EPIC

Looking at Us: Alka Sharma, Epic Architect

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Alka Sharma receives a PAWS Award from Dr. Scott Allen (left) and Dr. Andy Agwunobi (right) March 29, 2018, in Keller Auditorium. (Kristin Wallace/UConn Health photo)

The cheers were loud when Alka Sharma was presented with a PAWS Award this spring. It’s a testament to the numerous colleagues who understand and appreciate her contributions, particularly to the transition to our new electronic health record, UConn HealthONE. Alka is an application architect in the Information Technology Department who, among other things, was instrumental to the technical dress rehearsal, or TDR—the testing of the functionality of every work station that would use HealthONE to ensure device compatibility. She lives in Southington.

Describe the HealthONE journey and your role in it?

My HealthONE journey has been fun. It has included many highs, a few lows, and more than a couple unexpected twists and turns. I have learned many valuable lessons and insights about myself, my abilities, and most importantly, my true potential.

I have been fortunate enough to work under four different chief information officers. Each of them saw some kind of potential and assigned me challenging and high-profile projects. I remember talking to Bruce Metz, our current CIO, and asking to lead “Technical Dress Rehearsal” (TDR) alongside project manager Dean Moroniti.

Alka Sharma

Favorite movie:
“The Emperor’s Club” with Kevin Kline

Favorite holiday:
Thanksgiving—John and I cook for the entire family and they enjoy each and every dish!

Favorite place to visit:
California

Famous person you’d most like to meet:
Michelle Obama… and I’d really love to have lunch with Dr. Andy one day.

Something about you today that your younger self would never believe:
I would play a key role in an Epic implementation for a hospital.

Bruce brought a unique perspective to my personal and professional development and his wisdom pushed me to see things about my own leadership capabilities and aptitudes that I had never seen, fully appreciated or understood in myself before.

I report directly to AVP of Strategic Projects Rob Darby, who is clearly interested in helping me grow as an employee. I continue to emulate his energy, expertise, and vision for UConn. Rob has also provided me many opportunities to grow in my role. He empowers me to make decisions in my current role and is open to new ideas. However, my thirst for learning and passion for work makes Rob’s job a bit difficult.

What is your assessment of how we’re doing with HealthONE so far?

Our go-live (April 28) was very successful. Our open ticket rate was below 20 percent after five weeks. I think we are doing great. HealthONE’s success is largely a collaborative effort from all of the HealthONE analysts, who deserve recognition as well.

What was your reaction to being honored with a PAWS award this spring?

I was overwhelmed and humbled by the nomination from [application analyst] Cori Brown. It’s a great feeling to be recognized by your peers. It was a busy month as we were preparing for go-live, yet a lot of people showed up to support my nomination, which made it even more special.

How would you describe the changes you’ve seen at UConn Health since your arrival here?

All the changes that I have witnessed in IT have been very positive, specifically the decision to move to our integrated system, HealthONE. Some folks have left but new people joined, bringing fresh outlook to technology and research, and they have made transformative changes to enhance patient care.

Personally, I love change because it gives one an opportunity to learn, unlearn old things and relearn new things.

What do you like to do when you’re not at work?

I like to watch inspirational videos on YouTube and love ironing to de-stress.

HealthONE Planned Maintenance Sunday, July 15

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The reason for the maintenance:

Planned maintenance for the HealthONE system involves the following:

  • Special Updates (SUs) to our production and training environments by Epic datacenter staff.
  • Network switch upgrade by UConn IT. Switches allow different devices on a network to communicate.

The date and time of the maintenance:

  • HealthONE Maintenance, Sunday 7/15/2018, 1:00 a.m. through 5:00 a.m.

Services that will be down:

We are expecting services to be down during this maintenance window. HealthONE will be in read-only mode (SRO) from 1:00 to 5:00 a.m. on Sunday, July 15.

Users logged into the system will receive a message that a planned downtime is occurring within 15 minutes of the scheduled maintenance. The same message will reappear 5 mins prior to the start of the maintenance window. Users should save their work and logout of the environment.  If users do not log out before the start of the maintenance, they will risk losing any unsaved information.

After 1:00 a.m., your HealthONE desktop icon will provide SRO access. Follow your department’s published downtime procedures.

During this time, the UConn Network Team will reboot the network switches floor by floor, which may cause brief SRO interruption as well as interruptions to all network based applications.  Expect an approximately 15-minute outage per floor.

One notable limitation of the SRO environment is that In Basket is not available. Please use phone or pager for time-sensitive situations, such as a critical result or an urgent consult request.

What will be done then:

Epic datacenter staff will install July updates and UConn Network Team will upgrade network switches concurrently. Once tested by Epic staff it will be turned over to UConn HealthONE IT for validation.

If everything goes as planned:

Once UConn validation is complete users logged into HealthONE will receive notification to log back out of HealthONE (read-only-mode environment) and immediately log back in. This will redirect all users back onto the HealthONE Production environment.

What we need you to do:

Please post in your areas to notify your staff of this maintenance window.

As with any scheduled maintenance activities, we would want all areas to review their downtime procedures with their staff.

Where to go for updates:

Please call the Help Desk at x4400 option #1 with any additional issues experienced during this outage window.

More Dragon Training Available

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Please see the latest on additional Dragon dictation training opportunities:

  • Dragon 301 – Provider Optimization Sessions: UConn IT and Nuance Dragon support have teamed up to bring two additional training weeks to UConn Health providers. If you’re feeling ready for next steps, optimization training will be held July 10 through July 13 and July 23 through July 27, five times per day for ATE training. This one-hour session is scheduled at your office, workspace or clinic to optimize the integration of HealthONE, reducing the number of clicks needed for your workflow. If you would like to signup, contact Bert Romeo at extension 8054 to schedule your one-on-one session.
  • Incoming Residents & Fellows Dragon e-Learning: All incoming residents and fellows have been provided Health Stream access to Dragon e-Learning. If you are a resident or fellow and would like to use Dragon, please refer to your Health Stream assignments.
  • Did You Miss out on Dragon Training Last Month? If you are a provider and didn’t have an opportunity to be initially trained on Dragon dictation, and wish to do so, contact Bert Romeo at extension 8054 to be scheduled for in-classroom training at the Academic Library. At this time, we do not have regularly scheduled training but accommodations can be made that will work with your schedule.
  • Emergency Medicine Department-Wide Workflow Optimization: And finally, a team of HealthONE ASAP providers, Epic Analysts and Dragon support team members are currently building integrated workflow optimizations for the Department of Emergency Medicine. If you are a technologically savvy provider and wish to take on the lead role for your department, contact Bert Romeo at extension 8054. Once the ED workflow is complete, we will schedule your department to be next in line for this time-saving workshop.

HealthONE: Celebrating Early Success

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CIO Bruce Metz gets ready to kick off a celebration of go-live the morning of April 28. (HealthONE file photo)

UConn Health is now two months into a patient care transformation centered around an integrated electronic health record. As expected, it has been an adjustment period, but with the challenges come a number of success stories and early wins for the UConn Health community, including both providers and patients.

“We are in the early stages of our HealthONE journey,” says UConn Health Chief Information Officer Bruce Metz. “Go-live was only the beginning. We are starting to see some progress and benefits to patient care and efficiency that bode well for the future. The key is to stay on track by continuing to learn and refine HealthONE in order to realize all the capabilities it has to offer. Embracing the change with patience and foresight makes all the difference. It’s important to remember this is a marathon, not a sprint.”

Here are some early reviews:

“I used to spend four hours writing notes. Now I only spend one hour writing notes.”
—Dr. Neha Jain, psychiatrist

“HealthONE is WAY better than Nextgen for doing orders/charts for the doctor. Takes me a quarter of the time to chart. Vast improvement!”
—Dr. Craig Rodner, orthopedic surgeon

“As an OR nurse, I love blood. With HealthONE, ordering blood is fast and easy! No more filling out lab slips, faxing and hoping that the fax made it to the blood bank. This is a huge improvement over our legacy system.”
—Ellen Benson, OR nurse manager

Staff and leadership from the Outpatient Pavilion shortly after activation. (HealthONE file photo)

“Really happy about ‘No more writing and no more paper’ in the Phlebotomy Team Department! All work is accounted for individually.”
—Aretha Floyd, inpatient phlebotomist

“One of my studies requires an extra blood sample with the early morning labs and with the use of the ‘Treatment Team Sticky Note’ on the patient’s chart, this sample was obtained easily. This process would not have been as seamless without our new EHR.”
—Sharon DiMauro, clinical research coordinator

“It’s been great, especially for billing. We’re able to capture so much more now.”
—Dr. Heiko Schmitt, cardiologist

“Prior to go-live, it was not uncommon to have three or four different programs open in order to provide proper care to patients. Now only one is required. HealthONE has vastly improved patient continuity of care and efficiency of documentation.”
—Dr. Ben Ristau, urologic oncologist

“One of my principal orders trainers shared that a surgery resident recently commented that he was ‘pleased with the technology leap forward’ that UConn has taken. As a resident that has previous rotations at UConn prior to HealthONE implementation, he notes the application is a great improvement.”
—Liz Zibell, HealthONE clinical applications director

HealthONE Service Advisory–Resolved: Mobile App Connectivity

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Click image for full instructions.

[Updated 3:15 p.m. June 19]

We had a considerable down time involving the use of our Haiku, Canto and Rover applications.  This has been fixed and all are operational at this time.  Should you have a device that is not reconnecting, please use the instructions on the attached document.

If that process does not restart your device and you are not back on line, please call 4400, option 1 and identify your device which is effected by the mobile outage.  Please provide a call back number for the mobile support team to contact the user to assist.

Thank you for your patience and understanding!

HealthONE Service Advisory: Missing Zeroes

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[As of 11:15 a.m. June 19]

Following is an advisory from Surescripts:

Date: June 18, 2018

Title: Notification of Potential Patient Safety Issue (PPSI) – Missing leading zero (aka, “Naked decimal”) in some Medication History response messages

Details: Surescripts recently determined that some Medication History response messages provided by certain pharmacy benefit managers (PBMs) and pharmacies may be missing leading zeroes in front of decimals in the Drug Description or Drug Strength field which could result in misinterpretation.

For example, instead of:

<DrugDescription>ANAGRELIDE HYDROCHLORIDE 0.5 MG CAPS</DrugDescription>,

it is transmitted as:

<DrugDescription>ANAGRELIDE HYDROCHLORIDE .5 MG CAPS</DrugDescription>.

As noted in our Medication History for Ambulatory Implementation Guide 10.6 (for PBMs) and Medication History Load for Pharmacies Implementation Guide v6.2, and supported by specific recommendations from the Institute for Safe Medication Practices (ISMP) and the Joint Commission, Medication History responses should always include a leading zero in front of a decimal for values less than 1 and greater than 0.

Surescripts conducted an analysis of sample data in 2018 and determined this issue is occurring in the Drug Description field of approximately 1.45% of Medication History response messages. This issue may also be occurring in the following fields:

  • Directions
  • Quantity
  • DrugCoded
  • Strength
  • Diagnosis Code

There have been no reported cases of patient harm due to this issue, although due to the risk of an end-user not seeing a decimal point, and the potential for inaccurate doses to be transmitted as a result, this issue represents a Potential Patient Safety Issue (PPSI).

Surescripts is working with the data sources involved to resolve the issue as quickly as possible. We will provide an update on the fix as soon as it is available.

Meantime, please direct questions to x4400, Option 1.

Getting Our Patients to the Portal

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myHealthONEHave you signed up for myHealthONE, our new patient portal, yet? This is a convenient and empowering tool for our patients to manage their health, likely in ways they might not realize, including:

  • Viewing test results faster and easier than ever.
  • Messaging the office and avoiding telephone hold times.

What better way for our patients to learn about the benefits of myHealthONE than from the providers and staff with whom they come into contact every day? As faculty and staff, the more familiar we are with the portal’s features and advantages, the better equipped we are to share them with our patients. And if you already have signed up, please send your questions and feedback to healthoneupdates@uchc.edu; perhaps you’ll help identify ways to improve myHealthONE and make it more useful for everyone. When our patients use myHealthONE, we all win!

This was first reported in the June 14 Pulse. Watch for additional HealthONE updates in Lifeline, in the Pulse, at uconnhealthexpress.uchc.edu/HealthONE, and on Twitter @UConnHealthONE.

HealthONE and Research

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In preparation for go-live, we identified 29 clinical trials to be built in to HealthONE. As of early June, we’ve nearly doubled that goal, with 57 already built. What does HealthONE have to do with UConn Health’s research mission?

  • It enables streamlined billing for research trials. Previously there was no widely-used/established method to electronically track what expenses should be billed to the study vs. those that should be filed under the patient’s insurance. This efficiency allows for streamlined generation of revenue!
  • It helps study coordinators track patient status and progress within the trial electronically.
  • It saves time by replacing manual tracking in spreadsheets with a single click.
  • It can generate research statements electronically allowing for easier and quicker payment of ancillary research charges.

HealthONE is indicated for any/all studies that have an order to place in the system or involve an investigational agent, drug or device.

This was first reported in the June 12 HealthONE update. Watch for additional HealthONE updates in Lifeline, in the Pulse, at uconnhealthexpress.uchc.edu/HealthONE, and on Twitter @UConnHealthONE.

For Office Staff: Advanced Beneficiary Notifications

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With the arrival of UConn HealthONE, UConn Health providers are responsible for explaining the meaning, need and options associated with an ABN (Advanced Beneficiary Notification of Noncoverage) when one is required for a Medicare patient. Office staff will need to print the ABN form from HealthONE, acquire the patient’s signature, and scan the signed form into HealthONE.

HealthONE Service Advisory

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(Updated May 18, 9:25 a.m.)

Epic Outage Resolved

The Epic system (which powers UConn HealthONE) is back up and running. Users can now log back into the system. All providers should enter their written orders during the downtime into HealthONE.

The HealthONE Command Center is reachable at x4400 if any technical issues are encountered.