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will set off a warning if the patient meets two or more signs of SIRS allowing for early identification and rapid INPATIENTintervention.Key Points:1) Physician builders with EPIC certifications are vital for meaningful data and patient care2) During a quality improvement build it is necessary to make sure intervention goals are quantifiable tomeasure impact3) In general, whenever application coordinators build applications it is important to implement and reassessthe impact versus intentionSession 96PARTIAL HOSPITALIZATION PSYCHIATRY PROGRAM BUILD―Daniel NollI presented Partial Hospitalization Psychiatry Program Build this year at UGM. I showed other organizationsour 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 101FOCUS GROUP- MY CHART BEDSIDE―Nina EmersonSession led by Epic on what is currently available in the Bedside application, and what features they areplanning in the future. They discussed how to allow patients to \"Bring their own device.\" Customers alsoshared their experiences with Bedside so far, including what devices they anticipate using. It sounded likemost customers are looking at Android tablets due to issues they've had with iphones, but want to supportpatients bringing in their own ipads as well.Key Points:1) They are embedding a \"tour\" feature that explains to the patient how to use the program2) Questionnaires for the patient file to flowsheets. Please note that when I looked at this feature in thedevelopment lab, the nurse can't easily see WHAT patient user filed the data. For example if a familymember is set up with bedside as well as the patient, it's not very clear if the questionnaire was answered bythe patient or family member which could be relevant3) The pain management setup looked really good - it allows the patient to document their pain, and theneducates them on the multiple ways to deal with pain (meds, massage, etc.) so they have a betterunderstanding of pain management and can make more educated decisions―Samantha CaoDemo of Bedside features that includes log-in, patient education, service requests, and care team. Patientscan seamlessly create a MyChart account if they don't have one. Covered 3 main improvement requests: 1)access to other apps utilize extensible web framework), 2) integration with the rest of Epic in terms of patienteducation (back to Epic 2012), 3) Integration with MyChart (only available in Epic 2015). Bedside can be builtto force patients to complete certain activities before having access to the more \"fun\" features of Bedside. 101 | P a g e

Key Points: INPATIENT1) Epic is working on an iOS platform for Bedside to be launched April 1st, 20152) MyChart Bedside questionnaires is being developed and filed in flowsheets. Ex: pain managementquestionnaire tied to patient education and interventions―Deidre Keeves, PTJanet Cambell and Mike Epley (Epic) presented future mychart bedside development. Key areas includelaunch of Bedside for IOS devices on April 1st 2015. Organizations that have installed mychart bedside havedemonstrated a significant improvement in HCAHPS scores in the following domains: Overall rating,Willingness to Recommend, Nurse Communication, Doctor Communication, Communication Re: Meds,Responsiveness, and Discharge. Despite the nominal (under $5) per patient per discharge fee for use ofbedside, organizations are finding a good financial ROI based on the improved HCAHPS scores.Key Points:1) Future release of IOS will allow more organizations to adopt and support a bring your own device strategyso patients can use their own tablets2) Project teams for mychart beside are typically more aligned with the Inpatient/Clin Doc teams but a feworganizations are still running them through their mychart team3) The presenting organizations are using the tablets in hospital and not sending them home with patients―Grace LeeCurrently 7 organizations are utilizing \"Mychart Bedside\" and 15 more are about to go live. Greatersatisfaction in instant communication between patient/ pt's family with the caring team. Allows everyoneinvolved to be aware of the current situation of the patient, down to what time patient took his last painmedication. Family members have been quoted to say they feel \"empowered\". Previously they only hadAndroid platform available but as of 4/1/2015, ios platform will be introduced.Key Points:1) Solid data gathering capability: Satisfaction surveys, risk scores and Research study participation2) Even for those who are not familiar with tablet system, took average of 15 min to teach patients. However,even that was decreased by providing \"guided tours\" of the tablet system by providing screen overlay3) All about increasing patient engagement! And MUST do Production Dress Rehearsal to work outnetwork/server issuesSession 120SUCCESS AT 7- MEDICATION SAFETY CULTURE―Meg Furukawa, RN, MNThe journey to barcoded medication administration was presented along with strategies to achieve highcompliance with scanning. Strategies to improve compliance were discussed as well as the process forimplementing barcoded breast milk and blood administrationKey Points:1) Standardize the scanners wherever possible2) Scan all medications ahead of time to ensure they would work in the system and give nurses’ confidencethat it would work3) Barcode compliance numbers are a blessing and a curse. Review for medications that don't scan so theycan be fixed. Leadership needs to set the thresholdSession 142E.I.E.I…OB TRIAGE AND MEDICAL SCREENING EXAM 102 | P a g e

―Lorraine Malden, RN, BSN INPATIENTFollowing EMTALA regulations for OB patients, Texas Health Resources created a limited screen exam (similarto an ED triage)Key Points:1) Revenue losses and HIM denials prompted this change in practice. To my knowledge UCLA is notexperiencing this problem with Outpatient OB patientsSession 144ED TO L&D WORKFLOW―Lorraine Malden, RN, BSNOptimize Epic build to address non-standard workflow for the ED to L&D ptKey Points:1) Need field to indicate where the delivery occurs for BOA (birth out of aspesis): LDR, ER, Out of Hospital,Ambulance, Other (comment)2) The screening tool built by this Florida hospital in ASAP for L&D pts being triaged has application at use inour facility. The L&D clerk uses the transfer button to arrive ptSession 150CLINICAL TRANSFORMATION- URINARY CATHETER PROTOCOL―Meg Furukawa, RN, MNThis hospital did a quality improvement initiative to improve removal of urinary catheters to meet SCIPrequirements. Some of the strategies used included development of a nursing protocol to remove catheters,an order set that nurses enter daily, a BPA to remind nurses to assess the catheter status and a report to lookat urinary catheter usage and removal.Key Points:1) Make it easy to do the right thing2) Protocol format eliminates the need to bug providers for orders3) Integrate the protocol into daily practice with EMR interactionsSession 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 Points:1) Using smartforms, information is charted in the form to create the body of the report for general resultsand fetal anatomySession 164MOO-VELOUS PSYCHIATRIC PROVIDER DOCUMENTATION―David MuiCone Health shared their experiences and approach for implementing new provider documentationrequirements for their psychiatric hospitals. They are composed of a couple psychiatric locations, albeitsmaller than UCLAKey Points: 103 | P a g e

1) Because their physicians were not compliant in documenting all the necessary psych-related information, INPATIENTthey utilized a very comprehensive SmartForm that was created by one of their physicians on the build team2) Patient-friendly indications of use did not seem problematic for them, but many of the other attendees tothe session were voicing their problems with psychiatrists having to provide indications for meds they are notprescribing3) UCLA has a Master Treatment Plan which is simply better and more efficient to use than a note templateSession 169PHYSICIAN EFFICIENCY AND USABILITY- QUICK WINS FOR EPICCARE INPATIENT WINS―Christine Alanes, RNEpic provides a session on quick wins and the items they showed were all items we've incorporated in ourphysician workflow, but good to know that other sites found these tips and tricks valuable. There were manyitems mentioned that is already in place such as tracking charges on patient list, right-click in the ordercomposer to close it, order composer open for required items, interval H&P added to the navigator, display e-prescribing status)Key Points:1) Ask if this is something we want to consider now: a) Chart Review - color code tabs no available in 2010b) Suppress Dispense/Refill Requirement c) Suppress Med Rec for certain types of orders such as patientclasses, non-meds, supplies2) Teaching points to re-visit: In Basket. a) Help button - explains why you got this message. We receive manytickets from MDs asking why they have received this IN Basket message and what to do with it. b) Auto-advance one In Basket message to the next when you click Done. c) Chart Search also searches activities3) Future Projects for the Spring/Summer 2015. a) Personalize patient header per specialty (i.e.OB - wouldhave gestational age). b) Within the sidebar report add a \"Table of Contents\" in the Manage Orders Activityto help MDs navigate. It serves as cheat-cheat. c) Quick List of Charges for common charges in the preferencelist. 4) Cascading questions for a larger group of orders.―Jeff Banting, MBAThe presentation outline quick wins for upgrade functionality when upgrading the system. Epic presentedinpatient, reporting and inbasket functionality that do not require large amount of build and updatesKey Points:1) Patient list searching requires indexing and should be implemented few weeks after implementation2) Activity links can be accessed within in-basket3) Documentation functionality now allows you to track copies of notes―Darryl Hiyama, MDVery helpful session. Even 2012 and now 2014 versions offer a number of fixes to existing shortcomings inthe system. Personalization menu, Chart review filters, User customized SmartLists and pushing info out forUser SmartLinks are big wins.Session 180WOMEN & INFANT OPTIMIZATION- GETTING OUT OF THE SILO―Lorraine Malden, RN, BSNLearned the challenges that are created in Labor and Delivery and the need for collaboration to eliminateworking in silos. Regular meetings with representatives from multiple disciplines: ambulatory OB clinic,anesthesia, respiratory therapy, Maternal Fetal Medicine OB MD, IT (Stork Builder/Trainer), Nursing isimportant for making sure all workflows are working optimally. L&D operates with inpatient, HOD,anesthesia, ambulatory, radiant, OBIX, ADT, and OpTime. 104 | P a g e

Key Points: INPATIENT1) Connection with Women & Infant staff needed: stork team with end users, formation of and OB specificFocus Group and monthly meetingsSession 190IMPLEMENTING EFFECTIVE THERAPY PLANS―Jeff Banting, MBALearned about pros and cons for phases of care VS therapy pan build. Reviewed how organization setupadditional build that uses reports and security points to help implement therapy plans. Organizationdiscussed testing scenarios and additional findings when implementing therapy plans.Key Points:1) Saw how organization setup outpatient infusion navigator2) Organization stressed on importance of education and training3) Reviewed lessons learned about lab orders, follow up communication, completing treatments and deletingunwanted ordersSession 197TRANSFERS FOR A SUCCESSFUL DISCHARGE READMIT―Jeff Banting, MBADiscussed challenges faced with implementing a discharge readmit workflow at their site. Used creativesolutions and unique navigators to face this challenge. Discussed how this increased use of the navigator andprevented workarounds to just use the normal discharge navigator.Key Points:1) Used Color header to indicate user was in the IFT workflow and remind when to release orders2) Used a unique phase of care similar to how UCLA uses them3) Group also used a unique IFT nursing communication to change the header color and also send the bedrequest (unique and useful)―Allan Wu, MDPresentation of various solutions for transferring a patient from one facility to another. Applicable to UCLAworkflow transferring between RRMC and 1W Rehab in particular where a Discharge-Readmit workflow isunderway vs Discharge and then separate Admit. Applicable to workflow if transferred to RRMC forprocedure as well. No perfect solution so far. Mentioned a phase-of-care, but not clear how used.Key Points:1) Header changes to color PURPLE to indicate that you are in the wrong encounter within the Discharge-Readmit - relatively easy to consider and implement, but will need training to understand how this works2) Modified med rec and included an Order Releaser section -- lots of technical workflow engine rule build --need a broader strategy first3) Learned of a print group that can just reflect the last \"type\" of med rec done -- whether Discharge-ReadmitMed Rec or Discharge Med Rec. CAN BE HELPFUL for our RRMC->Rehab workflow at UCLASession 205MAMA GOAT CHECKS ON HER HOSPITALIZED KIDS―Lorraine Malden, RN, BSNLearn methods to empower parents of NICU/Nursery patient’s access to information on feeds, weights, statusupdate and upcoming appointments. This allowed NICU parents to know when best to visit at the hospitalfor skin-to skin and feedings. For newborn nursery mothers it gave them information on follow-up appointslike with audiology and follow-up pediatrician apt. 105 | P a g e

Key Points: INPATIENT1) In order to increase members connected with My Chart and increase participation in MyChart. Birth Clerkwas provisioned to sign-up baby prior to discharge and to give a tutorial session to mother on how to accessand obtain information―Tina Nguyen, MD, FACOGHow one cenger allows parents to enter their neonate’s mycharts as a proxy to see their progress in the NICUKey Points:1) Proxy MyChartSession 210CODE NARRATOR TRIALS AND TRIBULATIONS―Meg Furukawa, RN, MNParkview Hospital described their challenges and successes with Code Narrator implementation. Theypresent lessons learned as well as successes in the ED and ongoing challenges in the Inpatient unitsKey Points:1) Training is everything! SME engagement creates win. Silence does not equal harmony2) Unable to titrate drips in One Step Meds. Create flowsheet rows in narrator for staff roles - works betterthan Add Staff3) Find ways so that the recording nurse can see what is going on during the code (i.e. WOWs, laptops) In2014, each team has their own toolbox - ED, IP - be consistent as much as possibleSession 220GROWING PHYSICIAN EFFICIENCY WITH ORGANIC TECHNIQUES―Christine Alanes, RNBeaumont Health had the same strategy we did for UCLASession 223ROVER-GIVING THE COWS A BREAK―Alyssa Doyle BSN, RNHackensak University - overview of recent Rover implementation. Mostly covered build details. Using thenewly developed worklist functionality from rover. Rover now has a bottom tool bar navigation system.Observations from their Pilot - it was important for nurses to introduce Rover to the patient & family - theystarted to get complaints that nurses were on their phones in the patient rooms.Key Points:1) Ensure there is a CICARE connection with Rover implementation - rules to login prior to walking into room -introduce patient to the device and functionality2) Need to change logout times on device so they do not time out in 1 minute. Time extended to 5 minutesturned out to be perfect3) Hotswap batteries at beginning of each shift - phone pulls charge from case―Deidre Keeves, PTHackensack University Medical Center presented their Rover implementation. They targeted areas such as theED and OR where they already had back up WOW's and strong clinical educators in place to supplement theeffort. They used Airwatch MDM with their iOS devices and tested both single app mode and open but locked 106 | P a g e

mode and ended up staying with open but locked MDM strategy. They did not use voice and text on the same INPATIENTdevices for this Rover pilot because it was difficult to hear with some the barcoding sleds they piloted.Key Points:1) Rover uses the same security class as Haiku and Canto so it makes sense to leverage project team expertswho are already familiar with Epic's other mobile apps2) Their training strategy included 2 hours or classroom training for nurses and 1.5 hours of barcoding mobileskills lab. This was for staff that had never done barcode scanning in the past3) Lessons learned: they found it helpful to extend the screen lockout time for their iOS devices, nurses wereinstructed to hot swap the batteries each shiftSession 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 have tocall SNF'S, the system could automatically reach out to the current contracted vendors. Right Fax interfacehas been completed.Key Points:1) Wonderful tool for Disease management2) Who would build and maintained these scoring systemsSession 243E-I-E-ICU―Yvonne Mugford, RNPatient rooms equipped with epic bedside monitors and two was audio/video system, conference roomequipped with two-way audio/video feed and nursing is notified of changes in scoreKey Points:1) Use Graph presentation as much as possible2) Combine data in a meaningful waySession 244IMPROVING PHYSICIAN SIGN-OUT USING THE 2014 HANDOFF TOOL―Andrew BeerA presentation by Stanford Children's Health on their implementation of the Epic 2014 Handoff tool. This is anew feature in 2014 and has allowed them to overhaul their physicians' patient hand off process. Discussionincludes their build and issues they facedKey Points:1) The new hand off tool can be accessed from the patient list and printed from it as well. It prints inlandscape mode, allowing it to contain multiple patients per page, contrary to the older patient list reportsthey were using2) A new feature is that each specialty can have their own handoff notes (cardiology, etc.). This makes it easyif multiple physicians need to hand off the same patient to their respective colleagues. However, thisseparation makes it difficult for one specialty to hand off to another3) There is a view-only version of this available in the 2014 Canto table application, which can make hand offseven more flexible 107 | P a g e

―Francisco Jordan INPATIENTDemonstrated the use of their 2014 Handoff tool. Discussed their approach to building the tool. Specializedhandoff builds for note entry and rounds report. Described the difference between the 2010 tool and thenew and improved 2014 handoff tool. Described the build efforts involved to implement the Handoff tool.Key Points:1) Stanford Children’s Health had been using the 2010/2012 singout tool for a while before they upgraded to2014. Additional prior to Epic they had a system to documenting electronically so this was not a big changefor them culturally2) The Handoff tool was built out mostly by providers. They standardized it with a lot of information thatneeds to be communicated in a short amount of time while paying attention to patient details3) Embedded their Handoff tool with similar links to what we currently use at UCLA. Gives the physicians theability quickly document notesSession 248NO SILOS- A SINGLE MANAGE ORDERS BUILD FOR ALL USERS―David MuiAllina Health shared their approach to the Manage Orders activity. The analyst shared his build that consistedof one Manage Orders activity for all clinical users. This was not Epic's set-upKey Points:1) Main reason for them to adopt this approach is consistency in what the users2) They had 9 tabs in the Manage Orders activity! (Too many, in my opinion.)3) They pulled in a Verify Pharmacy Benefits sections into the Home Medications tab of Manage Orders. (Liveson our discharge navigator currently.)Session 252OLD MCDONALD’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), theresults 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 number2) 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 patientsSession 253SUCCESS AT 7- NURSES VS. HAI-CAUTI―Meg Furukawa, RN, MNStrategies to reduce catheter-associated UTIs are presented including clinical decision support, interventionsand social media.Key Points: 108 | P a g e

1) Need support from all levels of the hospital for success INPATIENT2) Be careful with the number of BPAs that fire for nurses to avoid alert fatigue, recognize the power of socialmedia in communication3) Need people, process and technology for a successful organizational transformationSession 255FOCUS GROUP- STORK OBSTETRICS―Nina EmersonThe focus group went through some features that have come out in 2014, as well as a preview for futurefeatures to get customer input.Key Points:1) 2015 will have a new HIE standard interface available for Birth Certificates, although it doesn't sound likeCA currently accepts interfaced information. It is something to keep an eye on though.2) In 2014, the results console can open right to putting additional orders in.3) In the delivery summary, in 2014 you can set it up so it doesn't include blank items in the note that'sgenerated.Session 259OPTIMIZATION STRATEGIES FOR MEDICATION―Jason WilliamsLearn methods for monitoring medication alerts and formatting the data in ways which can help yourorganization make decisions about medication alert settings. Presenters review standard Epic reports and datamanipulation techniques, and they discuss appropriate governance and decision making forums formedication alert changes.Key Points:1) Leverage Epic's OOB Med Alert Statistics report and analyze pain points to address2) Need governance to decide what to turn off3) Make quick buttons for override reasonSession 270REHAB DOCUMENTATION ROUNDUP―Allan Wu, MDComprehensive look at strategies used to document rehab workflow from Hattiesburg Clinic. Used uniqueNavigator section for handling initial Rehab screen, then extensive use of flowsheets to document work fromeach service and pulls into notes by SmartLinks.Key Points:1) Designed flowsheet rows that cross inpatient encounters to facilitate documentation of rehab elementsbetween encounters2) Uniquely got compliance to allow flowsheet rows to serve as signatures electronically for a team-basednote to allow signing of parts of interdisciplinary note (by pulling in the signature) on an as-needed basis incase not everyone is at the same conference3) Impressive work done with SmartLinks, flowsheet rows, and well-designed template to allow teamconference to create note in real-time during discussion shown on board; cut down time for interdisciplinaryconference weekly from 3 hrs to 40 minutes! 109 | P a g e

Session 273 INPATIENTDISCHARGE WORKFLOW- HORSE-HIGH, PIG-TIGHT, AND BULL-STRONG―Andrew BeerA presentation by Reading Health of the development of their Epic discharge workflow. Describes many oftheir challenges and the options they tried to facilitate discharges.Key Points:1) Use one universal discharge order set, the contents which displays to the physician is modified to fit thepatient condition by looking at which problems are on the patient's problem list, as well as potentially bywhich orders are currently active on the patient2) This order set is suggested via a BPA in the discharge navigator, rather than having their physicians searchfor it3) They are meeting Meaningful Use Stage 2 continuity of care document requirements through use of the\"Follow-Up\" navigator section. They are using Fax and Mail optionsSession 285FOCUS GROUP- OPTIME OPERATING ROOM MANAGEMENT―Hanna TameruSome of the biggest enhancements coming for OpTime are: Global med substitution, mass inactivation ofpreference cards, quick case button for trauma cases, a more interactive flight board, snapboardenhancements, text/page notifications to periop staff, resource management, CMS procedure/admit ordersworkflow with reminders showing at different stage of the patient care, and new care plan activity (PNDS canbe added to this new activity).Key Points:1) If a case is still in a virtual add-on room on day of surgery, a verify rule can be set not to allow verificationuntil patient is scheduled in the correct room2) In 2015 version, staff will be able to scan equipment based on a serial number3) In 2015 version, surgery status update can be sent via text to patient family in the waiting areaSession 296ORDERS DRIVEN AVS EXPERIENCES―Jason WilliamsHow to Setup the AVS to be based off orders and the answers presented in the orders. This is driven by orderswith specific names, questions placed in the discharge navigators and orders sets. Reducing confusion ininstructions and reducing blank areas previously caused by using smart texts or information drawn in fromother sourcesKey Points:1) The functionality discussed in this section would be useful, however with upgrade felt that improvementsdiscussed would require too large of a workflow overhaul minus the below points2) Idea is sound however seems like would make the discharge process a bit longer causing delays indischarge process3) Works for hospitals with not as many sites, not very applicable to UCLASession 303STANDARDIZING MULTI-FACILITY TRANSFUSION BUILD―Meg Furukawa, RN, MN 110 | P a g e

This presentation describes how the health system standardized the order sets for adult and pediatric INPATIENTtransfusions including massive transfusions. The session also presents areas that could not be standardizedand strategies for managing these.Key Points:1) Multidisciplinary workgroup is essential for success2) Colors in order sets help differentiate the sections and make it easier to use the order set3) Default all choices in the Massive Transfusion order set, add volume and units row on Blood AdminFlowsheetSession 307SIMPLIFYING ORDER CLUTTER―Christine Alanes, RNThis site had issues with their order sets being used as check lists and an order would be requested foreverything a physician would want a nurse to perform regardless if it was part of their standard procedures atthe hospital or department level. They presented their long term strategy on how they cleaned up theirorders, order sets and created an infrastructure for this process.Key Points:1) Dr. Shaw made a very good point that we want to focus on clinicians taking care of the patient not theclutter and that it's all about usability. The goal is to be able to look at a set of active orders on a patient andget a feeling of what is going with the clinically. I realize we need to have a process of reviewing new ordersand how it should display for the nurses in their active orders report2) How do we get to a place where an order is not required for standards of care, and we can create a culturewhere physicians and nursing can come to an agreement3) If a physician’s edits an order (i.e. nursing communication) how easy it for the nurse to know to look at thechanges? If physicians don't write negative orders, how will the nurse know not to shower? We have 6negative orders available on the facility preference list. Need to review how we're communicating thesetypes of ordersSession 311OPTIMIZATION AT THE DISCHARGE CORRAL―Jason WilliamsDiscussed multiple ways to increase discharge use. Methods discussed include inbox messages, banners toindicate that patient is ready for discharge, med rec complete et al. Discussed methods to increase pharmacyconsult screen such as expected discharge date and timely use of consult orders pre discharge. Advocated useof multidisciplinary discharge listKey Points:1) Banner color change appears to be useful for a quick glance of what state of ADT the patient is in2) Heavy Use of inbasket reminders (May not be useful as inbasket is not robustly used at UCLA)3) Particular Hospital used a link for a discharge video to be presented to patient on the computer discussingthe process before dischargeSession 326THE NURSING SHIFT REPORT HANDOFF HOEDOWN―Meg Furukawa, RN, MNThis session presents ways to create an electronic version of a paper handoff report. The approach taken toensure complete and accurate information needed for seamless patient care is discussed along with how thiswas accomplished across various patient populations 111 | P a g e

Key Points: INPATIENT1) Create different reports for different specialties (MedSurg, ICU, Behavioral Health, Antepartum, L&D,Postpartum, Nursery, Peds, PICU and NICU) with common assessments across all (Neuro, CC, Resp, GI/GU)2) Get input for content from end users, modify as needed to make the report useful for them3) Make multiple copies of the Assessment print group and configure the look back time, display names andnumber of rows for each report―Yvonne Mugford, RNFollowed an ISHAPED (Introduce, Story, History, Assessment, Plan, Error Prevention, Dialogue) structure tosupport the handoff process. The report included AST information, Assessment information, lab results, MARand Orders. Used a sticky note in the handover and called it Story Sticky NoteKey Points:1) Made modifications based on feedback post go-live and now will work on reports from ED to Inpatient,PACU and RTSession 340FOCUS GROUP- EPICCARE INPATIENT―Nina EmersonI was only able to attend part of the session since it overlapped with a session I presented. This sessioncovered current and future updates for both Clin Doc and Orders, and reviewed customer suggestions andgathered feedback from customers. They included some information about Canto for rounding as well.Key Points:1) Patient list in 2015 is vastly different. The summary pane is gone, and instead spark lines and additionalprint groups are added right the patient list row for that patient. Now there is a sidebar that pops out formore information when needed2) Foundation has a nice physician documentation checklist. It alerts physicians if that patient has overduecosigns, missing progress note, missing pro fees, or orders to cosign3) 2015 will have a new, updated interface for Patient Education. Includes the ability to mark items that youtaught, but need to reinforce and highlights them in yellow. Also has improved patient summary report printgroups for reviewing the information later―David MuiEpic shared the new features they have worked on in response to the requests of different organizations. Inaddition, they showed a list of new features in development and to come in 2015 and beyond.Key Points:1) Quick wins include template filtering in flowsheets, service list splits between ADT and Notes, Consultnotes within Notewriter2) Requests currently on their plate: Allowing panels within panels, assigning fields in bulk for order sets(phase of care), order set imports, documentation in order sets, multiple folders open at one time in chargecapture3) Blood admin - no frequency field, new ordering format (development for beyond 2015)Session 368FINDING A NICU IN A HAYSTACK―Yvonne Mugford, RNInnove went from paper to electronic documentation. The session demonstrated the differences betweenadult and NICU documentationKey Points: 112 | P a g e

1) Babies are not little adults INPATIENTNICU build is unique405: Plowing through Discharge Process ImprovementsSession 375FROM THE FIELD- MYCHART BEDSIDE―Andrew BeerA presentation by two organizations, Ohio State and Mercy Health, demonstrating their recentimplementations of MyChart Bedside. This is a mobile tablet application which allows patients variouscommunication and education tools while in their bed.Key Points:1) The application supports a wide range of patient requests, from diet, comfort, consulting needs, etc. Alloptions presented to the patient can be set up to have various triggers in Epic. They can trigger InBasketnotifications, worklist tasks, etc.2) The application can also complete tasks for the nurses. For example, when patients complete readingeducational materials on the table and attest to their understanding, patient education tasks in Hyperspacecan automatically be closed.3) The application is very brand-able and customizable. This can be utilized to include an introductorytraining video right in the application, or include games and other entertainment options for the patient toaccess.205―Deidre Keeves, PTJanet Cambell and Mike Epley (Epic) presented future mychart bedside development. Key areas includelaunch of Bedside for IOS devices on April 1st 2015. Organizations that have installed mychart bedside havedemonstrated a significant improvement in HCAHPS scores in the following domains: Overall rating,Willingness to Recommend, Nurse Communication, Doctor Communication, Communication Re: Meds,Responsiveness, and Discharge. Despite the nominal (under $5) per patient per discharge fee for use ofbedside, organizations are finding a good financial ROI based on the improved HCAHPS scores.Key Points:1) Future release of IOS will allow more organizations to adopt and support a bring your own device strategyso patients can use their own tablets2) Project teams for mychart beside are typically more aligned with the Inpatient/Clin Doc teams but a feworganizations are still running them through their mychart team.3) The presenting organizations are using the tablets in hospital and not sending them home with patientsSession 384MOO-VING AHEAD- DISCHARGE TO READMIT MADE EASY―Nina EmersonTwo organizations shared their lessons learned around discharge/readmit, and how they have improved theirbuild and process.Key Points:1) Baptist Health has updated some button captions and added help text to their navigators, which we maywant to look at doing2) Baptist also utilizes a patient class of \"discharge readmit\" that's tied to Inpatient in ADT. It's in an order,defaulted in the discharge-readmit navigator and satisfies the 'does the pt have a discharge order?\" Criteria.This patient class also allows them for nurses to bypass the AVS checks to print an AVS for the patient. Addedsigned and held orders the AVS as \"Orders to be continued at receiving facility\" which the abstractors love 113 | P a g e

3) Need to review RN 363835, which may help us print an AVS for discharge-readmits without a new patient INPATIENTclassSession 405PLOWING THROUGH DISCHARGE PROCESS IMPROVEMENTS―Yvonne Mugford, RNMoved the discharge documentation to the physicians and had discharge orders feed the instructions on theAVS and Discharge SummaryKey Points:1) Created new workflows which are similar to oursSession 414OLD MACDONALD HAD AN OB EMERGENCY―Lorraine Malden, RN, BSNCreators displayed a way to manage postpartum hemorrhage complication in one-step systems wheremedications and documentation was all in one placeKey Points:1) Build a narrator for OB emergencies: includes one step medications/mass transfusion protocol/code purpleactivation. Built hemorrhage from CMQCC―Tina Nguyen, MD, FACOGUsing a trauma narrator to better document OB postpartum hemorrhageKey Points:1) Interesting way of documentation2) Currently unable to pull into MD notesSession 424PAINLESS PICKING EASY-TO-SELECT MED REC NAVIGATORS―Jason WilliamsThe core of the session was showing how they were able to create a link based discharge navigator sectionbased of BPA's and Decision Support. This presented the users with a choice of navigators to use based oninput from the ADT information and Patient Class. This reduced confusion among users on which navigator touse and increased compliance for themKey Points:1) When not directed, it can be hard to discern if a patient should be dc/readmit2) Making it easier to discern what the outcome prior to entering the navigator prevents a lot of confusionand increases productivity3) learned important and use of LRPSSession ACF01WELCOME AND EPIC UPDATES―Angela Amucha, BSN, RNLearned about how Healthy Planet can be used to monitor high risk patients, increase patient engagement,and execute actionable analytics. Epic has completed 4 Healthy Planet Implementations, 31 are in progress,and 33 are scheduled.Key Points: 114 | P a g e

1) Physician and Enterprise Dashboards can be used to display reports with quality measures, enterprise INPATIENTmeasures, wait times, and system proficiency2) Bulk action workflow can be used to identify patients that have not met quality measures and place bulkorders with an attached letter. Questionnaires can be assigned to a group of patients using the bulk actionworkflowSession General SessionEXECUTIVE SUMMARY―Meg Furukawa, RN, MNCEO presented an overview of the current state of the company, new installations, thoughts on the futurestate of healthcare and a peek at some of the new development that will be elaborated on more duringWednesday'sKey Points:1) Epic has additional support programs for short-term projects and can evaluate your system to see if youare using all of the functionalities that make a system easier to use2) Engaged users create best outcomes3) Technology drives businessSession HIM11IDENTITY ROUNDTABLE―David MuiEpic hosted this session to go over the new features coming in 2015. I attended this session in hopes oflearning what is to come with Chart Corrections, as the Inpatient teams are bombarded with requests tomake corrections is patient charts. There seems to be many robust tools that will give HIM Operations theability to better manage chart corrections.Key Points:1) The ability to move a Note between charts2) The ability to remove Diagnoses3) Contact moves can occur while the patient is in the hospital…it is possible currently, but will be much saferand streamlined in the future releasesSession LAB03MULTI-FACILITY ORDER TRANSMITTAL FOR BEAKER―Jeff Banting, MBALearned about how OSF healthcare system implemented a multi-facility order transmittal rule for beaker.Discussed key workflow for inpatient areas. Discussed label printing and how periop rule was split.Key Points:1) Label printing and managing expectations for dummy labs to test for printing2) Periop rule was split to account for other various workflows3) Setup for order transmittal rule to implement at location levelSession Hien Nguyen MeetingMEETING WITH HIEN NGUYEN, UC DAVIS―Scott BaileyInterested in leveraging UCLA/OHIA's near-real-time data capability for their SIRS identification andintervention system. Currently uses Clarity data which is next-day data availability. 115 | P a g e

Key Points: data INPATIENT1) UC Davis has SIRS identification and intervention system based on Clarity2) Interested in leveraging UCLA/OHIA's near-real-time data capabilitySession NAC01NURSING EFFICIENCY AND USABILITY QUICK WINS―Meg Furukawa, RN, MNEpic presented ideas for improving nursing usability and efficiency through functionality that is available in2012 or 2014 versions. These functionalities can be easily implemented and include addition of new clinicalreports from 25 sites, additions to sidebar reports, interfacing with infusion pumps, readmission risk andchart search. Epic now has Nurse Builder classes, similar to their Physician Builder classes. UCLA's PatientStory is part of the upcoming Foundation System refuel.Key Points:1) Look at Foundation System for new clinical reports before building your own2) Readmission Risk (LACE) will be added to Foundation System in November 20143) Nurse Builder classes are a good way to gain an understanding of what build options are available to helpfacilitate discussions and plans with business ownersSession NAC03CLINICAL ADOPTION- PREPARING FOR HARVEST―Meg Furukawa, RN, MNThis session presented an overview on ways to achieve operational readiness by using three steps, identifyingand documenting future-state technology workflows, engaging staff in future-state operational workflowassessments to systematically identify the process, policy and job role changes that these workflows willintroduce and create actionable plans that change leaders and owners can use to implement, communicateand sustain those changes.Key Points:1) Implementation refers to the installation and activation of a functional system at a single moment of time2) Technology, change and operational readiness are necessary for success implementations and adoptionSession NAC06TELLING THE TALE OB DELIVERY FROM PRENATAL THROUGH POSTPARTUM―Meg Furukawa, RN, MNThis session presented an overview of how providers and nurses worked with end users to develop tools tobe able to see the perinatal patient's story (admission, labor, delivery, and postpartum) in a concise fashion ata glance.Key Points:1) Accordion reports are a good way to present an overview of the patient's story2) Need to include end users in all aspects of the rework to ensure the changes meet their needs3) Testing is important to ensure all data appears where it should―Nina EmersonDescribes how to improve chart review for L&D patients by utilizing a robust Patient Summary report and aSynopsis report.Key Points:1) The goals of their project that they met with a synopsis report will be met with the L&D timeline we areimplementing with 2014, so that part won't apply for us 116 | P a g e

2) Their Patient Summary \"Labor Story\" report is similar to our Patient Story. They have a couple of INPATIENTadditional items that may be nice additions to our OB Patient Story - namely a link to baby's chart, prenatallab results, and pregnancy history information3) Quality really liked their Synopsis report. We should make sure they are trained on the new LabSession NAC08FARM IMPLEMENTS & RUTABAGAS- AN APPROACH TO ORDERS PROLIFERATION―David MuiAurora Health shared their experiences with their active orders report showing way too many NotifyPhysician (as well as other general communication orders) orders for their patients. For some patients, therewere up to 30 Notify Physician orders to account for different parameters. Their solution was to revamp theorder and include a list of questions in one order and consolidate all parameters into one.Key Points:1) Aurora Health implemented order set restrictors to not show Notify Physician orders if they are alreadypresent2) Their new Notify Physician order has multiple LQLs to specify different parameters, as well as a question tospecify WHO to notify3) Communication is KEY for such far-reaching changesSession NAC12PEARLS- WORK LIST―Meg Furukawa, RN, MNTwo hospitals including UCLA presented an overview of the Work List implementation and optimizationincluding challenges, lessons learned and the need for input from nursing to be successful.Key Points:1) Spend time up front with end users to decide how the Work List will be used and what tasks will appear onthe Work List for best buy-in at go-live2) Order transmittal analysts should be involved in the build discussions and decision making from thebeginning to make the build succeed3) An integrated approach (operations, users, application teams) is key to the success of the Work ListSession NAC19PEARLS- MODIFIED EARLY WARNING SYSTEM (MEWS)―Meg Furukawa, RN, MNTwo hospitals present their processes and build to document risk scores using the MEWS score. Details of thebuild were presented and challenges were discussed.Key Points:1) Create a complete workflow with score visibility, score action and score reporting tied to patient outcomes2) Use discrete data where ever possible for best results3) It is possible to configure the build to page charge nurses or a response team when a threshold is reachedSession NAC25CPM-TRACK-WRANGLING REQUIRED DOCUMENTATION―Lorraine Malden, RN, BSNLearn methods for assisting end user with visual aid related to required documentation. Presenters reviewedon aligning pt population aligned with CPM content. 117 | P a g e

Key Points: INPATIENT1) Required documentation is set from admission and based off of 12 hour shifts2) Currently this functionality is not being used for UCLA Perinatal workflows, but is something we would liketo incorporateSession NAC26EPIC MONITOR- PATIENT SAFETY AND THROUGHPUT STATUS AT A GLANCE―Meg Furukawa, RN, MNThe speaker demonstrated their Unit Facility Board which is uses the Epic Monitor functionality. It displayssafety information and discharge readiness using icons. The board preserves patient confidentiality.Key Points:1) 2014 allows grouping of icons within a single column instead of in individual columns2) Customize the display item based on information needed for patient safety3) Consider where the boards will be displayed when planning build. Thin clients don't work at presentSession NAC33GROWING OUTCOMES USING A CLINICAL DOCUMENTATION COMMITTEE―Meg Furukawa, RN, MNThe speakers described a Clinical Documentation Committee (CDC) at their hospital who was responsible forprioritizing the requests for changes. The committee members are multidisciplinary staff along with projectteam. The CDC has positively impacted fulfillment of documentation requirements and quality outcomemeasures at their hospital.Key Points:1) Create a charter to identify the functions of the committee2) Discuss general topics with the entire committee and break into smaller application-specific groups asneeded3) Change from a reactive to a proactive approach to optimizing the systemSession 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.―Hawkin Woo, MD, MPH, FACP2015 Labs Express Lane New Snap Bar for Ordering for common Diagnoses. Meds & Orders hovering createspreview window. Notes Add Diagnoses and Problem List from the Note section. IB messages have Snapbar.2015 Features Canto New IP Handoff, New Snapshot, New Note documentation(Smartform HPI, SmartformPE, take photo with tablet, annotate and add to note, quick orders from Preference List (need building), linkfor Citrix and full Hyperspace, stick note hand written.Key Points:1) Canto 2014 more CPOE and documentationSession PAC06EARLY IDENTIFICATION OF SEPSIS IN A PEDIATRIC ED 118 | P a g e

―Frank Day, MD INPATIENTReview sepsis screening smart forms and BPA decision support to assist early identification of pediatric sepsispatients. Presenters from University of Chicago discuss their build and multiple BPA strategy (different forRNs and MDs).Key Points:1) Smart form data collection for triage nurses, BPA fires for RN each time new vitals are entered, includeslook back that allows for data correction2) Additional BPA for MDs, a \"chart review\" option allows is to fire again when next MD opens chart; 80 firesper 2000 visits, lots of false +s3) The majority of sepsis patients are being picked up by abnormal vitals, as opposed to clinical parameters(which are usually documented on obviously sick children, but not in real time)Session 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 PAC16ENHANCING THE INPATIENT PROVIDER DISCHARGE PROCESS THROUGH CENTRALIZATION―Darryl Hiyama, MDUniversity of Rochester discharge handoff report. Smartform discharge summary. Specialty specific dischargenavigator. Did not need a comprehensive course summary. Concise document with uniform format,encourage a patient specific narrative, with only clinically necessary info. Include accurate medication list,send promptly on discharge, and highlight key follow-up items. Key elements: concise narrative of hospitalcourse; procedures and complications, highlights of test results, pending test results, consultants, significantmedication changes. Smartform sections, consultant, service, significant med changes, date of discharge,discharge attending, procedures and findings (cardiac testing, endoscopy, OR procedure, Other Procedure).Significant imaging results, concise hospital narrative (free text). PCP Handoff Report with links looking to theSDEs in the Smartform. Programming point in Sys Def ADT action. Discharge AVS Snapshot. DischargeSummary created from same links as the Handoff Report. Med list excluded. Sign DC Summary activity innavigator. Cn use ruble based extension for specialty navigator build.Key Points:1) PCP input of what they want to see in the discharge summary2) PCP, inpatient providers, eRecord analysts, training, and communication teams, senior hospital leadership,HIMSSession PAC19OPTIMIZING THE FAMILY HISTORY HARVEST―Frank Day, MD 119 | P a g e

Learn how Dartmouth-Hitchcock created a multispecialty cross-discipline group and modified the basic Epic INPATIENTtools to create a new lexicon, navigator display, relative lists, and print groups, resulting in improved FHcollection. Presenters discuss the tensions between detailed vs. generic disease descriptors, and how to setup a governance structure for family history activity.Key Points:1) A multidisciplinary workgroup cleaned up duplicates, misspellings, abbrevs, and inconsistencies in modelfamily history. \"Neg hx\" is first column, then diagnoses appear by most to least common.2) Workgroup met with specialty groups for many items, removed if not clinically useful. Peds Amb contentkept separate3) This would be a great starting point for optimization of UCLAs family history activitySession PAC20NEONATAL-BASED BLOOD PRODUCT ORDERING AND BILIRUBIN NOMOGRAM AUTOMATION―Jeff Banting, MBAOrganization presented custom cache coding in the question record that automatically does calculation forpediatric weight based blood product ordering. Beasumont health system outline issues with using aprocedure order vs a medication order. They also presented management and guidelines of neonatalhyperbilirubinemia.Key Points:1) The load code default weight based volume in order question which is based on custom cache coding - dcalTotalBloodTransfusionVol^XXWBHORD3(ID,DAT,10,.QR)2) Outputs total blood to prepare and displays lq response3) Calls getTransWeight to calculate appropriate weight to useSession PAC21PEARLS- AVS―Mark Grossman, MD, MBA, FAAP, FACPUniform view, clarify meds, look at mychart version, 4 meetings over 2-4 months.Key Points:1) Tips and tricks on the hyperspace splash screen2) Fix page breaks for med list, fewer pages, fonts and format3) Update SER addresses in master file―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, etc.―Nina EmersonYale and UCSF describe the changes they've made to their AVSs since their go live, and how they organizedtheir optimization project.Key Points:1) Follow up section: Make sure addresses listed for providers are clinics where they see patients, and nottheir offices, which are sometimes a different location2) Medication list: Separate PRN and scheduled medications for patients3) Had a great way of getting some lab results on the AVS. Built a flowsheet in the navigator wherephysicians could indicate \"release Chem 7 results to AVS\" and then SmartText populated it onto AVS. 120 | P a g e

However, this was a ton of build, and they find this is only utilized for 1% of discharges. So may be a good INPATIENTmethod for a particular specialty need like transplant, but wasn't successful for internal med.―Hawkin Woo, MD, MPH, FACPYale. Patient/Family Council, Pre-existing Workgroups (Providers and Nurses), Analyst team with Medicaldirectors, etc. 29 AVS condensed to 26. About 12 hours meeting with stakeholder and 40 hrs. per AVSchanged. UCSF: Patient \"This looks like a letter from a serial killer, not from my doctor” Different fonts,colors, font sizes, different sections, written sections. Met 2x/month x 1 year. Simplified Follow-up Section,highlight a Main Follow-up.Key Points:1) Appearance is important―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 thatincludes patients 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 AVSSession PAC24LEVERAGING THE HIDDEN POTENTIAL OF SMARTFORMS―Melissa Chun, OD, FAAOPresenter developed a NoteWriter based SmartForm tied to Epic SmartData elements to document acolonoscopy assessment, automate colonoscopy follow-up recommendations, generate colonoscopy follow-up letter, and story all data as discreet data elements. Algorithm developed for the colonoscopy assessmentthat generated a series of questions, leading to recommendations and text blocks. Included detailedSmartForm Scripting in presentation.Key Points:1) Skilled physician builder using SmartForm scripting can created standardized letter template retrievingsaved generated text from SmartData Elements via SmartLinks generating English and Spanish languageversions2) Was submitted to Epic for review and consideration for release by Epic to all customersSession PAC26INPATIENT PROBLEM-ORIENTED CHARTING- FROM DECISION TO ADOPTION―Melissa Chun, OD, FAAOLee Memorial presented why they decided to utilize problem-oriented charting in inpatient and how theyimplemented at their organization. They have several great screenshots on how this makes specialty notesmuch more visible. They also discussed adoption and training, and tools that can be used to assist, likesidebar reports that can link to the more complete note/encounter. They also discussed how this made coremeasure documentation easier.Key Points:1) With problem-oriented charting, the notes follow the problem and are more easily visible in differentencounters. This is very beneficial for chronic problems2) While we currently allow physicians access to problem oriented charting, our navigators are not set up inthe ideal way to encourage it. With changing navigators and some SmartTexts, it actually becomes more 121 | P a g e

efficient to use problem-oriented charting. The physician puts their specialty in a section at the top, and the INPATIENTright note template then pops into their navigator3) Specialist notes are easier to find―Darryl Hiyama, MDUsed smartforms with rules logic to complete the path review after colonoscopic biopsy.Key Points:1) Versatile tool2) A LOT of build so should only use on bigger utility projectsSession Periop01OPTIME WELCOME & DEVELOPMENT PREVIEW―Hanna TameruThis session was an introduction to the periop forum and an update on future build from the OpTime team.The OpTime team demoed system enhancements coming in the 2014 and future versions. One of the topitems highlighted was the Procedure pass project that they are working on and will be coming in the 2015version. Epic estimates 30% of cancelled cases could be avoided by better visibility of patient readiness forsurgery (progress on test results, consents, etc...) Procedure pass will help with this because it will make thisvisibility easier by making that information easily accessible.Key Points:1) OpTime will be utilizing mychart a lot more in the future, such as sending reminders to patients, patientsbeing able to check in using their phone.2) A lot more enhancements for the flight board/snapboard are coming.3) Anesthesia style interface is being integrated for PACU RNs, so they can view patient data the same wayAnesthesia doesSession Periop04PEARLS- PROCEDURAL DOCUMENTATION―Hanna TameruSwedish medical center and Stanford hospital went over their pain rounding workflow, PAT clinic workflow,and TEE procedure note smartform. Swedish medical center utilizes the in-basket tool as a worklist forrounding on pain patients. The in-basket list is automatically populated if certain criteria is met based onanesthesia documentation in intra-op. Stanford uses a robust smartform (includes scripting, macros, etc.) towrite their TEE procedure note.Key Points:1) In-basket can automatically be populated with patient information based on a note2) Smartform can be used to drive billing, to populate results, and chart review by using macros and scripting3) Event case tracking can be set up to automatically populate an in-basket messageSession Periop05SURGEON PANEL―Hanna TameruA panel of surgeons from Kaiser, Gunderson, and University of Chicago discussed their successes andchallenges with ordersets, case request orders, phases of care, and ADT transfer/MAR hold. All thesehospitals use department specific order sets and have the case request order as part of their pre-op ordersets.Users find that physician case ordering not to be a big deal and most comply and actually like being able to 122 | P a g e

request this electronically. Kaiser and University of Chicago do not use the MAR hold functionality as they saw INPATIENTtoo many issues with orders being discontinuedKey Points:1) Most organizations use physician case ordering and have the case request order as part of the pre-op orderset2) Upcoming new functionality of being able to save several versions of a user orders set is highly anticipated3) Service specific questionnaire can be included as part of the case request orderSession Periop07PREFERENCE CARD CLEANUP―Hanna TameruMercy hospital discussed their process for cleaning up their preference cards. The process involved surgeons,periop leadership, periop staff, finance staff, and materials management. They picked top procedures foreach service line for the clean-up and invited each surgeon to a room to go over each item on their card whilein the room with the supplies. All items that were not used 80% of the time, were changed to show as PRN.Bringing these items un-opened was a huge behavior change that had to be supported by physicians.Key Points:1) The process of setting up a room with supplies on each preference card and inviting each surgeon to goover them was very labor intensive2) One big lesson learned from the process was how important it was to have the key people involved. Havingthe surgeon and a scrub tech (or someone who knows what each item is called) was for example huge3) All the physicians at Mercy are employees of Mercy hospital. That made a big difference in engagement ofphysicians in the processSession Periop09AUTOMATED OR REPORTING WORKBENCH REPORTS―Hanna TameruNYU langue went over how they set up a full screen display board that shows real-time workbench reports.The reports display first case late starts and turnover time by the OR. The reports run every 15 minutesKey Points:1) It is possible for workbench reports to be set up to auto run and display information2) Having this information visible to different types of staff in the main area of the OR was found very helpful3) Before this board was displayed on time starts were at 65%, but after this was set up, it increased to 79%.Session Periop12PRE-ANESTHESIA TESTING- IT’S NOT THE DESTINATION, IT’S THE JOURNEY―Hanna TameruDuke University went over their PAT clinic workflow. When surgeons request the surgery case, they use alinked appointment request. This request automatically populates the PAT status board. The PAT clinic isstaffed by RNs, PAs, and NPs.Key Points:1) It is possible to request a PAT appointment through case request2) Duke uses a BPA that fires to warn staff to add ROS to history or problem list if not already thereSession Periop14PEARLS: ANESTHESIA AND L&D 123 | P a g e

―Hanna Tameru INPATIENTCommunity Health Network and Parkland presented on their L&D workflow. The anesthesia L&D greaseboard is very flexible and can be set up to have custom views and columns that encourage timelydocumentation completion. New functionality of the labor epidural space was discussed by Parkland. Thisfunctionality is in the 2015 version, but is being SU'd back to 2014. It allows data to continue from intra-op.Key Points:1) New labor epidural workspace functionality is available for 2014 version2) L&D grease board can be set up on pre-log in screen, so it's visible without having to log inSession PMAC03HARVESTING A BUMPER CROP OF OPTIMIZATION PROJECTS USING VALUE STREAMS―David MuiValue 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 thisorganization shared their experiences and process for managing all their optimization project requests byfocusing on what is important to the vision of the organizationKey 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 first!Session PMAC05TEND TO YOUR PRINTERS, WORKSTATIONS, AND TDR TO REAP A SUCCESSFUL GO-LIVE―Jeff Banting, MBAReview major pieces of printer and workstation build. Share resource metrics for different phases. Sharelessons learned.Key Points:1) Review cycle of printer/workstation by develop standards, review inventory, upgrade hardware, uploadepr/lws, do printer mapping, complete TDR, implement at go live, and offer ongoing support.Session RF02ENTERPRISE IMAGING- LESSONS LEARNED & NON-INVASIVE TOOLS FOR PULMONARY & EEG LABS―Alyssa Doyle BSN, RNUsing a cardiant/radiant solution The University of Utah Health implemented as solution for their proceduralHOD's. This follows a current recommendation of Epic (not recommended at our time of go-live) The solutiondoes not seem to be more advantageous than the workflow implemented at UCLA. If we were to move to aCardiant Platform it may be a preferential change for the Cardiology HOD in order to streamline theCardiologist workflow.Key Points:1) Adapt the ECHO workflow - model works across cardiology2) Can now configure to not drop accession numbers3) Current Epic recommendation 124 | P a g e

Session RF04 INPATIENTYEEHAW! USING AN MRI SAFETY SCREENING FORM―Alyssa Doyle BSN, RNSSM Healthcare Wisconsin reviewed their implementation of an MRI screening form in the 2014 version ofEpic. The upgrade just took place in June. They had originally one live with a smartphrase for outpatients andpaper process for inpatients. The smartphrase was cumbersome and not user friendly. Ultimately the userswere happy to go-live with the new toolKey Points:1) Analyze opportunities to pull existing data from the chart where possible to reduce clicks2) Utilize printgroups and display data in a sidebar to complement the questions in order to view all info onone page3) If planning to printout copy to have patients sign - make sure you program it to display commentsassociated with the FSR―Cindy SwainPresented how they implemented the MRI screening form along with lessons learned.Key Points:1) Work with both nurses and radiology to write questions and design form2) Pull forward/present as much info as possible to prevent excess work3) Work coming in the future to support verification of implantsSession SAF02IMPROVING SAFETY WITH ACCURATE PATIENT MEDICATION LISTS―Angela Amucha, BSN, RNPhysician and Pharmacy engagement in medication reconciliation and leveraging the EHR to encourageAmbulatory medication adherenceKey Points:1) Importance of clinical staff flagging medications for removal that patients are no longer taking2) Highlight comments entered in for a medication to make it more visible for providers completingmedication reconciliation―Meg Furukawa, RN, MNPhysKaiser and Stormont-Vail shared techniques for promoting consistent and effective management ofpatient's active medication lists in the Ambulatory and Inpatient settings. The value of physician andpharmacist involvement was discussed along with ways to use the EHR to help with ambulatory medicationreconciliation adherence. Improvement is based on measurement develop metrics to monitor baselineperformance and track improvements. Share data with everyone.Key Points:1) The medication list should be both what the patient should be taking as well as what they are actuallytaking2) Discontinue medications that should not be continued instead of making them \"Don’t Order\" in med rec toprevent downstream consequences of confusion at discharge3) Leverage the EHR to guide providers into proper medication reconciliation. Support the physician'sworkflow and make it easy to manage the medication list and do the right thingSession SNAP08CASH CROPS- PHYSICIAN DOCUMENTATION-DRIVEN CHARGE CAPTURE 125 | P a g e

―Nina Emerson INPATIENTThis was a session from Stanford on some of the build they did to help make the \"Charging note-by-note\"feature in Epic as helpful for the physicians as possible. They described how the functionality can be usedfrom In Basket as well as how to setup rules to be very specific about how/when the pop up occurs.Key Points:1) It's possible to set up the pop up based on an CER rule set in LSD, meaning you get very specific about whatspecialties or log in departments will be prompted to enter charges2) Can set it up so that if a charge was already entered on a note, you don't get prompted a second time (i.e.,editing a note)3) The most difficult piece of setting this up is around mid-level providers. They had many Aps on the sametemplate, but only some of them can charge. This became challenging to separate―Jason WilliamsSession discussed the new pop-up functionality for charge capture when opening certain note types. This forthe particular hospital increased charges submitted and reduced service date errors as the service date isstamped as the time of note writing. How to set up these rules, alerts and pop-ups were all discussed.Key Points:1) Learned complexity of criteria for firing the pop-up depending on the note types (Can be quite high)2) Explored new pop-up functionality of professional fee charge capture/I feel may be irritating to some rolesthat prefer to use other routes to charge capture3) Rules can customize and cater to who receives the pop-ups, which specialty and roles are customizable aswell. (Useful for Surgeon Roles)―Christine Alanes, RNStanford’s presentation addressed the same concerns we have with Epic's 2014 enhancement pop-up ChargeCapture by note type. We will follow-up with the PI's on the information learned from this session.Key Points:1) We can exclude certain roles like the surgeons and OB from being part of this enhancement since theydon't charge the same way as the other services2) Will our physicians complain about the pop-up each time they write a note?Session SNAP29MEETING CMS 2 MIDNIGHT REQUIREMENTS―Jeff Banting, MBALearned how Bon Secours Health System set up Admit orders to comply with midnight rule compliance. Wasinformed on what gaps the organization faced. Reviewed key implementation points. Saw how BPA wasimplemented for this build.Key Points:1) Future plans for recertification of BPAs2) Reviewed two organization on how they've set up their CM2 2 admit orders3) Saw how organization set up their print groups that allow the build to work with their workflowSession UnsessionBLOOD PRODUCT ADMINISTRATION MODULE―Jeff Banting, MBADiscussion around setting up blood matching for various organizations. Learned about future reportenhancements for 2015. Discussed scanning logic for barcode scanning.Key Points: 126 | P a g e

1) Beaker does not do matching with Blood admin module INLAPBATIENT2) The patient identification matches need to go through interface3) Critical thinking for blood matching will not be replaced―Meg Furukawa, RN, MNDiscussion around setting up blood matching for various organizations. Learned about future reportenhancements for 2015. Discussed scanning logic for barcode scanning.Key Points:1) Beaker does not do matching with Blood admin module2) The patient identification matches need to go through interface3) Critical thinking for blood matching will not be replacedSession UnsessionMEETING THE PERINATAL MEASURES―Lorraine Malden, RN, BSNDiscussion surrounded about using the delivery summary to pull report data needed to meet Perinatal CoreMeasures: skin to skin, infant location to meet baby friendly criteria.Key Points:1) Possibility exists to have information from delivery summary, namely newborn measurements flow to theNICU flow sheets as a read only row. The weight section then calculates percentage weight loss from birthweight or from previous day―Tina Nguyen, MD, FACOGA small group of ob/gyn providers and nurses talking about issues with Stork build and how to meet the newperinatal measures.Key Points:1) UCLA is doing well. Many places are having issues with provider buy inSession UnsessionBLOOD ADMINISTRATION WITH EPIC―Christine Alanes, RNDuring the unsession that was broken out to small topics (reports, MTP, new implementation reports) it wasthe most useful session to freely ask questions and hear other sites express their challenges with build,testing and implementation. BPAM (Blood Product Administration Module) is a fairly new module and theblood admin team has been working on an interfactive report that UCLA has been wanting, but will not bereleased until 2015. The October call will be an opportunity to give feedback. If we plan to use Rover in thefuture for blood admin, the sleds used would need to be approved. I asked for additional resources availablefor bringing this module up and they put together a week-by-week which should serve as a checklist. Therewas no other sites I was aware of that was using SafetraceTX as their 3rd party system. It was mainly Softlaband SunQuest.Key Points:1) Test! Test! Test!Hospital/Surgery orders only encounter - issues with preop blood orders crossing encounters. Blood productscoming through the interface as a different product. What information is being sent through the interfaceCSN/MRN? Does the transfuse and prepare order need to be on the same encounter?2) Scanners being used for blood admin would need to be thoroughly tested by blood bank and it required a99% passing rate. This requirement was not made known to us by Epic and will need to follow-up with ourcompliance department at UCLA 127 | P a g e

Session 68 LABWALK THE LAB AUTOMATION LINE―Bukeka ChandlerNorth Memorial Healthcare, located in Robbinsdale, Minnesota. shared their experience of replacing their labautomation line with Centralink, which is Siemens middleware that centralizes data management andautomates manual processes for improved consistency, quality, and efficiency. It provides a singlecommunication link between lab instruments, automation systems, and multiple users within a centrallaboratory or across multiple laboratories. Although this was a very technical session and involved specificdetails regarding implementation, there was apparent success with a turnaround time in 2013 of 32 minutes(receive to result), which improved in 2014 with 26 minutes (receive to result).Key Points:1) The importance of ensuring that there is no service disruption during implementation and maintainingexisting turnaround time goals2) The need for central storage of speciments; recommended 9,000 refrigeration storage unit3) Incorporate new \"What if….\" lab procedure in the event of component failure within Aptio (automationline)Session 223ROVER: GIVING THE COWS A BREAK―Deidre Keeves, PTHackensack University Medical Center presented their Rover implementation. They targeted areas such as theED and OR where they already had back up WOW's and strong clinical educators in place to supplement theeffort. They used Airwatch MDM with their iOS devices and tested both single app mode and open but lockedmode and ended up staying with open but locked MDM strategy. They did not use voice and text on the samedevices for this Rover pilot because it was difficult to hear with some the barcoding sleds they piloted.Key Points:1) Rover uses the same security class as Haiku and Canto so it makes sense to leverage project team expertswho are already familiar with Epic's other mobile apps2) Their training strategy included 2 hours or classroom training for nurses and 1.5 hours of barcoding mobileskills lab. This was for staff that had never done barcode scanning in the past3) Lessons learned: they found it helpful to extend the screen lockout time for their iOS devices, nurses wereinstructed to hot swap the batteries each shift 128 | P a g e

Session 22 MYCHART & MOBILE APPSHERDING VIRTUAL VENUES OF CARE―Deidre Keeves, PTNovant presenter Richard Capps and Buffy Harris presented video visits and eVisits and MyChartoptimization. Goal was to maximize patient engagement since patients will soon expect this type of service.Patients like the convenience of asynchronous eVisits but there was a huge adoption factor in getting doctorscomfortable with using telehealth. Once live, the physicians found value in providing this service.Key Points:1) Virtual visits at the core are about extending the relationship between the provider and the patients in anew way. They turned on eVisits at flat out of pocket rate of $40 per visit starting with 4 diagnoses: cough,diarrhea, red eye, and urinary symptoms. Scaled it to 165 participating providers2) This organization allowed their physicians to opt into turning on direct open scheduling. The cadence teamwas heavily involved in creating special scheduling blocks to make sure providers still had some control overtheir schedule3) Turned on video visits in MyChart and charge flat rate of $50 per visit. 87 providers are online and toparticipate the patient is required to have internet and a web cam. Key to success was that every participatingprovider practiced first with a trainer before launching programSession 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 build―Shehzad SheikhThe presenter from University of Pittsburgh Medical Center shared the details and insights on home grownmobile app using Interconnect web service that returns estimated wait time for urgent care departments toprovide better overall patient service. Explains the process of how was the research carried out in the cache'globals to find the data and access it through custom web service.Key Points:1) It is reassuring to see that use Interconnect web services are a key to continued innovation for lightweightdata usage, like the current use of web service by OHIA solutions team2) Approach the environment team to gain required access to PLY environment to carry out some POCs forour current Executive ED Dashboard projectSession 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 patient 129 | P a g e

had smart phones, in order to engage those patients, during the check in process, they offered their patients MyYCChHaArtRaTnd&MMoObBileILAEpApsPPSto 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 staff memberoffering the text option to click on “consent” button on behalf of patient and for it to be documented under“Documents” navigator. Heavy internal marketing was done throughout the system and made this processpart 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 44PATIENT ENGAGEMENT VIA MYCHART AND WELCOME QUESTIONNAIRES―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 physicians―David GomezRetooled question and questionnaires to become more patient-friendly. Eliminated sections that were toolong or complicated. Only wanted to capture the \"pertinent\" positive answers. The physician could talk tothe patient about the negatives in person, and thus turned off the pertinent negatives in the questionnaire.Physician buy off promoting the tablets was key to success.Key Points:1) It was very important to get physician involvement when implementing Welcome Kiosks. In the facilitieswhere there was strong physician involvement there was more usage of the Welcome Kiosks―Mark Grossman, MD, MBA, FAAP, FACPMyChart and welcome kiosk using a windows tablet: health history questionnaires, we are not ready for thisyet, evolve MyChart questionnaires before welcomeSession 58HATCHING VIDEO VISITS 130 | P a g e

―Samantha Cao MYCHART & MOBILE APPSStarted 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 toaccess their 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―Deidre Keeves, PTStanford brought up their eCare video visit platform in Sept 2013 using myChart video visits and they nowhave about 30% of their self-scheduled visits as video visits. Their reimbursement strategy is to include theirACO patients and all others are fee for service, they currently get about 75% reimbursements for video visits.Since their pilot they later adopted an RVU based model assigning video visits the same RVU's for physiciansas they get with in person office visits.Key Points:1) Involving the MA was key to their operational workflow. The MA will call back to reschedule any patientswho are not appropriate, and at times when physician is running late, the MA will initiate the session2) The found lots of uptake in the early morning time periods from 7-9am allowing them to capture theworking patients. The hired an MD who only does video visits3) Their current challenges with scaling the solution include: 1) use of fat clients in the provider office areburdensome for upgrades and maintenance, dependency on flash 2) they have challenges testing acrossvarious device drivers and browsers―Grace LeeStanford 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. 131 | P a g e

Key Points: MYCHART & MOBILE APPS1) 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 101FOCUS GROUP- MYCHART BEDSIDE―Samantha CaoDemo of Bedside features that includes log-in, patient education, service requests, and care team. Patientscan seamlessly create a MyChart account if they don't have one. Covered 3 main improvement requests: 1)access to other apps utilize extensible web framework), 2) integration with the rest of Epic in terms of patienteducation (back to Epic 2012), 3) Integration with MyChart (only available in Epic 2015). Bedside can be builtto force patients to complete certain activities before having access to the more \"fun\" features of Bedside.Key Points:1) Epic is working on an iOS platform for Bedside to be launched April 1st, 20152) MyChart Bedside questionnaires is being developed and filed in flowsheets. Ex: pain managementquestionnaire tied to patient education and interventions―Bukeka ChandlerThe Nursing Advisory Council (NAC) shared Ohio State University's experience with piloting \"MyChartBedside.\" Bedside is where a patient can see their medical record while being an inpatient using tablets. Thispilot was implemented in December 2013 within their Cardiac Critical Care and Oncology department andboth units received 12 tablet computers. Stats were presented to show demographics, testimonials wereshared to show successes, and lessons learned were discussed to support best practices.Key Points:1) More hands on training for all staff is needed to successfully implement MyChart Bedside.2) If implemented, remember to consider longer power cords for rooms and customize apps and display3) The android/tablet is the largest platform based on market share. It makes perfect sense to implementMyChart Bedside through the use of tablets, which cost as low as $50.―Deidre Keeves, PTJanet Cambell and Mike Epley (Epic) presented future mychart bedside development. Key areas includelaunch of Bedside for IOS devices on April 1st 2015. Organizations that have installed mychart bedside have 132 | P a g e

demonstrated a significant improvement in HCAHPS scores in the following domains: Overall rating, MYCHART & MOBILE APPSWillingess to Recommend, Nurse Communication, Doctor Communication, Communication Re: Meds,Responsiveness, and Discharge. Despite the nominal (under $5) per patient per discharge fee for use ofbedside, organizations are finding a good financial ROI based on the improved HCAHPS scores.Key Points:1) Future release of IOS will allow more organizations to adopt and support and bring your own devicestrategy so patients can use their own tablets.2) Project teams for mychart beside are typically more aligned with the Inpatient/Clin Doc teams but a feworganizations are still running them through their mychart team.3) The presenting organizations are using the tablets in hospital and not sending them home with patients―Grace LeeCurrently 7 organizations are utilizing \"Mychart Bedside\" and 15 more are about to go live. Greatersatisfaction in instant communication between patient/ pt's family with the caring team. Allows everyoneinvolved to be aware of the current situation of the patient, down to what time patient took his last painmedication. Family members have been quoted to say they feel \"empowered\". Previously they only hadAndroid platform available but as of 4/1/2015, ios platform will be introduced.Key Points:1) Solid data gathering capability: Satisfaction surveys, risk scores and Research study participation2) Even for those who are not familiar with tablet system, took average of 15 min to teach patients. However,even that was decreased by providing \"guided tours\" of the tablet system by providing screen overlay3) All about increasing patient engagement! And MUST do Production Dress Rehearsal to work outnetwork/server issuesSession 111LIFESTYLE CHANGE TOOLS PROMOTE A HEALTHY HARVEST―Samantha CaoUniversity of Pittsburgh Medical Center presents on the tools they utilized to help patients with long termweight maintenance focused on integration into PCP interaction with patients. Success of program led toMAINTAIN-pc study (movement of all tools into Epic instead of 3rd party vendor). Tools used include e-visits,questionnaires, flowsheets, secure messaging, letter encounters, BPAs. Measure of engagement gauged byactivity within past 2 weeks - 72% engagement (presenter attributes high engagement/re-engagement tointegration with MyChart).Key Points:1) Keep as much patient-provider interaction within Epic as possible instead of connecting to many additionalvendors/products. Do not use VLM vendor (currently trying to sign UCLA as a client2) Utilize patient messaging to send regular health tips and reminders if they are participating in the program3) Questionnaire build took the most time. Utilized it for patient education based on patient's responseSession 145PATIENT ENTERED DATA EMR INTEGRATION VIA TELEPHONY―Deidre Keeves, PTCleveland Clinic presented project team construct for their implementation of a voice recognition based callservice. Included was a full team structural review of: Web, database, hosting, telephony servers,communication with Epic, IVR development, QA and support model. Lessons learned: you can't fully rely onspeech recognition and it's difficult to authenticate patients over the phone. They mitigated this butsupplementing their solution with a worqueue that sent variants to a live call center.Key Points: 133 | P a g e

1) Web services are a fast robust way of getting real time data out of epic that prevents the redundancy and MYCHART & MOBILE APPSmaintenance required of HL7 and clarity.2) Cleveland Clinic built an application to audit and log all of their access to web services. If anything getscaught in a loop they put a layer on top of web services called an \"Enterprise Service Bus\" that letsorganization audit and govern use of web services. Primary use of this is enterprise application management.3) See Epic's web services data handbook. If they develop any custom web services, they later replace themwith Epic released web service once they are developed. Goal should be to support the framework that canprovide mobile projects, not the individual applications.Session 153SOWING SEEDS FOR MYCHART SUCCESS―Samantha CaoThe Ohio State University Wexner Medical Center presented on how they engaged users and patients to meetMU Stage 2 and utilized a faster workflow for granting proxy access to MyChart. They formed a MyChartworkgroup 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 of ambulatoryservices 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 objective.2) 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 too.3) 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 goals.―Bukeka ChandlerIn this session, Ohio State University's Wexner Medical Center shared how their numbers were low whenmeeting Meaningful Use (MU) objectives. They presented how they had to change their strategy in order tonot only successfully meet Meaningful use objectives, but to increase patient engagement, improve thepatient experience, and build loyalty. They had to identify their number one goal which was \"Adoption andPromotion of MyChart.\" They led us through their process of training leadership and staff, being transparentand setting internal goals to ensure that everyone knew what was going on, and explaining the benefits ofadopting MyChart to staff and patients.Key Points:1) Establishing \"buy-in\" of senior management by not only educating them on how to use MyChart, but whyMyChart is necessary, its benefits, and to stay competitive. Having leadership set clear objectives, prioritizeaction steps, and develop clear and easy to understand measures of success will help other staff to trulyadopt My Chart.2) Never begin talking to users about a product before establishing the support of leadership. Leadershiphelps to set the tone for adoption, promotion, and marketing.3) Create a best practices document and share with physicians reminding them to: 1) Mention My Chartmessaging throughout the visit, 2) Respond promptly to messages from patients, 3) Encourage patients tocomplete their pre-visit history questionnaires, 4) Teach them about the My Chart mobile app, and 5) Signpatients up in the exam room.―Grace Lee 134 | P a g e

One of the difficult MU objectives for many hospitals is to meet the 50% or greater Mychart activation rate MYCHART & MOBILE APPSand 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 lowperformance clinics, which encouraged low performer to up their activation rate. Also, mychart messageturnaround time was monitored to ensure patient satisfaction.Key Points:1) Monitor physician and office staff's mychart message turnaround time.2) 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 roomSession 189CLUCK-CLUCK-CLICK- PATIENT-REPORTED OUTCOMES IN CARDIOLOGY―Samantha CaoUniversity of Pittsburg presented use of a windows tablet in the cardiology clinics to collect point of carebased questionnaires. Their project team describes that they experienced a high volume of demand forquestionnaire build that exceeded resource capacity. They used an intake strategy that allowed eachrequestor to define the business need, ROI, and key clinical actions that would result from the data beingcollected.Key Points:1) Lessons learned: include free text response options, make the questions visible along with the responseswhere the provider reviews the information, have a clear mission statement and measurable goals for eachquestionnaire project2) During the intake process, have the business owners think about and define what clinical actions will takeplace as a result of collecting the data3) They included a clinical project champion in each clinic that went live with the questionnaires. Clinics trackcompletion metrics and are encouraged to hit an 80% questionnaire completion goal. If the goal is not metthe project team gets involved to trouble shoot through additional site visitsSession 205MAMA GOAT CHECKS ON HER KIDS―Lorraine Malden, RN, BSNLearn methods to empower parents of NICU/Nursery patient’s access to information on feeds, weights,status update and upcoming appointments. This allowed NICU parents to know when best to visit at thehospital for skin-to skin and feedings. For newborn nursery mothers it gave them information on follow-upappoints like with audiology and follow-up pediatrician appt.Key Points:1) In order to increase members connected with My Chart and increase participation in MyChart. Birth Clerkwas provisioned to sign-up baby prior to discharge and to give a tutorial session to mother on how to accessand obtain informationSession 215LEAVIN’ THE FARM- MYCHART & WELCOME FROM TOTS TO TEENS―Bukeka ChandlerThis session involved two presenters: The Children's Hospital of Philadelphia and Sutter Health. TheChildren's Hospital of Philadelphia shared strategies to collect vital pediatric information through MyChart 135 | P a g e

and Welcome questionnaires. One method is the use of Epic's Welcome patient kiosk that allows patients to MYCHART & MOBILE APPScheck-in for appointments, updated demographics, verify insurance information, make copay payments andcomplete visit questionnaires. Sutton Health, which is a leading nonprofit network of community-basedhealthcare providers, presented how they transitioned into teens having MyChart access; they shared proxyfeatures (i.e., what they can do and see), requirements regarding parental permission and enrollment, buildchallenges, and communications.Key Points:1) Sutter Health emphasized the importance of internal communication being initiated by leadership; a memosent out by leadership to announce project2) Sutter Health has a web page that allows access to be extended past 12 with one click, if it existedpreviously. This is definitely a feature to consider3) Consider social media (i.e., Facebook and Twitter) for external communications announcing upcomingMyChart features, special promotions, marketing, etc.―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 accountKey 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>―Samantha CaoParkview Using combination of MyChart and Welcome to collect pediatric data such as developmental andbehavior screening data. Questionnaires are assigned based on scheduled appointments (rule-based). Processis well-received by providers and staff and encourages them to get their patients signed-up on MyChart.Other strategies used to promote MyChart in the pediatric population include the following: questionnaire-only access to upcoming appointments and questionnaires via proxy when parent is making the appointmentand promote to teens that they have access to their doctor for sound medical advice. Sutter has rolled outaccess to teens and their parental proxy. Has special access class for parents who need full access.Confidential messaging is not available on the mobile app (must communicate this)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)Session 223ROVER- GIVING THE COWS A BREAK 136 | P a g e

―Meg Furukawa, RN, MN MYCHART & MOBILE APPSHackensak University - overview of recent Rover implementation. Mostly covered build details. Using thenewly developed worklist functionality from rover. Rover now has a bottom tool bar navigation system.Observations from their Pilot - it was important for nurses to introduce Rover to the patient & family - theystarted to get complaints that nurses were on their phones in the patient roomsKey Points:1) Ensure there is a CICARE connection with Rover implementation - rules to login prior to walking into room -introduce patient to the device and functionality2) Need to change logout times on device so they do not time out in 1 minute. Time extended to 5 minutesturned out to be perfect3) Hotswap batteries at beginning of each shift - phone pulls charge from caseSession 244IMPROVING PHYSICIAN SIGN-OUT USING THE 2014 HANDOFF TOOL―Andrew BeerA presentation by Stanford Children's Health on their implementation of the Epic 2014 Handoff tool. This is anew feature in 2014 and has allowed them to overhaul their physicians' patient hand off process. Discussionincludes their build and issues they faced.Key Points:1) The new hand off tool can be accessed from the patient list and printed from it as well. It prints inlandscape mode, allowing it to contain multiple patients per page, contrary to the older patient list reportsthey were using2) A new feature is that each specialty can have their own handoff notes (cardiology, etc.). This makes it easyif multiple physicians need to hand off the same patient to their respective colleagues. However, thisseparation makes it difficult for one specialty to hand off to another3) There is a view-only version of this available in the 2014 Canto table application, which can make hand offseven more flexibleSession 265CREATING A FOUNDATION OF CONFIDENCE FOR ALL END USERS―Bukeka ChandlerThis session addressed how Henry Ford Health System, in Detroit, Michigan, strategically planned to transitionfrom their \"home-grown\" legacy system to using Epic. First, they created a learning map experience whichinvolved delineating a map of their current state vs. a map of what Epic would look like. Second, they engagedstakeholders in training and established various teams to train 20,000 users within a 6 month timeframe.Finally, they provided users with access to a 24 hour playground to make practice perfect and strategicallyplaced super users where needed.Key Points:1) Establish teams to come together to walk through the workflow. This will help end users to become moreconfident because they were heard, engaged and included in the process.2) Teams should consist of a diverse group of people to engender a well-rounded process.3) Encourage shadowing of high performance physicians to influence better performance of other physicians.Session 277SUCCESS AT 7- BENEFITS OF MYCHART MEGA-ADAPTION―Grace Lee 137 | P a g e

Novant Healthcare really took advantage of 'Mychart' to meet Meaningful Use and to meet ACO model. MYCHART & MOBILE APPSOffering 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 open scheduling(direct scheduling) 2,411 new patients were brought into the system, generating over 4.1 million dollars inrevenue. No show rate via open scheduling was only 4%, much less than average no show rate. Video visitand E-visits were also offered to patients via mychartKey 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 298FERTILIZING THE GROWTH OF PATIENT ENGAGEMENT TOOLS―Jody GasparMychart is the best tool to help organize patient engagement by offering pre-registration and online bill pay.Key Points:1) Ensure patient engagement tools are simple and easy to understand2) Be bold and try new things (put activation codes on the AVS and pt statement)3) Make mychart part of the revenue cycle―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, 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―Grace LeePatient 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 takecare of bills increased efficiency, resulted in higher collection rate and increased overall satisfaction for ourpatientsKey Points:1) Ensure patient engagement tools are built to be intuitive and simple2) Make Mychart part of the organizational culture, including revenue cycle 138 | P a g e

3) Continue to increase adoption of technology, don't be afraid of the new MYCHART & MOBILE APPSSession 305SUCCESS AT 7- MYCHART PLUS CLINICAL SOCIAL MEDIA―Bukeka ChandlerChildren's Medical Center (Dallas) shared how they arrived at a family-friendly patient portal. Their goal wasto focus on patient engagement by meeting the customer where they are, which is online using innovativetechnology. But first they had to accept the realization that they were missing an opportunity by not beingknowledgeable about the patient portal and that it was time to redesign their website. Their process involvedidentifying needs by conducting cross organization interviews, identifying platform and technologies that areapplicable across all audiences, engaging stakeholders (i.e., general public, patients, families, providers, andstaff) and creating a one-stop-shop for parents regarding proxy sign-upKey Points:1) Consider an audio button on website to accommodate those patients/parents who cannot read. Thepresenter mentioned they have many Spanish speaking families who can't read English or Spanish2) Staff must know their role and be knowledgeable about the patient portal and how it works.3) Education and marketing are key components of the staff interaction with patients. Both will help toincrease patient use, which in turn will help better meet Meaningful Use objectives.―Deidre Keeves, PTChildren's medical center Dallas presented on mychart website enhancements and sited their patientengagement efforts as a key contributing factor in achieving their Davies award. Presenters described theoverhaul of the organization's public website with integrated single sign on access to their mychart portal.Key Points:1) They tried a social network on their children's site but since retired it. Existing social media networks madethis redundant and not used.2) By combining organizational web content and using mychart login they have content specific delivery ofinformation based on the child's needs. Online education links and tracks my health (for example: pediatricglucose tracking in mychart plus specific information about the offices of each of the child’s specialists.)Session 319PANEL- PROVIDER MASTER FILE (SER) MAINTENANCE―Bukeka ChandlerMaineHealth, located in Maine and New Hampshire, along with Franciscan Alliance in Indiana, presented anoverview of SER (Schedulable Epic Resource), their SER maintenance model, which includes team formation,standards/templates, creation and update processes, and clean-up, and their SER teams that are on call for 24hours. This centralized model handles all additions, deletions, and modifications. However, handlingtransition of physicians has been difficult. Therefore, a third party was required for verification purposes.Key Points:1) A third party to handle verification of fax numbers and addresses would help in tracking new physiciansand those transitioning out.2) Consider creating a verification form and sending it out regularly to be filled out. This can serve as a backupprocess to the third party verification vendor.3) Need to have a 24 hour on call SER team.Session 322OVERCOMING THE OPTIMIZATION BLACK HOLE 139 | P a g e

―Samantha Cao MYCHART & MOBILE APPSScottsdale Lincoln Health Network described how they wrapped their arms around the massive backlog ofoptimization service requests (600+) after go-live. Leadership decision to freeze optimization and convened a\"clean-up\" crew to review and approve/deny tickets (6 week process). Once list was approved, worked withIT group each month to prioritize tickets. Group consisted of people who understood the bigger picture,system build, and operational workflows. Once cleaned up, the organization implemented a structuredrequest and approval process. Patient safety, user-efficiency, strategic-fit, compliance clinical outcomes,financial implications are evaluated with each optimization request.Key Points:1) Optimization requests must be filtered through clinical informatics staffs who then submit the ticket ontheir behalf completes with desired design details. Currently have only 40 open tickets due to their newprocess (2 wk process from submission to build).2) Changes are bundled to production. All minor changes are communicated on a \"huddle board\" that eachdepartment looks at to share changes with staff. Bigger changes are additionally shared through e-learningsand tipsheets.)3) Organization stuck to standardized system to minimize maintenance requirements (rejected requests thatare user/department specificSession 335FOCUS GROUP- MYCHART―Deidre Keeves, PTEpic presented existing features: drop down menus in 2014 to reduce time for patients to locate info, careteam and appointment wigits that allows better usability without any extra build. Open scheduling can allowpre-registration of new and existing patients and create new mychart account. Epic presented upcomingfeatures in 2015: med refill is easier, get medical advice allows send a message or start eVisit, IOS voice overusing apple speech in mychart mobile. In 2015 they are looking to unify the look of IOS and Android mychartmobile apps.Key Points:1) There are lots of open and direct scheduling enhancements coming in future mychart development. Multi-participant video visits allow you to pull in an interpreter2) Lots of mychart mobile app development -patient billing, estimated charges for appointment beforescheduling, pre-payment, push updates to patients on appointment openings if they are on waitlist(FastPass), arrival time/appointment time, add appointments to your personal calendars and use eCheck inon mobile devices. Extension of mychart mobile to add your own mobile apps3) MyChart mobile app extensibility allows you to direct patients to your mobile web pages and other mobileapps. (See Hacking Haiku section to design a workflow that lets users get directly back to mychart afterlaunching out to other apps.) There will be a charge and contract amendment for epic and self-submittedcustom apps. Self-branded, self-submitted gives you the ability to bundle on more features if you have anative app building team. Targeting end of October for custom submitted apps, available for IOS and android―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 alers via Mychart App. Epic 2015 will allow us to brand our own Mychart app.Key Points: 140 | P a g e

1) Physicians will be able to assign flow sheets to patients via mychart, having them keep track of MYCHART & MOBILE APPSweight/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 status2) Using Mychart, organizations will be able to bring in \"new\" patients, who seeking quick access tohealthcare via web or video visits3) During initial consent signing, include verbiage for \"care everywhere\" pre-authorizationSession 357MAKING SENSE OF HEALTH MAINTENANCE―Bukeka ChandlerDartmouth-Hitchcock Medical Center in New Hampshire explored qualities of an effective reminder system,how they constructed a more intuitive health maintenance activity, and what they wanted from healthmaintenance. Their process began with analyzing their vernacular to simplify definitions and abbreviations toavoid confusion, making buttons more intuitive, and determining what to teach.Key Points:1) An accurate clinical reminder system in one location to manage preventive care is imperative2) Having an audit trail that involves multiple users is necessary and should be mandatory3) Use consistent definitions and avoid excessive use of acronymsSession 375FROM THE FIELD- MYCHART BEDSIDE―Andrew BeerA presentation by two organizations, Ohio State and Mercy Health, demonstrating their recentimplementations of MyChart Bedside. This is a mobile tablet application which allows patients variouscommunication and education tools while in their bed.Key Points:1) The application supports a wide range of patient requests, from diet, comfort, consulting needs, etc. Alloptions presented to the patient can be set up to have various triggers in Epic. They can trigger InBasketnotifications, worklist tasks, etc2) The application can also complete tasks for the nurses. For example, when patients complete readingeducational materials on the table and attest to their understanding, patient education tasks in Hyperspacecan automatically be closed3) The application is very brand-able and customizable. This can be utilized to include an introductorytraining video right in the application, or include games and other entertainment options for the patient toaccess―Deidre Keeves, PTMercy Health and Ohio state presenters recapped their experience going live with the Mychart Bedsideapplication. Both organizations have seen a significant increase in HCAHPS scores and both plan to scale theBedside programs hospital wide.Key Points:1) IT staff are turning the devices over between patients. They had initial challenges with their MDM strategybut used a pilot to iron out the kinks before scaling the program2) Use of a short welcome tutorial video for patients led to a significantly shorter training time to start eachpatient up 141 | P a g e

3) Both organizations emphasized the positive impact about developing out photos and staff bio information MYCHART & MOBILE APPSin the Treatment Team section of my chart. They started with a feed of HR nametag photos but staff andproviders liked the option of adding an image of their choiceSession 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 islaunched 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 MyChart andin Epic for the clinician to act on and is available to launch ad hoc within the navigator. For Providers, \"reviewflowsheets\" section to see results over time. Created Encounter type \"patient survey department\" to displayin Chart Review2) Eligibility for specific screenings are pulled from the patient problem list3) Regular screening of patients have generated a higher volume of referralsSession PAC13HACKING HAIKU- WHEN YOU JUST CAN’T LEAVE WELL ENOUGH ALONE―Deidre Keeves, PTDirector of mobile technology strategy (Ricky Bloomfield MD) from Duke, presented how to build customfeatures in Haiku. He describes creation of a native \"mobile companion app\" that integrates with Haiku andCanto workflows to Augment provider inpatient tools by providing access to BiliTool decision support withinthe workflow.Key Points:1) Session included Virtual Goodie Bag - step by step instructions on how to create these aps and full sourcecode for the companion app for free on GitHub. They also created a way to pull recent list of departmentsfrom Hyperspace into Haiku using code from Sheng Han - university of Michigan to create a customdepartment list in haiku that matches recent departments used in Hyperspace.2) Created a code to link into BiliTool from Haiku. Created a custom print group that executes the API code forsending info to BiliTool and launching the web tool. The code generated a button that was displayedanywhere a Biliruben displayed in Haiku.3) Integrated link to launch Up To Date. Within \"active problems\" or \"current meds\", search Up-to-date forthe active problem. Creates a search query for each active problem you click on.Session PAC29A COMMUNITY COLLABORATIVE APPROACH TO OPEN NOTES―Deidre Keeves, PT 142 | P a g e

Legacy Health presented Open Notes project for automatically showing office visits when a provider chooses MYCHART & MOBILE APPSto opt in and patient enrolls in mychart. Small pilot 12 docs, excludes adolescents. OHSU - shows the officevisit progress note print group in after visit summary which goes into mychart. NW Kaiser implemented opennotes region wide in April, 2014 - 2/3 of their patients are on myChart.Key Points:1) They gave the physician an option to opt out of showing the open note by using a dot phrase .opnoteNo.Most did not opt out, metrics found that they had less than 1% opt out rate if you exclude 19 docs that optedout every time.2) Kaiser believes communication about the open notes initiative is best timed at about 1 month before go-live.3) Physicians were concerned about its impact to their inbasket messaging but there was no discernableincrease in calls or complaints. There is no patient centric reason to not share notes!―Mark Grossman, MD, MBA, FAAP, FACPOpen notes: phase opt out for a specific noteSession SNAP40EPIC ACCESS FOR RESEARCH MONITORS―Josi MillerAccess for research monitors had been problematic prior to the use of Link, this allowed Hackensack torestrict the timeframe, patients, and encounters that study monitors could see. The legal process andagreement development was time-consuming. Received largely positive feedback from study monitors viasurvey, found there were still some concerns around accessing scanned documents.Key Points:1) Created an EMP with restricted Day and Times of Access2) More efficient process that release inspector or manual review 143 | P a g e

Session 1 PharmaPcyHARMACYMEDICATION INTERACTIONS & DOSAGE WARNINGS―Bernard Katz, MD2014 allows setting of warnings at an individual provider level so that repeated warnings aren't shownKey Points:1) Set level at \"highest\" severity2) Kaiser Allow individual physicians to \"hide\" repeated warnings3) Need to reevaluate every 6 months to be sure still want to hide the warningsSession 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 prescription.2) 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 tracking.Session 259FOCUS GROUP- OPTIMIZING STRATEGIES FOR MEDICATION―John Lou, MDLearn methods for monitoring medication alerts and formatting the data in ways which can help yourorganization make decisions about medication alert settings. Presenters review standard Epic reports anddata manipulation techniques, and they discuss appropriate governance and decision making forums formedication alert changes.Key Points:1) Leverage Epic's OOB Med Alert Statistics report and analyze pain points to address2) Need governance to decide what to turn off3) Make quick buttons for override reasonSession 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 eyetoward balance, 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 issues 144 | P a g e

3) The acuity scale was extended into Beacon by rating each treatment plan with an acuity score, so that the PHARMACYacuity of patients could be judged by the front desk simply by checking which treatment plan they were onSession 414OLD MACDONALD HAD AN OB EMERGENCY―Lorraine Malden, RN, BSNCreators displayed a way to manage postpartum hemorrhage complication in one-step systems wheremedications and documentation was all in one placeKey Points:1) Build a narrator for OB emergencies: includes one step medications/mass transfusion protocol/code purpleactivation. Built hemorrhage from CMQCCSession PharmAC02WILLOW AMBULATORY WELCOME & WHAT’S NEW―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 2015Key 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 ableto get started earlier on pre-authorizations for prescription coverage, enhancing patient experience uponpick-up.2) 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, ifneeded.3) In 2015 the ability to bill to research accounts will be added.Session 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 message.2) 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 fixescumbersome.3) When doing setup and build for Inventory, care should be taken in defining the initial medication stocks. Inthe 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 stock had in fact notbeen ordered that recently. 145 | P a g e

Session PharmAC09 PHARMACYWILLOW AMBULATORY DEVELOPMENT DESIGN―Andrew BeerPreview session where Epic's Willow Ambulatory developers demonstrate some of their latest projects andsolicit design discussions from the customer representatives.Key Points:1) A project of significant interest and controversy is adding the ability for pharmacists in Willow Ambulatoryto suggest 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 currently.2) 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 up.Session PharmAC10PEARLS- TRANSITIONS OF CARE & MOVING FROM CARTS TO THE DISPENSE QUEUE―Andrew BeerAn overview of how Aurora implemented a system for involving pharmacists more closely in medicationreconciliation during transitions of care. Followed by a presentation of how Stanford moved from automatedcart runs to using the dispense queue to manage cart dispenses of medications and wastage.Key Points:1) Aurora built a BPA to remind nurses not to discharge patients until a pharmacist has reviewed theirdischarge medication reconciliation.2) 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 up.3) Using the dispense queue activity instead of letting cart fills run automatically allows pharmacy techs tocancel unnecessary dispenses, such as new IV bags when no new bag is in fact projected to be needed. Thisapproach reduces wastage.Session PharmAC15PRESCRIPTION MOVEMENT- UPS 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 fulfillment.Key Points:1) The University of Colorado found that UPS was a much more responsive shipping partner for mailingprescriptions 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 Epic.2) Central Fill functionality in Willow Ambulatory allows the use of MyChart notifications to patients whenprescriptions are ready. A drawback is that the notification currently sends when the prescription has beenprepared, but in some cases it may not be ready for physical pickup at that moment.3) Online credit card pre-payment for prescriptions is coming to Willow Ambulatory, piggybacking offMyChart credit card payment development.Session Unsession 146 | P a g e

COMPOUNDED MEDICATIONS PHARMACY―Bernard Katz, MDAbility to enter compounded medications into CareConnect 147 | P a g e

Session 34 REPORTINGTHINKING OUTSIDE THE CORRAL: CREATIVE ENTERPRISE CRM―Bukeka ChandlerThis session entailed Stanford Health Care sharing innovative usage of CRM within their various entities (i.e.,Patient Access Services, Social Work & Case Management, and Senior Patient Representatives) andpresenting each of their initial workflows, their challenges, and how CRM helped to improve tracking andreporting. CRM (Customer Relationship Management) is an Epic communication tool which allows us to storenon-clinical documentation regarding patients in a centralized place.Key Points:1) Out of the entities presented, I could mainly relate to the Senior Patient Representatives due to the natureof their work (i.e., provide resolution for any concern or issue patients and family members may have withtheir care experience). Having CRM reduced the use of a third party system and kept PHI in a centralized,secure system.2) Developed a Haiku platform for CRM which allowed CRMs to be accessed directly on phones andresponded to immediatelySession 37COGITO DATA WAREHOUSE USE CASES FOR SUCCESS―Josi MillerLarge focus on lessons learned in prior data mart initiative and key elements to successfully implementCogito. Focus has to be on the institutional need and having developers interact closely with business ownersso they aren't siloed. Importance of a research data council in Cogito strategy, responsible for prioritizationof projects, research access auditing, and a funding mechanism. Facilitated researcher access to view data inthe warehouse as an initial use case, with a focus on clinical data extraction, de-identified data, andcollaboration.Key Points:1) The governance structure should support appropriate access without stifling growth of the datawarehouse.2) Collaboration across separate groups is key if the warehouse is to truly be considered an institutionalresource.Session 60IT AIN’T CROP CIRCLES, Y’ALL: DEMYSTIFYING REPORTING―Josi MillerInterpreting the needs of the requestor to create usable reports.Key Points:1) Created \"Technical Requirements Analyst\" to be the intermediary between requestor & clarity team whocan speak the language and can complete/finalization the form on behalf of the requestor.2) Form should include: report layout, values/fields, grouping, sorting, summaries/averages/calculations, etc.―Darryl Hiyama, MDLarge volume of data and report requests for SMS Health (network). Identified bottlenecks: developerbottlenecks, end user feedback, patterns in tickets.Key Points:1) Was not very helpful session 148 | P a g e

Session 70 REPORTINGHARVEST INFORMATION ON CLINICAL DASHBOARDS―Nina EmersonMount Sinai presented on how they setup their system to appropriately capture metrics needed to populateclinical dashboards. They needed a 'war room' style approach to get the build completed, and how theincreased visibility of these metric to their clinicians has improved compliance in several areas.Key Points:1) The setup is difficult - Epic is new to the functionality, and they needed to get developers to come onsitefor a war room style setup because they weren't getting the answers they needed trying to work remotely.2) They made dashboards the home page because they felt that otherwise, people wouldn't regularly viewthem. However this is then an extra click to get to schedule or patient lists3) Nurse managers use the dashboards in huddles with their staff, and review why certain patients are or arenot meeting metrics as a group.Session 86HARVESTING EMR INFORMATION TO DRIVE INNOVATION―Kathie HaleHow EPIC & external data can improve actions: populations, productivity, provider relationships & growth.Key Points:1) Data transforms into Information which transforms into Knowledge which transforms into Action. Identifymeasures and investigate & design reporting to aid in actions.2) Inputs are critical as the output relies on it. (garbage in = garbage out)3) Understand the maturity of each initiative & measure the results.Session 108ED PROVIDERS- REACHING ACROSS THE PLAINS―Kathie Hale33 Emergency Departments, 1800 visits a day. On 2012 version. Needed to increase utilization ofdocumentation tools. ID workflows that needed modication. 12 ASAP analyst involved. Collaborated withall ED's to identify where there was a need. There were difficulties finding a common meeting time. Analysison what kept MDs late was completed to see where documentation was impacting physicians. 20% ofphysicians were not using tools such as HPI and Procedure forms. Many providers did not chart at bedside,requested navigators that required less clicks. There were surveys on how they would like to becommunicated with about changes - most wanted a face to face communication, more than 50% stated theywere unaware of upgrades and changes. There was a training gap. Needed classes on basic training.Key Points:1) For communication they rolled out a dashboard with communication of upgrades, updated monthly, justfor physicians with links to training documents2) Assessment tool with links to videos where they can do additional training, average of 1 min long3) Updated navigators by removing unused sections and activitiesSession 109PLANTING SEEDS- ANALYTICS FOR EVERYONE―Jody GasparHow analytics team supports the skill development and engagement of clinicians in decision making.Key Points: 149 | P a g e

1) Create a team to prioritize reports REPORTING2) Create a reports library with criteria for each and who should use3) 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 reports)2) Create reports with definitions and the users of the reports3) Use dashboards to consistently report and distribute timelySession 159DIGGING THE WELL-NESS AND OTHER POPULATION REGISTRIES―Eric Cheng, MD, MS, FAANThis session explained the need to create registries. It summarized the registries available in Epic and theones they had to create. Some tips: RWB used to define My patients. Weekly run will add and deletepatients. Outreach of care gaps done centrallyKey Points:1) We should build registries immediately. There is no need to wait2) Naming convention of groups is critically important; this is the most important lesson given by the speakers3) Need to give physicians ability to remove patientsSession 168DATA GOVERNANCE FOR ASAP WEBI UNIVERSE DEVELOPMENT―Frank Day, MDLearn about an ASAP WebI Universe that allows users to query information on their own with little reliancefrom IT. Presenters from Mount Sanai discuss how metrics were determined and documented to clearlyindicate which actions trigger metrics, and demo reports created to track trends and convert the data flowinto a Universe, once the metrics were considered “stable.”Key Points:1) A governance committee standardized metric definitions and change management2) Created universe from clarity, accessible by end users via webi and business objects info view (can wrapwebi reports in radar 2014)3) End user errors do occur, but they can compare with daily summary reports and call reporting team forsupportSession 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 focus 150 | P a g e