Background: Dr. Stephanie Bui used Epic at the University of Pennsylvania Health System prior to joining UCLA in October 2010.
When you previously used Epic, what did you like best about the system? What I like best is the coordination of care with all the other physicians in the system. It is much easier to get to everything. Not having the office staff spend so much time looking for charts is amazing.
With Epic, it's really nice to have everything in one place. The big thing is not having this mess of charts. Three people (a referral coordinator, a doctor and a nurse) could be viewing a chart at the same time.
Do you feel you were ready to use the system when it went live? I'm fairly computer savvy, so it wasn't totally foreign. There was a lot of hands-on training before Epic was implemented at my practice.
If you were to do your Epic training again, would you do anything differently? The training sessions the doctors had in the classroom, could have been done more systematically. We would get very easily side-tracked in the session, and spend all of our time talking about one very specific aspect of the program, and then not have time to finish the training. I think shorter sessions that meet more frequently would be helpful. I prefer the hands-on training.
In terms of the logistics around the processes, has the system saved you time? Absolutely.
How did you allocate your time when you first started using the system? At the beginning, it definitely takes much more time to see each patient because you have to make sure you're doing everything correctly. But by the end of my time there [at Penn], I was definitely saving time.
During the first two to three weeks of go-live, our patient appointments were reduced by half. This allowed me the time I needed to adapt to having patient encounters while using the system. By three weeks, I was seeing more patients while using the EHR system. Our group actually ramped up a little more quickly because our staff was really good at learning the system.
What was the most helpful part of the transition to Epic? Having those two weeks with support staff around and having the reduced patient schedule helped to reduce the angst among the physicians and staff.
How was it for you coming to UCLA without Epic? It was hard. You realize how hard it is to read other doctors' handwriting. How frustrating it is when you can't find a chart-not having everything right at your fingertips. Now, this is different here because there's a lot on C-view. So I can still pull up labs and consults. At least it's something, but it was definitely harder going back to paper charts.
What did you find were the most helpful features of Epic? For things like billing, you can make the templates in Epic so that you cover what you need to cover for billing. If you're coding something in Level 4 for billing, something will pop up to say, 'This isn't a Level 4'- so you know you need to document something else, support it as a Level 4 visit. It was also helpful having the medication lists come up; so if I forget the dose of medication when I'm talking to the patient, it'll just [automatically] pop up for me.
What advice would you give your colleagues here at UCLA? That everything's going to be OK. It's going to take a little while to get comfortable with it. I was only using it [the Epic system] for three months, and I was very comfortable with it when I left. So it doesn't take that long. Once you start using it, you realize how much better it is than before-both for us and for patient care.