CCI Town Hall Carrie Hall April 2, PM Center for Clinical Investigation Town Hall for Epic

Presentation Overview Explain Partners eCare and Epic Go-Live on May 30 th ! Epic workflows CCI workflow Non-CCI workflow Epic workflow from beginning to end Associating patients Scheduling Ordering Research Billing Review Timeline of events Resources available prior to, during and post-Go-Live

Partners eCare and Epic Partners eCare refers to the initiative to implement a shared electronic health record (EHR) system at all Partners HealthCare centers by 2017 This includes academic medical centers, hospitals, physician offices, rehabilitation centers and home health providers Epic software and, once fully-functional, will support more than 60,000 clinical and administrative professionals. Partners eCare builds upon the industry-leading software to complete its initiative: “one patient, one record, one team, one Partners statement” Epic Go-Live May 30, 2015

How will Epic Research work with CCI? Epic will route research charges; there are two Epic research workflows 1. Non-CCI Epic Work flow: If you are conducting research that uses BWH patient care resources 2. CCI Epic Workflow: If you are conducting research that uses Center for Clinical Investigation (CCI) resources

Which workflow should I use? The workflow is determined by who provides the resources for your study NOTE: CCI resources provided via the Harvard Catalyst CRC program are included in CCI workflow

Associating Subjects and setting “Status” in Study 1. When a subject is associated to the study they must be assigned a “status” 2. Subject status must set to “Enrolled” for billable items to be ordered in Epic.  “Enrolled” in Epic means the subject will have patient care charges associated with the study Visits with only non-billable services (e.g., room only) can assign other statuses to a subject NOTE:  Subject status MUST be set to “Enrolled” for Epic to properly route billable charges NOTE:  Subject status MUST be set to “Enrolled” for Epic to properly route billable charges

CCI Workflow Step 2: Schedule via Harvard Catalyst Scheduling Harvard Catalyst scheduling system and process remains unchanged and will continue to be CCI scheduling system. CCI staff will duplicate Harvard Catalyst schedule and create “HOVs” (Hospital Outpatient Visits) in Epic which will properly route charges.

CCI Workflow Step 3: Ordering through Epic  Orders that must be placed into Epic: 1. Medications (including investigational) 2. Procedures 3. Radiology tests 4. Labs being resulted at BWH Clinical Labs  There are two entry methods to enter orders in Epic 1. Enter orders into an already created encounter. 2. Enter orders by creating an ‘orders only’ encounter.  For CCI orders you ONLY enter as ‘orders only’ encounter.  For non-CCI orders you can use either entry methods. Note: Study coordinators can place all OUTPATIENT orders. All INPATIENT MEDICATIONS which must be entered by the ordering provider (PI/MD).

CCI Workflow Step 4a: Charge Flow at CCI 1. When study staff associates subjects to the study, billable charges will automatically route to the CCI Billing Review 2. CCI Admin Staff will review CCI Billing and route CCI charges to the CCI billing code and route study charges back to the study team’s Billing Review

CCI Workflow Step 4b: Research Billing Review In the Research Billing Review the PI or financial delegate will see charges not paid for by CCI and verify they are in the correct billing ‘Bucket’ PIs/financial delegates may change the ‘Bucket’ Once charges are in the correct ‘Bucket’ the PI/financial delegate selects ‘Mark Account as Reviewed’ approving the charges Billing charges are routed for review after services are provided; this is the verification to ensure correct billing 1 3 2

Epic documentation Document in EpicDocument Outside of Epic Routine Clinical Care documentation: As required for hospital inpatient, outpatient or infusion visit. Medication administration via EMAR This will include Facility Administered Medications (FAMs) which are medications administered in an outpatient visit. FAM documentation is new to all clinical trials, not only CCI clinical trials. Study-related documentation: Study related charting Study related nutrition instructions study related flow sheets Study documentation will later be able to be scanned into Epic.

Take Homes 1. CCI will still require paper orders – this CCI ordering process will continue unchanged. 2. F numbers will no longer be used and will be replaced with the Epic produced “Study Code” 3. HR is having a “Training Freeze” for new employees May 4 th to June 26 th. Research teams should have an interim plan in place. 4. If subject needs an MRN they must call registration themselves. Study staff will no longer be able to register subjects.

Where Are We Now? March 9-May 29: Application Training Begins Lafayette City Center April 2: CCI Town Hall for Epic Carrie Hall, 2-3PM April 15 and 21: Research Super User Meeting One Brigham Circle April 30: Clinical Trials Epic Info Session Shapiro Breakout Room, 9-11AM May 11-May 22: BWH Research Epic Lab Sessions BWH Main Campus (rotating locations) May 30: Epic Go-Live!

Epic Resources There are about 50 Super Users supporting staff during Go-Live Weekly Epic Office Hours: Tuesdays 2-3PM 221 Longwood Ave. ACC Conference Room (RF 372) No registration needed Epic Drop-In Hours: May 11-May 22: Rotating Locations Individualized info sessions for enrolling subjects and creating preference lists. You must register for a date/time via CCI Education Course ListCCI Education Course List Info link to Epic Research from CCI WebpageCCI Webpage Questions can be directed to Joey Sadlon at