Transcript Research Super User Meeting - Brigham and Women's Hospital

Research Super User Meeting
One Brigham Circle
April 15, 2015
1-2 PM
Contents of Presentation
 Research Super User description and requirements
 Review of Epic workflow for research
 Patient timeline
 Release of Information
 In Basket
 Epic documentation
 Take home information
 Typical issues and resolution
 Implementation timeline
 Resources available
What is a Research Super User?
 Advocate for healthy change
 Positive about transition into Epic
 Serves as initial point of contact for Partners eCare and Epic
related issues in their local department
 Provide “at the elbow” support for staff members using Epic
 Assist with troubleshooting application problems during
implementation
 Identify and escalate issues as needed
Research Super User Responsibilities
 Provide support for your own department as needed.
 Research Super Users are not required to work extra hours
or deviate from their home department or current workload.
 Research Super Users will be the first point of contact if
department end-users have Epic-related questions/issues.
Review of Epic Workflow
1. Study flows from Insight to Epic nightly
Review of Epic Workflow
1. Study flows from Insight to Epic nightly
 Studies will still go through Insight for proper IRB approval
 Once IRB approves study the study will automatically flow from Insight to Epic at
midnight as long as the study has the following:
Protocols with the Overall Status of ‘Active’
Protocols with the following Type of Protocol (Humans
1.
2.






Intervention/interaction
Excess human material
Tissue repository
Secondary use samples/data
Coordinating center/core lab
Cede Review
Linked to an Active fund (listed in Agreements
3.



Protocol header)
Project Details page)
With a project end date greater or equal to today
With one of the fund codes 066, 068, 072(corporate) or 070, 071 (federal) and the
budget expense is not equal to zero
With business unit 2200 (BWH)
Review of Epic Workflow
2. Associate subjects to the study and setting ‘status’
Review of Epic Workflow
2. Associate subjects to the study and setting ‘status’
1. When a subject is
associated to the study they
must be assigned a “status”
2. Subject status must set to
“Enrolled” for billable
items to be ordered in Epic.
 “Enrolled” in Epic
means the subject will
have patient care charges
associated with the study
Visits with only non-billable
services (e.g., room only) can
assign other statuses to a subject
NOTE:
Subject status MUST be set to
“Enrolled” for Epic to properly route
billable charges
Review of Epic Workflow
3. Associate research encounters with the study
Review of Epic Workflow
3. Associate research encounters with the study
 Research encounters are any visit, test, exam, procedure, etc. that has research
related charges or care.
 Research encounters must be linked to the study to send charges to the
Research Billing Review and not sent directly to insurance.
 Encounters must be linked prior to the encounter being ‘closed’.
 If an encounter is not linked and is closed and the charge went to insurance
incorrectly then the correction is made in Insight by a Patient Care Correction.
There are 3 types of encounters to link to research:
1.
2.
3.
Linking upcoming appointments to research
Linking HOV, ED or inpatient visits to research
Linking pre-admission visits to research
Note: If you are using CCI space or a Research Core you do not
associate encounters to research.
Review of Epic Workflow
4. Associate research orders with the study
Review of Epic Workflow
4. Associate research orders with the study
 Patient care orders that utilize BWH clinical resources will be entered into Epic
and linked to the study.


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Medications (including investigational)
Radiology exams
Lab work being done at BWH clinical lab
Diet orders
 Research orders must be linked to the study to send charges to the Research
Billing Review and not sent directly to insurance.
 Study coordinators are able to place, co-sign and act on all orders other than
medications.
 Study coordinator can place and ‘Pend’ a medication order but then must notify
the PI/MD to sign the order prior to acting on the order.
 When entering an order you must also associate with a diagnosis.
 Do not use v70.7 code
Note: If you are using CCI space or a Research Core you do not
associate orders to research.
Review of Epic Workflow
5. Research Billing Review
Review of Epic Workflow
5. Research Billing Review
Charges from linked encounters and linked orders are routed to the Research
Billing Review for review after services are provided; this is the verification to
ensure correct billing
 In the Research Billing Review
the PI or financial delegate
will see charges not paid for
by CCI and verify they are in
the correct billing ‘Bucket’
 PIs/financial delegates may
change the ‘Bucket’
 Once charges are in the
1
2
correct ‘Bucket’ the
PI/financial delegate selects
‘Mark Account as Reviewed’ 3
approving the charges
How will Epic Research work with CCI?
Epic will route research charges; there are two Epic research workflows
1. Non-CCI Epic
Work flow:
If you are conducting
research that uses
BWH patient care
resources
2. CCI Epic
Workflow:
If you are conducting
research that uses
Center for Clinical
Investigation (CCI)
resources
Billing Calendar/Patient Timeline
 Studies that have a Medicare Coverage Analysis (MCA) have a billing
calendar created by the PCRO. (~10% of BWH studies)
 A billing calendar is a template of charges associated to the study laid out
at the intervals specified in the protocol/MCA.
 A patient timeline is based on the billing calendar template and
individualized to each subject with specific calendar dates.
 Assists with setting subsequent visits in the appropriate timeframes as
prescribed by the PCRO.
 Better routes research charges into the correct bucket in the Research
Billing Review.
In Basket
 In Basket is the communication and task management tool
available in Epic.
 Functions research WILL use:
 Notification when a subject presents to the ED
 Notify PI/MD that a medication must be signed in a chart
 Functions research CAN use:
 Communication with subjects
 Communication with other staff
 Send patient charts, results, labs, reports securely
 Manage tasks to be done, by who and when
Release of Information
 Epic allows study staff to create ‘Batches’ of patients and
release their records to monitors via Epic Care Link.
 Epic Care Link is accessed by the monitors over the internet
so they do not need to come to BWH.
 Study staff are able to decide which subjects records will be
released and the time frame the monitor can access records
for.
 The monitor is able to see entire medical record.
 This is confirmed by IRB and is consistent with current practice
Epic documentation
Document in Epic
Routine clinical care documentation:
As required for hospital inpatient, outpatient
or infusion visit.
•Medication administration via EMAR
•This will include Facility
Administered Medications
(FAMs) which are medications
administered iduring an outpatient
visit.
•FAM documentation is new to all
clinical trials, not only CCI clinical
trials.
Document Outside of Epic
Study-related documentation:
•Study related charting
•Study related nutrition instructions
•Study related flow sheets
•Study documentation will later be
able to be scanned into Epic.
Additional Information
CCI will still require paper orders – CCI paper ordering
process will continue unchanged.
2. F numbers will no longer be used and will be replaced with
the Epic produced “Study Code”
3. HR is having a “Training Freeze” for new employees May
4th to June 26th.
1.

4.
Research teams should have an interim plan in place.
If subject needs an MRN they must call registration
themselves.

Study staff will no longer be able to register subjects.
Types of Issues
 End-users will want to know:
1.
Why do I need to learn and use Epic?
 Better patient care
 Improved checks for a safer patient environment
 Improved system for ordering and billing
 Use only one system and one chart throughout Partners
2.
How do I do my job?
 Relate old practices with new practices
 Use specific examples of how Epic will speed up and ease their work
 Bridge between software function and workplace function
“One patient, one record, one team, one Partners
statement”
Where Are We Now?
 March 9-May 29: Application Training Begins
 Lafayette City Center
 April 15 and 21: Research Super User Meeting
 One Brigham Circle
 April 30: Clinical Trials Epic Info Session
 Shapiro Breakout Room, 9-11AM
 May 5: CCI Town Hall for Epic
 One Brigham Circle, 2-3PM
 May 11-May 22: BWH Research Epic Drop-In Sessions
 BWH Main Campus (rotating locations)
 May 30: Epic Go-Live!
Available Resources
 BWH Center for Clinical Investigation website (CCI)
 One stop for tip sheets, videos, links, presentations
 eCare Training SharePoint
 Information about Epic training
 Epic Drop-In Sessions: May 11-May 22: Rotating Locations
 Individualized info sessions for enrolling subjects and creating preference lists.
 You must register for a date/time via CCI Education Course List
 Weekly Epic Office Hours:
 Tuesdays 2-3PM 221 Longwood Ave. ACC Conference Room (RF 372)
 No registration needed
 Questions can be directed to Joey Sadlon at
[email protected]