Abigail Gibson, (L), and Nuno Ferreira, MRI appointment schedulers in the Central Booking Office of the Joint Department of Medical Imaging (JDMI), work in their office in LuCliff over the weekend completing the conversion of patient appointments to the new Epic system. (Photo: UHN)

Madelyne Lee and her team were happy to put in some extra time at the office this past weekend.

Cardiac technologists at UHN's Peter Munk Cardiac Centre (PMCC), they conduct non-invasive tests on cardiac patients, including holter monitors and exercise stress tests. On Saturday and Sunday, they were in the clinic making sure about 900 future patient appointments and order requisitions – from June 4 to as far out as 2027 – were successfully converted to UHN's new health information system (HIS).

"There's been nothing but cheering," Madelyne, Team Lead of the Holter and Stress Lab at PMCC, says of the reaction of her and her colleagues to the new HIS from Epic as they've trained on it in recent weeks. "They're very excited and can't wait to start using it.

"It's just so user friendly."

This past weekend, Madelyne and her team were among more than 450 TeamUHN members across all clinical areas who worked to convert about 300,000 patient appointments to the new Epic system, which will be implemented on June 4.

The project to implement Epic is code-named Synapse to symbolize the interconnections created when there's a single source of truth about each patient's medical journey.

As of Monday, May 16, all appointments, scheduled orders, and surgical cases for UHN patients – both inpatients and outpatients – taking place on or after June 4 are in Epic. The more than 1,800 staff across UHN who book appointments have been trained to use Epic so that any new appointments for June 4 or later will also be in the system when it goes live across UHN.

"Having scheduling and registration teams start using Epic ahead of the rest of the organization helps ensure continuity of care, and maintain patient flow volumes as much as possible in June," says Mary Beth Carpenter, Senior Application Manager, Access & Revenue, Synapse. "The staff who started using Epic on May 16 get a head start on building comfort and confidence using the system for appointments, which reduces stress for staff and patients during the enterprise-wide go-live."

Calling scheduling "a fluid thing," Mary Beth says, "we needed to know that we've converted everything properly" before the scheduling go-live was given final approval late Sunday afternoon.

Until June 3, staff will continue to use the current scheduling systems to manage appointments occurring before June 4.

Cardiac technologist Ritu Ghotra, (L), and Madelyne Lee, Team Lead of the Holter and Stress Lab at UHN's Peter Munk Cardiac Centre, in the clinic with colleagues over the weekend making sure about 900 future patient appointments and order requisitions – from June 4 to as far out as 2027 – were successfully converted to UHN's new health information system (HIS). (Photo: UHN)

It took a massive team effort over the weekend to complete the task – ensuring all future-dated appointments were moved to the new system and validated in time for "go-live" on Monday morning.

Clinical support staff worked Saturday and Sunday in clinics at all hospital sites, in other UHN clinical locations, and from home to ensure the inpatient and outpatient appointments were successfully converted into Epic. They were supported by 40 members of the project team at the UHN Digital offices at Atrium on Bay.

"We've had a huge lift from teams across UHN," says Leanna Graham, Senior Director Professional Practice & Policy, and c​o-Chair the Patient Access Working Group for the Synapse project.

From the outset of planning for a new HIS, Leanna says UHN patients and families have talked about the need for easier access to reports and self-scheduling, and that will now be realized.

"The teams are really excited to see this happen," she says.

At the Holter and Stress Lab in PMCC, Madelyne says her team is looking forward to replacing their "pretty lengthy process" of filing patient test results, which sees them printed out, given to physicians for review before scanning and finally input of the paper into the Electronic Patient Record (EPR).

"Everyone is smiling because it will be so much more efficient with way less paper," Madelyne says.

For Abigail Gibson, MRI appointment scheduler in the Central Booking Office of the Joint Department of Medical Imaging (JDMI) located in LuCliff, any challenges with learning the new system will be temporary and well worth it to leave behind the existing system, she labels "a little prehistoric."

"It will make our lives easier," says Abigail, who is part of a team booking MRIs for Toronto General and Toronto Western hospitals, as well as the Princess Margaret Cancer Centre.

And she should know. As a member of the JDMI team for the past 18 months, Abigail previously booked MRI appointments for patients of Women's College Hospital, which uses an Epic system.

One of the big advantages for her team, Abigail says, is that with the Epic system the patient's appointment and their health records will now be in the same system, not two different ones.

"We're cutting out a whole system that we won't be using anymore," she says. "Definitely having everything all in one place is going to be a time-saver for sure."

Members of the Patient Access Team, Synapse, who spent the weekend at the UHN Digital offices at Atrium on Bay guiding participants and resolving issues, include, (L to R), Mary Beth Carpenter, Megan Sconci, Branka Dmitrovic and Ashley Uppal. (Photo: Synapse)

​The weekend was the culmination of work begun in January to build scheduling templates in Epic. The templates give each clinic and unit flexibility for how they structure their appointment cadence and details while also creating standardization.

Appointment-setting at UHN is decentralized, but with Epic there is now a standard approach, which makes it possible for appointments to be seamlessly seen by all who need to see them, including patients signed up for the myUHN Patient Portal.

Starting to use Epic for scheduling appointments is a significant milestone in the Synapse project and UHN's clinical transformation.

At LuCliff, Abigail says although "some people are worried because they have to learn something new," there's confidence that comes with knowing the benefits of the change and that everyone is in it together.

"It's going to be a challenge at some points, for sure," she says. "But, we're all going to help each other.

"And, at the end of the day, we know it will be better for everyone."

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