These systems are highly configurable because every hospital wants to do things their own way. There's a good chance many of your complaints are a result of configuration that can be changed. Go to your IT staff with a list.
I'm sure that it can be configured that way. But they won't give me the keys to set up custom filters. I've got contacts that realize that I'm not a moron, and I would never touch defaults in production, but I can't even get a playground where I can do EVERYTHING to figure out where the problems might be.
And if a guy who has their own IT staff telling them it can't/won't happen, despite actual onsite EPIC staff saying it's entirely possible, you see why. When you tell users to go away, and tell interested users that they can't share their improvements, not even privately, you are doing a disservice and you owe me at the least an explanation of why doing it is bad. Maybe there's a good reason that I should be allowed to mess my own system up but not let anyone else enjoy it that way, but I struggle to understand why. The whole thing can be re-imaged if I screw up too badly, after all.
You're blocked from the Epic-PLY and developer sandbox environments?
Are you talking about custom chart review filters? Also not sure why that's blocked, I use those a lot and we can copy them from other user profiles without going through IT. But yes to have this be a default for new users we still need IT approval which no one has bothered with.
This sounds like draconian institutional policies are the limiting factor.
There's a playground, but I have no more power there than I do in my own production environment except that I can write an order like "all-unicorn diet" and nobody would see it. I don't know precisely what you mean by Epic-PLY and "developer sandbox"; I'm an end-user, not a developer. Other than knowing some of the IT team and being the local point of contact, I'm no different from any other anesthesiologist in terms of control. What I would like is a sandbox where I can do anything, figure out what's possible, and then report to the team the things I've found and ask if it would be possible to put them in production. Maybe yes, maybe no, but we live and die by the status board (if you ever get involved with EMR and anesthesia, a good status board is the most critical piece of infrastructure). And I can't even share mine with others.
Draconian institutional policies are indeed an issue. WiFi calling is blocked, despite the fact that a significant part of our first floor has zero cell signal.
If you get bored, PM me and we'll set up a time where I can show you some samples. I'll need a few days to sanitize them of identifiable info.
Got it, Epic-PLY is the playground version that comes with every Epic install. Sounds like they've restricted playground user roles as well, you'd need your hospital IT to change that in the playground environment.
There's a developer sandbox as well that's more feature rich but from what you're describing I doubt they would have enabled access for you although most hospitals do. I would ask someone in IT you know to either give you a superuser role in the playground or access to vendorservices.epic.com
You can't PM on here but my e-mail is in my profile. If you're hitting a dead-end shoot me an e-mail and I can add you to my developer playground to mess around with.
Ah, it's rather hard to find but I do indeed have Epic PLY, thank you for the information. I shall investigate. There may be more abilities there than I knew about.
Still, sad that I have to go to HN and actual tech workers in completely different places to figure out how to use a system that is nominally under control of my own hospital. I don't blame you for not giving doctors admin access; I don't need it and quite a few would make a total hash of things, but I'm a lot more curious and a nice free playground where I could do things like schedule cases would be fun. If I break it, so what? It will reset tomorrow, and I'm fine with that. If I have a play day, I'll apply my notes for everything I have done and ask the IT team to make a snapshot.
No worries. As an aside I'm not a tech worker I'm primarily a clinician as well so I don't make access decisions but if it were up to me I would give MDs more.
Some places are better, most institutions I've been at have given me full access because I have a tech background and had a previous relationship with Epic but occasionally I've hit similar brick walls to you.
Every hospital I’ve worked at has used Epic and every one has a different “custom” version with different UI and user role configuration.
Even within the same hospital the UI and default displays widely varies based on context and role selection when logging in.
Nursing notes are definitely accessible in every version I’ve used and I also read them fairly frequently (often more useful than MD progress notes) so your hospital may be hiding non-provider notes from you. It would be strange though, are you sure you don’t have “show provider notes only” checked off (or that box hidden)?
I've looked under the Notes tab, and under Chart Review -> Notes, and turned off all filters. Nope. I get nursing "plan of care" notes, but not their regular floor notes.
Strange, I'm a radiologist and this happened to us at the very beginning of the Epic transition as well (they also dropped ER MD notes from our profile) but we gave that feedback and they changed it within a few weeks as we used the magic words of "impacting patient care".
This limitation isn't an Epic default feature and must have been set by your institution or whoever created the anesthesia role for some inexplicable reason, there wasn't actually a justification or privacy concern for why this was set this way for radiologists at my institution and seemingly was set by someone in IT thinking it was extraneous to us.
That's the vibe I get. "You don't need to change it"... yes, we do.
Dunno, at this point I'd settle for being able to establish custom filters for my status board. But I've learned that a lot of weirdnesses have to do with interfacing with other software.
This is true, but these custom configurations have become so ossified into each hospital's workflow that there's minimal hope of reversing the mistake.
And if a guy who has their own IT staff telling them it can't/won't happen, despite actual onsite EPIC staff saying it's entirely possible, you see why. When you tell users to go away, and tell interested users that they can't share their improvements, not even privately, you are doing a disservice and you owe me at the least an explanation of why doing it is bad. Maybe there's a good reason that I should be allowed to mess my own system up but not let anyone else enjoy it that way, but I struggle to understand why. The whole thing can be re-imaged if I screw up too badly, after all.