"The Epic system decision support technology interferes with the RN's duty and right to advocate in exclusive interest of their patients," said Jerry Fillingim, a labor representative of the California Nurses Association.
Since the July 1 go-live date at two jail-based clinics—the West County Facility and the Martinez Detention Facility—and one based at the John A. Davis Juvenile Hall in Martinez, nurses have filed 142 notices of Assignment Despite Objection, a form used by CNA.
It requires that members notify supervisors and seek a solution before filing the form. Many of the forms' complaints speak of improper or incomplete training.
In an interview Tuesday night with HealthLeaders, Contra Costa Health Services executives responded that fixes had been made to the system since July 1, but communication of those fixes to line staff has been inadequate.
"We need to look a the process that we're engaged in now, and we need to improve that," says Anna Roth, RN, CEO of Contra Costa Health Services, whose 164-bed county hospital as well as ambulatory services and clinics at detention facilities switched to Epic on July 1.
"The introduction and implementation of an EHR in and of itself is a huge change in workflow, but I do know we put a great deal of effort into working with front line staff designing the workflow," Roth says.