Implementation of Epic Beaker Clinical Pathology at an academic medical center

Abstract

Background:Epic Beaker Clinical Pathology (CP) is a relatively new laboratory information system (LIS) operating within the Epic suite of software applications. To date, there have not been any publications describing implementation of Beaker CP. In this report, we describe our experience in implementing Beaker CP version 2012 at a state academic medical center with a go-live of August 2014 and a subsequent upgrade to Beaker version 2014 in May 2015. The implementation of Beaker CP was concurrent with implementations of Epic modules for revenue cycle, patient scheduling, and patient registration.Methods:Our analysis covers approximately 3 years of time (2 years preimplementation of Beaker CP and roughly 1 year after) using data summarized from pre- and post-implementation meetings, debriefings, and the closure document for the project.Results:We summarize positive aspects of, and key factors leading to, a successful implementation of Beaker CP. The early inclusion of subject matter experts in the design and validation of Beaker workflows was very helpful. Since Beaker CP does not directly interface with laboratory instrumentation, the clinical laboratories spent extensive preimplementation effort establishing middleware interfaces. Immediate challenges postimplementation included bar code scanning and nursing adaptation to Beaker CP specimen collection. The most substantial changes in laboratory workflow occurred with microbiology orders. This posed a considerable challenge with microbiology orders from the operating rooms and required intensive interventions in the weeks following go-live. In postimplementation surveys, pathology staff, informatics staff, and end-users expressed satisfaction with the new LIS.Conclusions:Beaker CP can serve as an effective LIS for an academic medical center. Careful planning and preparation aid the transition to this LIS.

Frequency and causes of lipemia interference of clinical chemistry laboratory tests

“…The analyzers take an aliquot of the patient specimen and dilute in 0.9% sodium chloride saline to measure the absorbances for lipemia at 660 nm (primary wavelength) and 700 nm (secondary wavelength), for hemolysis at 570 nm (primary wavelength) and 600 nm (secondary wavelength), and for icterus at 480 nm (primary wavelength) and 505 nm (secondary wavelength). Interfacing throughout the laboratory is provided by Middleware software (Instrument Manager) from Data Innovations (Burlington, VA) [20] , [23] . Lipemia and hemolysis indices were extracted from Instrument Manager data in the time period of January 15, 2015 to May 31, 2016 using specimen accession numbers, allowing for linkage to patient data and the laboratory testing ordered on the accession number.…”

Operational impact of using a vanadate oxidase method for direct bilirubin measurements at an academic medical center clinical laboratory

“…The main automated clinical chemistry instrumentation in the UIHC core clinical laboratory is from Roche Diagnostics (Indianapolis, IN, USA) and consists of a cobas 8000 system with two c702, three c502, and five e602 analyzers. All serum/plasma assays run on the Roche analyzers have HI, icterus index, and lipemia index determined by spectrophotometry (SI2 Serum Index Gen.2, currently version 0586707002V2) which are used in autoverification rules for all chemistry tests [32] , [33] . The analyzers take an aliquot of the patient specimen and dilute in 0.9% sodium chloride solution to measure the absorbances for lipemia at 660 nm (primary wavelength) and 700 nm (secondary wavelength), for hemolysis at 570 nm (primary wavelength) and 600 nm (secondary wavelength), and for icterus at 480 nm (primary wavelength) and 505 nm (secondary wavelength).…”

“…Interfacing throughout the laboratory is provided by Middleware software (Instrument Manager) from Data Innovations (Burlington, VA) [32] , [33] . HI and lipemia index were extracted from Instrument Manager data in the time period of January 1, 2013 to July 31, 2016 using specimen accession numbers, allowing for linkage to patient data and the laboratory testing ordered on the accession number.…”

Preferred Names, Preferred Pronouns, and Gender Identity in the Electronic Medical Record and Laboratory Information System: Is Pathology Ready?

“…[ 22 ] The EMR throughout the UIHC health-care system has been Epic (EpicCare Inpatient and EpicCare Ambulatory, Madison, WI, USA) since 2009. The LIS for all clinical laboratories is Epic Beaker, with Beaker Clinical Pathology (CP) implemented in 2014[ 23 ] and Beaker Anatomic Pathology in 2015. Middleware software (Instrument Manager, Data Innovations, Burlington, VT, USA) is used throughout the clinical laboratories for interfacing of laboratory instruments to the LIS.…”