5 ms·

These systems are highly configurable because every hospital wants to do things their own way. There's a good chance many of your complaints are a result of con

by goda90 3y ago

These systems are highly configurable because every hospital wants to do things their own way. There's a good chance many of your complaints are a result of configuration that can be changed. Go to your IT staff with a list.

haldujai 3y ago
This. Every hospital I’ve worked at has used Epic and every one has a different “custom” version with different UI and user role configuration. Even within the same hospital the UI and default displays widely varies based on context and role selection when logging in. Nursing notes are definitely accessible in every version I’ve used and I also read them fairly frequently (often more useful than MD progress notes) so your hospital may be hiding non-provider notes from you. It would be strange though, are you sure you don’t have “show provider notes only” checked off (or that box hidden)?
- devilbunny 3y ago
  I've looked under the Notes tab, and under Chart Review -> Notes, and turned off all filters. Nope. I get nursing "plan of care" notes, but not their regular floor notes.
  - haldujai 3y ago
    Strange, I'm a radiologist and this happened to us at the very beginning of the Epic transition as well (they also dropped ER MD notes from our profile) but we gave that feedback and they changed it within a few weeks as we used the magic words of "impacting patient care". This limitation isn't an Epic default feature and must have been set by your institution or whoever created the anesthesia role for some inexplicable reason, there wasn't actually a justification or privacy concern for why this was set this way for radiologists at my institution and seemingly was set by someone in IT thinking it was extraneous to us.
    - devilbunny 3y ago
      That's the vibe I get. "You don't need to change it"... yes, we do. Dunno, at this point I'd settle for being able to establish custom filters for my status board. But I've learned that a lot of weirdnesses have to do with interfacing with other software.
sxg 3y ago
This is true, but these custom configurations have become so ossified into each hospital's workflow that there's minimal hope of reversing the mistake.
devilbunny 3y ago
I'm sure that it can be configured that way. But they won't give me the keys to set up custom filters. I've got contacts that realize that I'm not a moron, and I would never touch defaults in production, but I can't even get a playground where I can do EVERYTHING to figure out where the problems might be. And if a guy who has their own IT staff telling them it can't/won't happen, despite actual onsite EPIC staff saying it's entirely possible, you see why. When you tell users to go away, and tell interested users that they can't share their improvements, not even privately, you are doing a disservice and you owe me at the least an explanation of why doing it is bad. Maybe there's a good reason that I should be allowed to mess my own system up but not let anyone else enjoy it that way, but I struggle to understand why. The whole thing can be re-imaged if I screw up too badly, after all.
- haldujai 3y ago
  You're blocked from the Epic-PLY and developer sandbox environments? Are you talking about custom chart review filters? Also not sure why that's blocked, I use those a lot and we can copy them from other user profiles without going through IT. But yes to have this be a default for new users we still need IT approval which no one has bothered with. This sounds like draconian institutional policies are the limiting factor.
  - devilbunny 3y ago
    There's a playground, but I have no more power there than I do in my own production environment except that I can write an order like "all-unicorn diet" and nobody would see it. I don't know precisely what you mean by Epic-PLY and "developer sandbox"; I'm an end-user, not a developer. Other than knowing some of the IT team and being the local point of contact, I'm no different from any other anesthesiologist in terms of control. What I would like is a sandbox where I can do anything, figure out what's possible, and then report to the team the things I've found and ask if it would be possible to put them in production. Maybe yes, maybe no, but we live and die by the status board (if you ever get involved with EMR and anesthesia, a good status board is the most critical piece of infrastructure). And I can't even share mine with others. Draconian institutional policies are indeed an issue. WiFi calling is blocked, despite the fact that a significant part of our first floor has zero cell signal. If you get bored, PM me and we'll set up a time where I can show you some samples. I'll need a few days to sanitize them of identifiable info.

by goda90 3y ago

haldujai 3y ago

This. Every hospital I’ve worked at has used Epic and every one has a different “custom” version with different UI and user role configuration. Even within the same hospital the UI and default displays widely varies based on context and role selection when logging in. Nursing notes are definitely accessible in every version I’ve used and I also read them fairly frequently (often more useful than MD progress notes) so your hospital may be hiding non-provider notes from you. It would be strange though, are you sure you don’t have “show provider notes only” checked off (or that box hidden)?

devilbunny 3y ago
I've looked under the Notes tab, and under Chart Review -> Notes, and turned off all filters. Nope. I get nursing "plan of care" notes, but not their regular floor notes.
- haldujai 3y ago
  Strange, I'm a radiologist and this happened to us at the very beginning of the Epic transition as well (they also dropped ER MD notes from our profile) but we gave that feedback and they changed it within a few weeks as we used the magic words of "impacting patient care". This limitation isn't an Epic default feature and must have been set by your institution or whoever created the anesthesia role for some inexplicable reason, there wasn't actually a justification or privacy concern for why this was set this way for radiologists at my institution and seemingly was set by someone in IT thinking it was extraneous to us.
  - devilbunny 3y ago
    That's the vibe I get. "You don't need to change it"... yes, we do. Dunno, at this point I'd settle for being able to establish custom filters for my status board. But I've learned that a lot of weirdnesses have to do with interfacing with other software.

sxg 3y ago

This is true, but these custom configurations have become so ossified into each hospital's workflow that there's minimal hope of reversing the mistake.

devilbunny 3y ago

I'm sure that it can be configured that way. But they won't give me the keys to set up custom filters. I've got contacts that realize that I'm not a moron, and I would never touch defaults in production, but I can't even get a playground where I can do EVERYTHING to figure out where the problems might be. And if a guy who has their own IT staff telling them it can't/won't happen, despite actual onsite EPIC staff saying it's entirely possible, you see why. When you tell users to go away, and tell interested users that they can't share their improvements, not even privately, you are doing a disservice and you owe me at the least an explanation of why doing it is bad. Maybe there's a good reason that I should be allowed to mess my own system up but not let anyone else enjoy it that way, but I struggle to understand why. The whole thing can be re-imaged if I screw up too badly, after all.

haldujai 3y ago
You're blocked from the Epic-PLY and developer sandbox environments? Are you talking about custom chart review filters? Also not sure why that's blocked, I use those a lot and we can copy them from other user profiles without going through IT. But yes to have this be a default for new users we still need IT approval which no one has bothered with. This sounds like draconian institutional policies are the limiting factor.
- devilbunny 3y ago
  There's a playground, but I have no more power there than I do in my own production environment except that I can write an order like "all-unicorn diet" and nobody would see it. I don't know precisely what you mean by Epic-PLY and "developer sandbox"; I'm an end-user, not a developer. Other than knowing some of the IT team and being the local point of contact, I'm no different from any other anesthesiologist in terms of control. What I would like is a sandbox where I can do anything, figure out what's possible, and then report to the team the things I've found and ask if it would be possible to put them in production. Maybe yes, maybe no, but we live and die by the status board (if you ever get involved with EMR and anesthesia, a good status board is the most critical piece of infrastructure). And I can't even share mine with others. Draconian institutional policies are indeed an issue. WiFi calling is blocked, despite the fact that a significant part of our first floor has zero cell signal. If you get bored, PM me and we'll set up a time where I can show you some samples. I'll need a few days to sanitize them of identifiable info.