2019 Epic Upgrade & Alignment

1. 2019 Epic Upgrade & Alignment Cardiovascular/Cupid Presentation to inform the CV Workgroup members on the upcoming Epic changes that will impact caregivers. Lisa Hudson MSN, RN Sr. Clinical Informatics Architect

2. Disclaimer: Please note that based on feedback from Validation and User Acceptance testing changes to the build were possible after the development of this presentation.Therefore screen shots available in the presentation may not represent the final build delivered.

3. Epic Learning Home Dashboard Available March 18th • Learning Material Inside of Epic

4. Case Request • Case Request has a new look & feel- sections are streamlined to make it easier to locate specific case entry details.

5. Get to the Link Orders Activity from the Appointments Without Orders Report • In the Link Requests or Link Orders activity, select the Show all available requests or Show all available orders check box to manually link requests or orders to multiple visits in a panel or other sequentially linked appointments. • Epic has replaced the Verify Orders button in the Appointments Without Orders report with the Link Appt to Orders button so that HOV appointments can be linked to orders. Now, users can link appointments to orders for HOV, inpatient and outpatient visits.

6. NCDR Ischemia EvaluationNational Cardiovascular Data Registry Physicians who read Echo and or Nuclear Medicine stress studies will see a new SmartForm section in Study Review. • For Nuc Med exams, this section will be found on the Summary conclusions tab. • The physician responsible for reading the perfusion images will enter this information. • For Echo, it will found on the Peak Findings tab. • An evaluation of positive (ischemic), will require that you assign a risk level. • The documentation completed in this section will generate discrete data that will make reporting and compliance more efficient.

7. Quickly Schedule a Stemi Case • Get a patient quickly scheduled by using the Stemi button in the Epic toolbar. • Choosing Schedule from the Status Board opens the SnapBoard directly to drop the case on the schedule

8. New Dashboards for Invasive and Non-Invasive Departments • Updated metrics for procedure volume and recurrence rates, door-to-balloon time, complications, study findings, and more in a single invasive dashboard. • Non-Invasive Lab Quality Reporting Home dashboard. Monitor, report on, and track exam turnaround times, specific findings, study correlations, and more.

9. Updated Door-to-Balloon Times for the Cath Lab • The CV Cath/EP Invasive Lab Manager dashboard allows access to detailed reports for the PCI metrics. • Specific information for interventional emergency cardiology cases. 1. Click a PCI metric on the dashboard and select View PCI Details 2. Drill down populates

10. Vessel Drawing tab &Vessel Card tab (2 slides) • Document findings on the vessel drawing • Utilize vessel templates • Add diagram to final report • List vessel findings & interventions

11. Draw & Edit Stents • Add or edit stents through the Intervention View • Add Smartform Documentation right from the PCI

12. Documentation of Wall Motion & Perfusion • Echo readers: the Wall Scoring tab contains color-coded diagrams to document the left ventricular wall motion assessment. Nuc Med readers: the Polar Plot tab contains color-coded diagrams to document perfusion. Both diagram types use similar functionality for documentation.

13. Scanned Supply and Implant Data Automatically Files to the Correct Tab • Scan supply and implant barcodes without having to switch to the Supplies or Implants tab first. When the barcode is scanned the information gets added to the correct spot, and you will see a banner telling you where the supply data was added. For some scans, the banner may request additional information to ensure the data is added to the correct spot.

14. Other High Impact Changes for Epic v.2018 Upgrade & Instance Alignment • Patients at Risk for Violence Flag • Sexual Orientation and Gender Identity (SOGI) Updates • Updates to the look of Ambulatory Navigators & Workspaces

15. Patient at Risk For Violence Flag • New FYI flag titled Risk for Violence • Documenting the flag generates an alert to caregivers that a patient has a risk for violence • Alert displays in Patient header, schedules, lists and reports • FYI placed by House Supervisor, Security, Department Manager

16. Sexual Orientation/Gender Identity (SOGI) Overview • SOGI Phase 3 focuses on improving the patient experience and on better supporting patient-centered care. You can already capture nuances in patients' sex and gender, that goes beyond their legal sex, in Epic today. • There are new updates throughout the system to use and show patient’s gender or sex assigned at birth instead of legal sex when appropriate. The Sex field in Demographics now displays areas to capture Gender identity, Sex assigned at birth, and Sexual orientation. • There are also updates throughout the system that make it easier for users to see a patient's preferred name, such as in Patient Lists, Headers, Chart Review , Reports or InBasket. This is especially important for transgender or non-binary patients, but also helps improve the patient experience for any patient with a preferred name that differs from their legal name. • SmartLinks have been updated to retrieve a patient's titles and pronouns based on the patient's gender identity. • MyChart Patients can now view and edit more on the new Personal Information page, including: preferred name legal sex, sexual orientation, gender identity, and sex assigned at birth. • Baby Names now display the mothers preferred name as part of the baby naming convention.

17. Cupid RN – History section in procedure navigator • Preferred name is highlighted in banner • Sex is highlighted in banner when there is incongruence between legal sex, sex at birth and gender identity fields • Report and Smartform can be accessed by clicking on Sex field in banner • Preferred name added to wristband for adults/peds

18. Transcribed Orders Encounter – Ambulatory Facelift • Orders are now placed at the bottom of the workspace for ambulatory encounters

19. LDA Avatar • Clinicians can now review, assess, add, and remove LDAs from an avatar • The visual representation of the body helps clinicians quickly see where a patient's LDAs are located, making it easier for them to select the LDA they want to review or document on • Procedure Navigators will keep current LDA documentation- *some areas have option of documenting via LDA Avatar