Thank you to thousands of members of TeamUHN for the successful launch of our new health information system from Epic. (Video: UHN)

It's been nearly seven weeks since the push of a symbolic button signalled the go-live of UHN's new health information system (HIS) from Epic. Since that major milestone in UHN's clinical transformation, teams across the organization have been adapting to the use of this powerful new tool.

The project to implement Epic at UHN, which was code-named Synapse to symbolize the interconnections created when there's a single source of truth about each patient's medical journey, continues with the help of orange-vested at-the-elbow support staff and the round-the-clock Epic Contact Centre.

As the number of tickets created for issues lessens, there's increased understanding of the benefits of the new system. Here are a few examples from across UHN.

Saves time for staff and patients

From the outset, members of TeamUHN and patients and their families have talked about the improved efficiency of the new HIS, even if there was an initial learning curve.

For care teams, it's meant a central, electronic location for all patient information, notes, referrals and consultations, and an end to searching for charts. Some describe it as transformational.

"Oh, I loved my clinic!" Dr. Brian Hodges, a practicing psychiatrist who is EVP of Education and Chief Medical Officer at UHN, wrote in an email to colleagues about two weeks after go-live. “Everything worked perfectly. It is so much better to chart in this system than in my binders with pieces of paper.

"I feel like I have left the 18th Century and gone into the 21st Century directly."

Patients say they appreciate the ability to complete paperwork online and add information to their electronic charts ahead of appointments by using the enhanced myUHN Patient Portal. They also like being able to schedule some appointments and review – and correct – parts of their patient record.

"I checked myUHN account shortly after the implementation of Epic. It looks amazing," one UHN Patient Partner offered in feedback. "Even for us patients, [there] will be some work required, ie: updating meds, checking scheduling, and other personal info. I also find it important that I check the medical reports after each of my appointments for the accuracy and completeness.

"Just can't imagine not having my medical reports and test results!"

Another UHN Patient Partner said they had been using the new HIS from the start “and I quite like it."

"It is very intuitive and forgiving. Support staff are excellent.

"In the past, I have been involved in the launch of similar enterprise systems in a variety of companies and this was the best I've ever seen by far. Great work by all."

Improves communication among care teams

UHN teams have been giving positive feedback on the new secure communication tools within Epic that enable efficient communication and collaboration with other members of care teams.

At Princess Margaret Cancer Centre, Christine Hill, Acting Director, Radiation Therapy, says the early days of the new HIS has seen improvements in communication, quality of care and patient safety.

From the radiation therapy perspective, Christine says, the improved interfacing of appointments, notes and key information between Epic and MosaiQ, an electronic medical record and practice management system for oncology practitioners, “has been a huge win to ensure that everyone in the circle of care is aware of the appointments and care being provided to our patients."

"This improves quality of care and also patient safety," says Christine, adding that another "big win for us" was the amazing support of super users, keen reporting and tracking of issues by Radiation Medicine Program teams, and the willingness of all teams to come to solve the problems that were arising.

"For example, the radiation therapists reported the concerns of patients regarding the many notifications they were receiving from myUHN about treatment appointments," Christine says. “We collaborated with the Synapse experts, Patient Experience team and clinical teams to resolve the issue very quickly."

At Toronto General Hospital (TGH), a team reported that during the first week after go-live they were able to take a photo of a wound with a Rover – an iPhone that connects with the Epic system – to facilitate a consult with a wound care nurse.

Makes it easier for staff to do the right thing

Improving patient safety and the clinical experience for patients and staff alike is at the heart of UHN's new HIS from Epic. There have been numerous examples of success on that front.

Dr. Sam Sabbah, Chief of UHN's Emergency Departments at TGH and Toronto Western Hospital (TWH), referred to the clarity achieved with the replacement of paper orders with electronic ones through Epic.

"Two weeks ago, I was writing chicken scratch on carbon copy paper," he wrote in mid-June. "We are light-years ahead."

A nurse at TWH captured the sentiment of many in saying “no more deciphering handwriting" means no need to spend time seeking clarification, and a reduced risk of errors.

At Toronto Rehab (TR), Janet Newton, VP, Clinical, and Dr. Mark Bayley, Physiatrist-in-Chief and Program Medical Director, wrote in an email to all TR staff in the second week after go-live that "as our comfort grows, we're starting to recognize, more and more, the benefits of this new way of caring for patients."

"As one colleague told us," their email continues, "'I really like the assessment and screening tools in Epic. Sometimes it's challenging to remember everything we need to do, but the tools in Epic remind me, so my patients always get the best care possible.

"'The old paper forms had no built-in reminders!"

In the Laboratory Medicine Program, Dr. Christine Cserti-Gazdewich, Associate Medical Director – Blood Transfusion Laboratory & Consultant Hematologist, UHN, says the shift from traditional, hand-written hardcopy and/or phone orders to direct computerized order entry was “a major milestone."

"This brings start-to-finish tracking with enhanced traceability, accountability, and analytic capacity," Dr. Cserti-Gazdewich told colleagues in the first full week after go-live. "We were able to build upon a foundational system and tailor it to the UHN environment.

"Though we've had a range of not-unexpected growing pains after going live in such a complex system, I admit that the moment of loading my first blood order was suddenly more profound than I imagined it would be."


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