Tech & Health

October 26, 2017

EpicLeap launch signals start of bold new era

On Nov. 2, Vanderbilt University Medical Center (VUMC) will switch to a new computer system, called eStar, which will support the health system’s electronic health records, workflows for inpatient and outpatient care delivery, test ordering, billing and other hospital and clinic operations.

On Nov. 2, Vanderbilt University Medical Center (VUMC) will switch to a new computer system, called eStar, which will support the health system’s electronic health records, workflows for inpatient and outpatient care delivery, test ordering, billing and other hospital and clinic operations.

At the center of the EpicLeap galaxy is a system known as eStar, which comprises 25 different modules of Epic software. These modules underwent extensive customization to ensure they are fit for VUMC’s specific needs.

EpicLeap, the name given to the two-year project to switch to the new system, affects some 18,000 Medical Center employees who work in the health system, as well as VUMC’s patients who use the My Health at Vanderbilt web portal to communicate with clinicians regarding their care.

Benefits of eStar include:

• Compared to the group of applications being replaced, eStar is light years ahead from a systems integration standpoint. Leaders say greater systems integration and ease of use promises better coordination of care across different care settings, and greater efficiency for clinical teams.

• Fees for hospital and professional services will be consolidated as one bill instead of two, simplifying payments for patients.

• Patients will be able to go online to schedule clinic appointments, complete clinic intake forms and submit updates to their medical records.

• The eStar health record is fully interoperable with health records used by hundreds of other hospitals, such that, as patients engage with Vanderbilt, access to their medical records held by these outside providers will be automatic and seamless.

• An eStar mobile app will provide new convenience and flexibility for clinicians.

• As part of the eStar implementation, hospital and clinic teams have increased standardization of workflows and clinical documentation, improving the overall efficiency of care delivery, as well as simplifying communications with patients.

The eStar system is powered by software from Epic Systems Corp., based in Verona, Wisconsin.

Vanderbilt sought new software because vendor support for certain clinical applications used at VUMC will be discontinued next March. It is also an opportunity to think boldly about the future of health information technology at Vanderbilt.

“Once eStar is up and running, we’ll have more efficient ways to monitor outcomes, to use critical alerts and to track down and communicate with appropriate clinicians to manage problems. I’m very excited about the opportunities this gives us,” said Paul Sternberg Jr., M.D., Chief Patient Experience and Service Officer.

According to Marilyn Dubree, MSN, RN, Executive Chief Nursing Officer, the software switch is paying dividends already.

“The process of preparing for our eStar go live has created amazing teamwork and collaboration on the part of the Medical Center.

“The interdisciplinary problem solving around setting standards and putting into place new workflows — all of that has been really collaborative. That’s an investment that we made to be ready for go live, but it’s an investment that we will reap benefits from going forward,” Dubree said.

Much of the health information technology used at Vanderbilt was developed here over the past 25 years.

According to Kevin Johnson, M.D., M.S., Senior Vice President for Health Information Technology, eStar will undergo continuous improvement once it’s up and running. If anything, the transition to eStar stands to strengthen Vanderbilt’s leadership in health IT.

“We’ve long had an innovation agenda that was catalyzed by having access to and ownership of the clinical data and an information model that connected the data to the workflow, and we’ll be preserving that level of access to data and workflow.

“All the data from our new electronic health record will be available to us outside the vendor product.

“We’ve been pioneers forever,” Johnson said. “I see this transition as an opportunity for us to start to mature as an organization around the technology that underpins all our work, while being pioneers, ideally working with Epic, addressing present and future challenges in health care.”

According to Neal Patel, M.D., Chief Health Information Officer, the benefits of EpicLeap “will come from leveraging eStar to improve our ability to communicate amongst ourselves and with our patients utilizing an integrated system.

“The new system will allow patients to transition between specialty groups a lot more smoothly, and provides tools to engage the patient at an even higher level. We may not achieve all this at go live, but establishing this platform will allow us to springboard to the next level that Vanderbilt aspires to be.”

To help smooth the transition, careful consideration has been given to staffing and technical support during the implementation period when newly acquired eStar skills are in use in the clinical setting for the first time.

“If we need to pay more attention to the computer during this transition, we’ll really have to remember that there’s a patient in the room, that they’re going to be watching us, that we need to be sensitive to their needs and their experience as we grow in our comfort with the new system,” Sternberg said.

For the first several weeks, there will be hundreds of eStar experts on hand (wearing gold vests) expressly to provide one-on-one support for users.

For the initial three weeks, the ratio of “at the elbow” support personnel to clinicians will be one-to-four, for other clinical users one-to-six, and for back end office users one-to-eight. (There will be a total 1,386 “at the elbow” support personnel working during the day, and another 242 working at night.)

Meanwhile, during the day some 68 zone leaders (wearing red vests) will focus exclusively on go live, with another 25 working at night.

A command center, called the EpiCenter, will operate around the clock from the second floor of Vanderbilt University Adult Hospital, while a technical command center operates from an office building at 3401 West End Ave.

For more information visit the EpicLeap website (employee login required).