Implementation of Epic Beaker Clinical Pathology at Stanford University Medical Center

Tan, Brent; Fralick, Jennifer; Flores, William V.; Schrandt, Cary; Davis, Vicki G.; Bruynell, Tom; Wilson, Lisa; Christopher, John; Weber, Shirley N.; Shah, Neil

doi:10.1093/ajcp/aqw221

Cited by 4 publications

(6 citation statements)

References 8 publications

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“…38 Potentially inappropriate prescribing 15 , 16 , 28 and testing turnaround time showed improvements. 31 , 46 These findings illustrate some of the potential benefits of upgrading an EHR system, and may help practitioners understand the possible positive outcomes of a typically disruptive process. Outcomes that appeared at least temporarily worse—including prescribing errors, 15 , 16 drug-drug interaction alerts, 23 emergency-department waits, 44 job satisfaction, 18 , 19 and time spent in the EHR 7 , 10 , 30 , 34 —may require special attention as institutions undergo EHR transition.…”

Section: Discussionmentioning

confidence: 87%

“…Fifteen publications addressed a clinical care outcome. 7,10,[14][15][16][23][24][25]28,30,31,34,38,44,46 These include time series designs with quantitative data (n = 7), pre-post design with quantitative data (n = 5), and mixed-methods (n = 3). We identified three subcategories within clinical care outcomes: quality of care, patient safety, and workflow or productivity.…”

Section: Clinical Carementioning

confidence: 99%

“…Abramson, 2012 43 Qualitative, 1 post-deployment time Abramson, 2016 44 Qualitative, 1 post-deployment time Umstead, 2021 45 Qualitative, during transition Schreiber, 2020 46 Systematic review and case studies difference-in-difference Medicare studies. The Intermountain study did not find similar patterns across sites in the 10 patient safety measures they included.…”

Section: Patient Safetymentioning

confidence: 99%

“…23,28 Workflow/Productivity Seven studies measured aspects of workflow and productivity. 7,10,30,31,34,44,46 Four of these studies evaluated time spent on clinical encounters and in the EHR using pre-post study designs with one or two post-implementation time points; all four reported negative impacts on productivity immediately after transition. 7,10,30,34 These outcomes were consistent across the range of clinical settings included in the studies: glaucoma subspecialty practice, 7 emergency department, 30 preoperative assessment, 34 and urgent care.…”

Section: Patient Safetymentioning

confidence: 99%

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Transitioning from One Electronic Health Record to Another: A Systematic Review

Miake-Lye,

Cogan,

Mak

et al. 2023

J GEN INTERN MED

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Background Transitioning to a new electronic health record (EHR) presents different challenges than transitions from paper to electronic records. We synthesized the body of peer-reviewed literature on EHR-to-EHR transitions to evaluate the generalizability of published work and identify knowledge gaps where more evidence is needed. Methods We conducted a broad search in PubMed through July 2022 and collected all publications from two prior reviews. Peer-reviewed publications reporting on data from an EHR-to-EHR transition were included. We extracted data on study design, setting, sample size, EHR systems involved, dates of transition and data collection, outcomes reported, and key findings. Results The 40 included publications were grouped into thematic categories for narrative synthesis: clinical care outcomes (n = 15), provider perspectives (n = 11), data migration (n = 8), patient experience (n = 4), and other topics (n = 5). Many studies described single sites that are early adopters of technology with robust research resources, switching from a homegrown system to a commercial system, and emphasized the dynamic effect of transitioning on important clinical care and other outcomes over time. Discussion The published literature represents a heterogeneous mix of study designs and outcome measures, and while some of the stronger studies in this review used longitudinal approaches to compare outcomes across more sites, the current literature is primarily descriptive and is not designed to offer recommendations that can guide future EHR transitions. Transitioning from one EHR to another constitutes a major organizational change that requires nearly every person in the organization to change how they do their work. Future research should include human factors as well as diverse methodological approaches such as mixed methods and implementation science.

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Section: Discussionmentioning

confidence: 87%

Section: Clinical Carementioning

confidence: 99%

Section: Patient Safetymentioning

confidence: 99%

Section: Patient Safetymentioning

confidence: 99%

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Transitioning from One Electronic Health Record to Another: A Systematic Review

Miake-Lye,

Cogan,

Mak

et al. 2023

J GEN INTERN MED

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“…We have described our implementation of the Beaker CP module at the University of Iowa Hospitals and Clinics and more recently another group has also described their implementation of Beaker CP at an academic medical center. [ 2 3 ] In this document, we describe the implementation of the Beaker AP module at the University of Iowa.…”

Section: Introductionmentioning

confidence: 99%

Implementation of Epic Beaker Anatomic Pathology at an Academic Medical Center

Blau

Wilford

Dane

et al. 2017

Journal of Pathology Informatics

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Background:Beaker is a relatively new laboratory information system (LIS) offered by Epic Systems Corporation as part of its suite of health-care software and bundled with its electronic medical record, EpicCare. It is divided into two modules, Beaker anatomic pathology (Beaker AP) and Beaker Clinical Pathology. In this report, we describe our experience implementing Beaker AP version 2014 at an academic medical center with a go-live date of October 2015.Methods:This report covers preimplementation preparations and challenges beginning in September 2014, issues discovered soon after go-live in October 2015, and some post go-live optimizations using data from meetings, debriefings, and the project closure document.Results:We share specific issues that we encountered during implementation, including difficulties with the proposed frozen section workflow, developing a shared specimen source dictionary, and implementation of the standard Beaker workflow in large institution with trainees. We share specific strategies that we used to overcome these issues for a successful Beaker AP implementation. Several areas of the laboratory-required adaptation of the default Beaker build parameters to meet the needs of the workflow in a busy academic medical center. In a few areas, our laboratory was unable to use the Beaker functionality to support our workflow, and we have continued to use paper or have altered our workflow. In spite of several difficulties that required creative solutions before go-live, the implementation has been successful based on satisfaction surveys completed by pathologists and others who use the software. However, optimization of Beaker workflows has continued to be an ongoing process after go-live to the present time.Conclusions:The Beaker AP LIS can be successfully implemented at an academic medical center but requires significant forethought, creative adaptation, and continued shared management of the ongoing product by institutional and departmental information technology staff as well as laboratory managers to meet the needs of the laboratory.

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