CA Nurses Sound Alarm Over Epic EMR System

Scott Mace, for HealthLeaders Media , August 16, 2012

"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.

Scott Mace is senior technology editor at HealthLeaders Media.

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4 comments on "CA Nurses Sound Alarm Over Epic EMR System"

jltbdy (9/24/2012 at 11:31 AM)
Wow. sensationalism title. seems to me the content of this article has nothing to do with the title. Some other agenda? Simply because a facility's implementation has problems, doesnt mean the product is bad. I agree w/Andrew...mud slinging without any factual foundation. I'm a Hosp IT questions are: Why didnt the build issues get identified in testing? & Why can't the RN's work "with" IT instead of filing going around it?

Denise (8/27/2012 at 4:31 PM)
I have to agree in part with Andrew. Regardless of the system that is being used, ultimately nurses are the last line of defense to patients and the medications we receive. Computers will still have errors from time to time, but it does not mean that it is a bad system. We still have to mind our 5 "rights" (or however many there are now). Relying on computers to do the work for you will not serve you or your patients wisely. They are a tool to help and should not be seen as anything more.

Andrew (8/23/2012 at 12:08 PM)
Having worked extensively with Epic for the last 5 years, including several years actually at Epic, I feel your statement is incredibly unfair. In what situations have you seen where Epic doesn't hold up in challenging situations? What basic design flaws with the system are you referencing? I see you making broad statements without any real support or validation of your statements. Epic is a highly configurable system. The incident in question here is the result of a build error, not the fault of the application itself. There's nothing hard-coded into the system that would cause an incorrect dosage to be displayed. The incorrect dosage is 100% a build error on the analysts who was assigned to that particular build task. That's why Epic nor any other EMR, will EVER take the place of actual human review. Epic is installed to help make lives better, but that's very rarely without growing pains. What these nurses likely don't tell you or bring up is the insanely convoluted workflows, the mountains of handwritten and post-it notes that goes currently into meds admin [INVALID] I know, because I've seen it. The margin for error in a world-based on post-its is far far greater than that within a structured system.




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