1. Click To Edit Master Title Style ENTERPRISE EPIC SPECIALTY IMPLEMENTATION (EESI) 1 UW Medicine EESI Overview Enterprise EpicCare Specialty Implementation (EESI) Shared EHR across all ambulatory clinics HMC, NWH, UWMC BY THE NUMBERS 85+ CLINICS 30+ SPECIALTIES 1000 PROVIDERS 2000 STAFF WHY: Opportunity to standardize & improve individual patient care & population health Ability to collect & report on discrete data for quality management & research Ability to achieve regulatory compliance (MU, ICD-10, PQRS, etc) WHEN: EESI Go Live is May 20, 2014 (167 days and counting…)

2. BENEFITS 2 Facilitates meeting organizational Meaningful Use and other regulatory requirements. Enables cross site communication – Within UW Medicine Ambulatory Clinics – With external users of EpicCare (eg. Swedish, Valley, Group Health) No more paper fee sheets. Billing will be electronic! No more paper requisitions. Prescriptions are electronically sent to the patient’s pharmacy of choice. Facilitates patient’s access to their medical information via eCare (patient portal). Improves communication within the clinic care team and with referring practitioners.

3. Click To Edit Master Title Style ENTERPRISE EPIC SPECIALTY IMPLEMENTATION (EESI) 3 UW Medicine EESI Program Timeline GO-LIVE MAY 20 2014 TESTING & TRAINING FEB - MAY 2014 BUILD SEPT-JAN 2013-2014 ALIGNMENT JULY-AUG 2013 DISCOVERY MAY-JUNE 2013 WE ARE HERE FINALIZED SPECIALTY BUILD DESIGN Completed collaborative meetings, sign off COMPLETED DISCOVERY & ENGAGEMENT Collected data required for implementation FUTURE STATE APPLICATION DESIGN Reviewed with clinic managers SPECIALTY BUILD CONTINUES Cycle Two completed, testing in progress

4. Click To Edit Master Title Style ENTERPRISE EPIC SPECIALTY IMPLEMENTATION (EESI) 4 UW Medicine Specialty Build Collaborative specialty groups with representation from HMC, NWH, UWMC Specialty Navigator Build Common Chief Complaints Medical History Surgical History Family History Patient at a Glance (Epic Term: SnapShot) Data Collection Over Time (Epic Term: Documentation Flowsheets) Long Term Disease Management (Epic Term: Synopsis) Preference lists Note templates (Epic Term: Smart Texts) Order sets (Epic Term: Smart Sets)

5. PRIMARY PALETTE CMYK 10/30/100/45 PMS 1265 RGB 142/111/12 CMYK 44/ 46//78/19 PMS 871 (metallic) RGB 132/114/72 CMYK 0/0/24/6 RGB 242/236/194 CMYK 0/0/8 PMS 7499 at 50% tint RGB 249/247/231 SECONDARY PALETTE CMYK 100/100/0/15 PMS 273 RGB 56/25/122 CMYK 30/12/66/36 PMS 5767 RGB 125/120/49 CMYK 2/22/100/15 PMS 141 RGB 242/206/104 CMYK 41/11/2/6 PMS 644 RGB 178/191/20 CMYK 0/33/67/0 PMS 1495 RGB 255/153/63 CMYK 15/100/100/0 PMS 711 RGB 210/35/42 CMYK 0/0/0/65 RGB 119/120/123 Black White ACCENTS PMS: 117 RGB: 199/153/0 CMYK 100/100/0/15 PMS 273 RGB 59/24/90 UW Click To Edit Master Title Style EESI Project Update 5 UW Medicine What You Need to Know Now Training: Provider registration and scheduling now open Remaining user registration/ scheduling starts mid- Nov Ops Planning: Schedule reductions (5/20 – 6/6) Vacations by exception (5/14 – 6/6) Device Placement: Walkthroughs complete by 11/1 Device plan sign-off by 12/6 Transcription & Dictation: Two parallel projects Dragon approval for site licenses

6. PRIMARY PALETTE CMYK 10/30/100/45 PMS 1265 RGB 142/111/12 CMYK 44/ 46//78/19 PMS 871 (metallic) RGB 132/114/72 CMYK 0/0/24/6 RGB 242/236/194 CMYK 0/0/8 PMS 7499 at 50% tint RGB 249/247/231 SECONDARY PALETTE CMYK 100/100/0/15 PMS 273 RGB 56/25/122 CMYK 30/12/66/36 PMS 5767 RGB 125/120/49 CMYK 2/22/100/15 PMS 141 RGB 242/206/104 CMYK 41/11/2/6 PMS 644 RGB 178/191/20 CMYK 0/33/67/0 PMS 1495 RGB 255/153/63 CMYK 15/100/100/0 PMS 711 RGB 210/35/42 CMYK 0/0/0/65 RGB 119/120/123 Black White ACCENTS PMS: 117 RGB: 199/153/0 CMYK 100/100/0/15 PMS 273 RGB 59/24/90 UW Click To Edit Master Title Style EESI Project Update 6 UW Medicine Planning for Go-live Schedule Changes Managers & Medical Directors ensure appropriate schedule Discourage time away from clinic during 3 weeks post go-Live Strongly consider holding slots for urgent/semi-urgent patients Sensitivity to learning needs: Return to full productivity according to practitioner’s ability Quick learners can add additional visits as requested; No increases in first week Current EpicCare users (those who cross clinics) may not need schedule reductions; Consider impact on staff Encourage providers to schedule more clinics with fewer patients during go-live weeks if possible to increase access and increase provider learning when support available

7. PRIMARY PALETTE CMYK 10/30/100/45 PMS 1265 RGB 142/111/12 CMYK 44/ 46//78/19 PMS 871 (metallic) RGB 132/114/72 CMYK 0/0/24/6 RGB 242/236/194 CMYK 0/0/8 PMS 7499 at 50% tint RGB 249/247/231 SECONDARY PALETTE CMYK 100/100/0/15 PMS 273 RGB 56/25/122 CMYK 30/12/66/36 PMS 5767 RGB 125/120/49 CMYK 2/22/100/15 PMS 141 RGB 242/206/104 CMYK 41/11/2/6 PMS 644 RGB 178/191/20 CMYK 0/33/67/0 PMS 1495 RGB 255/153/63 CMYK 15/100/100/0 PMS 711 RGB 210/35/42 CMYK 0/0/0/65 RGB 119/120/123 Black White ACCENTS PMS: 117 RGB: 199/153/0 CMYK 100/100/0/15 PMS 273 RGB 59/24/90 UW Click To Edit Master Title Style EESI Project Update 7 UW Medicine Week 1 50% reduction in volume (no more than 4 patients per charting provider each half-day session) Week 2 40% reduction in volume (no more than 6 patients per each half-day session) Week 3 30% reduction in volume (no more than 7 patients in each half day session) Week 420% reduction in volume Week 510% reduction in volume Week 60% reduction in volume Schedule Reduction Guidelines Block schedules now for go-live!

8. Click To Edit Master Title Style ENTERPRISE EPIC SPECIALTY IMPLEMENTATION (EESI) 8 UW Medicine What can you do to make this EESIer ? Preparation Clean up your problem lists (ICD-9 or SNOMED code based) and medication lists in Orca If you are computer-challenged (typing or navigation skills), problem solve with your clinic manager or clinic chief ahead of time Work with your clinic leadership to adopt compliant clinic workflows ahead of implementation Training Sign up for training Complete the e-learnings before you go to class Implementation Down-schedule your clinics during go-live Schedule as many extra clinic sessions as you can while there is at-the-elbow support available Acknowledge that this will be hard work and the first few months will be stressful

9. Click To Edit Master Title Style ENTERPRISE EPIC SPECIALTY IMPLEMENTATION 9 UW Medicine PositionRXORDERS MA, Eye Technician Can pend medication orders -existing medication refill -active but expired refill CANNOT -sign medication refills - set up to pend discontinued meds - set up to pend new RX requests Can pend labs, imaging, referrals Can order, sign and perform POCT tests if there is a written protocol (requires cosign) CANNOT sign any other orders ?? Eye tech can administer diagnostic eye drops with protocol RNCan pend medication orders -existing medication refill -active but expired refill Can order and sign RX (not controlled substances) with verbal orders under urgent conditions – needs cosign (within 48 hours) CANNOT -sign routine medication refills - set up to pend discontinued meds - set up to pend new RX requests Can pend labs, imaging, referrals Can order, sign and perform POCT tests if there is a written protocol (requires cosign) Can order and sign for labs, Imaging, EKG with verbal orders under urgent conditions – needs cosign (within 48 hours?) Can administer flu/pneumo vaccine without individual physician order *POCT – chemstick, UA dip, urine pregnancy, EKG (probably not POCT?), rapid strep, urine drug screen, others????? (policy on other protocol orders is pending) Draft Compliance Discussion: Orders

10. Click To Edit Master Title Style ENTERPRISE EPIC SPECIALTY IMPLEMENTATION (EESI) 10 UW Medicine And finally…