions are ready for pick-up, it isalso possible, through contracting with an SMS vendor, to set up alerts via automated text message2) Going live simultaneously with Willow Ambulatory and Inventory is not advised. Epic recommends againstit, and customer experiences raised during the session were not positive. The two modules share too manymoving parts between themselves, and going live with both at once makes troubleshooting difficult and fixescumbersome3) When doing setup and build for Inventory, care should be taken in defining the initial medication stocks.In the presentation it was mentioned they had used a 6 month purchase history to determine whichmedications to track with Inventory, and this was not sufficient as many medications in stokc had in fact notbeen ordered that recentlySession PharmAC15PRESCRIPTION MOVEMENT UPA DELIVERY - CENTRAL FILL―Andrew BeerA description of how prescription shipping can be accomplished through integration with UPS software toprint labels, and a comparison of using UPS as a shipping provider vs. the USPS. Followed by a presentationon the uses of the Central Fill functionality in Willow Ambulatory, which include notifying patients whenprescriptions are ready and tracking prescription fulfillmentSession PharmAC29WILLOW AMBULATORY DEVELOPMENT DESIGN―Andrew BeerPreview session where Epic's Willow Ambulatory developers demonstrate some of their latest projects andsolicit design discussions from the customer representativesKey Points:1) A project of significant interest and controversy is adding the ability for pharmacists in Willow Amb. tosuggest prescription modifications before sending a refill request out for provider approval. Epic's currentplan did not include any highlighting of the pharmacist’s suggested changes, leaving it to chance whether theprovider would notice the revisions or simply approve the refill as they do currently2) A project is underway to allow prior authorization coverage information to pull from Hyperspace whenpresent, alleviating the need for pharmacists to enter it themselves or log in to Hyperspace to look it upKey Points: 49 | P a g e

1) The University of Colorado found that UPS was a much more responsive shipping partner for mailing AMBULATORYprescriptions than the US Postal Service. Especially useful was that, through Epic's help, they were able tointegrate with UPS shipping software to automatically print shipping labels pulling information from Epic2) Central Fill functionality in Willow Amb. allows the use of MyChart notifications to patients whenprescriptions are ready. A drawback is that the notification currently sends when the prescription has been3) Online credit card pre-payment for prescriptions is coming to Willow Amb., piggybacking off MyChartcredit card payment developmentSession PMAC01STOP BREAKING EACH OTHER’S BUILD MANAGING INTEGRATION―Scott ShermanLearn methodology and approach used at University of Michigan for managing changes and migrations ofbuild from POC to PRD. Presenters reviewed issues, tools and approach to address systemic issues withchange management for system build.Key Points:1) Individuals on each team were able to Data Courier their own build2) Established weekly integrated review sessions; review emergency requests previously approved outside ofgroup3) Lentify masterfiles that individual teams can DC without review and master files that require team reviewSession PMAC03HARVESTING A BUMPER CROP OF OPTIMIZATION PROJECTS USING VALUE STREAMS―Scott ShermanValue Stream - sequence of activities required to provide a service along with information, materials, andworth flows. (e.g. med mgmt, care planning, MD documentation, Revenue Cycle, etc.)The speakers from this organization shared their experiences and process for managing all their optimizationproject requests by focusing on what is important to the vision of the organization.Key Points:1) Close the \"inside channel\" to build team so that no projects \"sneak\" in and bypass normal review process2) The completion of a project means nothing if there is no Accountability, Alignment, and Acceptance fromthe end-users, key stakeholders, and leadership3) Do not \"improve\" systems and structures (build), if you have not assessed the processes that use them.Operational issues should not be fixed by an optimization project as a first resort. Resolve the root issue firstSession SAC01INTRODUCTION & ONE-CLICK PHYSICIAN SCHEDULING FROM DISCHARGE NAVIGATOR―Laxmi KumarLearn how LSU use the Discharge Navigator to schedule patients for Follow Up appointmentsKey Points:1) Not useful for UCLA2) Allows for scheduling only one follow up appointment3) UCLA has a better system in place. The discharge order for follow up appointment is sent to a WQ, which isworked on the DOM teamSession SAC02DAIRY YOU-KEEP SCHEDULING SIMPLE 50 | P a g e