Mar. 04 2020

Student Q&A: An Epic Experience

Before starting as a Master of Public Health student at the Columbia Mailman School, Katrina Traicoff worked as an Emergency Department Scribe in Memphis, Tennessee. As a personal scribe to two physicians, she learned about the clinical aspect of healthcare and the challenges of working with an electronic medical record system on the provider side.

Today, Traicoff, who will earn her degree in the Department of Health Policy and Management this spring, is an integral member of a team responsible for one of the largest electronic medical record implementations in the country. Beginning during her summer practicum last year, the job with ColumbiaDoctors has given her hands-on experience with the roll-out of the EpicTogether system at Columbia University Irving Medical Center and beyond.

How did you choose to do your practicum at Columbia Doctors?

I had previously worked in the clinical field, but never on the administrative side of a hospital. However, working as a scribe in the Emergency Department with the electronic medical record gave me helpful clinical background for working at ColumbiaDoctors.

Health IT is progressing in leaps and bounds. Electronic medical records have been around for a while. But they used to be more rudimentary, and initially were just a way to get rid of paper. Now, we’re entering an age where health care organizations want to optimize and integrate. Electronic medical records incorporate so many different aspects, for example, revenue, billing, scheduling, patient records, insurance, orders, e-prescribing. There isn’t anything you can do in the hospital that isn’t accounted for in the electronic medical record.

I’m assisting with the launch of EpicTogether, which is the joint electronic medical record for Weill Cornell, NewYork-Presbyterian, and Columbia Doctors. This is the largest Epic implementation that Epic has ever done. The aim is to implement an integrated electronic health record and business platform replacing dozens of EHRs and other systems across our three institutions and for over 100,000 users.

Preparations began in January 2017, when we signed a contract with EPIC. In July 2018, we started creating the interface and customizing the platform. In January 2019, the platform was complete. In April, we started testing. In October, we started training. And then on February 1st, we launched the system for all of West Campus (Milstein, CHONY, and Allen Hospital, ColumbiaDoctors, and Columbia Dental). Our implementation was a success and the fact that we were able to achieve this in a fairly short time was pretty remarkable.

What are some of the challenges of launching the new system?

Implementing EPIC Together has been challenging because it introduced an entirely new workflow to physicians and other clinicians. On the flip side, many providers were ready for a new system that would ease their lives. With the new system, it’s easier and to document the visit so the physicians can prioritize the actual patient interaction.

To make things easier, we put a lot of time into thinking about training. We implemented a peer-to-peer training model that leveraged our own staff to train users and provide support during the launch rather than relying solely on Epic or vendors for training and support. This way Epic knowledge would stay with the institution and our employees will be available during the transition period and beyond to help with adoption and optimization.

What does a typical day look like for you?

With the implementation, I created online video tutorials on how to use the system. We have an entire website called EpicTogether. On there we have tip sheets, workflows, and videos that train you on different tools on Epic. I didn’t have any experience before with videos, but I got on Adobe Captivate and filmed myself. Now, there are dozens of videos that users can look up in one spot, and all the information is there. We also have tip sheets accompanying those. This way, people can just go on the website to find what they need. Other tasks included patient chart correction, training verification, and administratively closing out notes. For me, completing these tasks is fulfilling. It’s a big part of my personality. I like to see something tangible come out of my work.

Recently, I’ve been working on a volunteer program that I’ve project-managed to ease the patient sign-in process. Right now, we’re signing in patients with a welcome kiosk on a tablet. We piloted a program with 40 on-site volunteers to help patients who are older or less familiar with the system.   

How do you sum up your experience on the job? 

Although I definitely incorporated coursework into my internship—especially understanding insurance and health economics—there are some things you can only learn from being on the job. So many things can happen. I’ve learned to deal with issues in an efficient manner and how to communicate to leadership and my team. This skill is vital in any work environment.