Worry to Wonder: An Epic Journey

What will it be like? Will I be able to learn it? Will my job or patients be affected because of this new system? Let me introduce myself. My name is Chris Richard, BSN, RN. I was a clinical leader at Brigham and Women’s Faulkner Hospital and a super user during their Epic (electronic health record) go live two years ago. I had all the same questions, hesitations, and fears that our staff has now. I know that I won’t be able to change how you feel, but you can read about my experience and become hopeful. After all, I took a job at McLean knowing that I would be going through go live again.

My peers and I went through the same Epic classes as you are going through. Initially, we were all excited. Let’s face it; Meditech, an older electronic medical record system, has its issues. Anything that replaced it must be better right? We arrived at our first class. The system looked nothing like I thought it would. I was nervous. Four hours went by and not one of the teachers told me how I would be using Epic to do my job. I remember after the first class, feeling less hopeful. “I thought I was going to learn how to do my job,” I said. “I don’t think I remember anything they taught me,” I said. Later, I was told that the classes are to teach you how to use the computer system, not how to do my job. That would have been helpful to know up front. Oh well, live and learn. The second class briefly reviewed what we did in the first class. Surprisingly, I had remembered some of it. It was my first little success. Then they taught us how to pass medications. I felt a little better. At least it was a task I was familiar with. I needed to know how to do that as I cared for patients. We discussed how you do education for your patients in the Epic system. “That’s important for my patients, too,” I thought. I paid a little more attention. The second class went by faster than the first. As we left, I remember that the conversation on the ride back to the hospital was more positive than after the first class. Our last class was easier still, with slightly more hope and positivity.

However, even though we could begin to see some concrete use for the program, we were still skeptical. And now we were told to make time during our busy shifts to “play in the playground,” a sample environment for the Epic system. About half of the super users did and some of us didn’t. As time went on, you could tell who had been practicing because they were the ones who became far less anxious. Putting in 15 or 20 minutes every couple of shifts made all the difference. Moreover, once you found out that it helps, you were excited to cover for someone else to get practice time, too.

And there we were, the day of go live. We’d had our classes, most of us had practiced, and all the nerves came back. 5 am came and we flipped the off switch on Meditech and the on switch to Epic. We were slow. We were confused at times. Yes, there were some computer glitches. But... you are smart! You have been trained. The training works. You have super users at your side! Once you entered a set of vital signs, you did it! It was faster the next time. It was the same with passing meds, doing a patient belonging sheet, starting a plan of care, writing a note, or doing an assessment. You did all these things on your first shift.

The next shift was easier, and so on, and so on, and then we realized the most amazing thing: it wasn’t so bad. It was really hard. We were all really anxious. We all struggled on our first day (OK, first few days...) But, and I heard this hundreds (really, hundreds) of times: people said that if they knew before go live what it was really going to be like, they would never have worried so much.