Research is an essential part of our DNA as an academic health system. Whether you are a pharmacist, nurse, or physician, research is happening all around you – often to the direct benefit of patients.
However, good research depends on good data, strict compliance to ensure patient safety and data integrity, and the ability to collaborate. Epic weaves research capabilities into system design, to minimize barriers to using applications that support clinical research.
Integration with clinical care
“It is our job to advance knowledge and advance clinical care through research,” said Eric Wallace, M.D., UAB Medicine chief medical information officer and digital health officer. “We have to do it in a way that allows people to participate in research safely and reliably, without distracting from the care they’re already receiving.”
The current processes include workflow in OnCore, paper documentation in research binders, and in some cases, information entered into Cerner.
With Epic, the EHR will become part of the research process, and it should make our work more convenient, collaborative, and compliant. Furthermore, it will unite all of the documentation for the patient’s care, whether provided through a clinical trial or not. This is better for patients and clinicians.
Quality and patient safety
Epic also enhances patient safety and quality through more visible data, easier communication, and more accessible clinical insights.
“If I’m a clinician, and I’m seeing a patient who’s enrolled in a clinical trial, I need to know exactly what their participation in the clinical trial means for their care. This can include knowing what drugs I can and cannot prescribe,” Dr. Wallace said. “Epic gives us a way to document, communicate, and manage the research alongside clinical care, including alerts within the chart to notify providers when things should and should not be done. That’s what we’ve needed.”
Data stored in Epic will flow between research teams and clinicians, and this real-time patient information will allow them to proceed more confidently.
Christopher Sorenson, AVP of project and IT financial management and program director for the Epic Journey, says the new EHR also will help with compliance and coordination in large-scale studies.
“Epic is going to give us more transparency into what’s happening across studies,” Sorenson said. “There’s a risk when you have disconnected systems. Epic’s ability to bring that under one roof really helps reduce the opportunity for errors or misunderstandings.”
More efficient processes
The clinical trials process is the most tangible way that research and life-changing care are linked. Unlike Cerner, Epic will house clinical trial information.
“This is important because it places the study into a normal clinical workflow, meaning that trial orders can be placed just like other orders,” Dr. Wallace said. “And that progress will be easier to follow for everyone.”
Having one system also means less data-entry work by research coordinators and others downstream. “For both patients and their care teams, it means we’re not missing anything,” Sorenson said. “Everyone who participates in their care will know what trial they’re in, which protocols apply, and what’s expected.”
Another benefit is in finding eligible patients for clinical trials, a process that often relies on either manual chart review or delayed referrals.
“It’s always been a challenge finding the right people at the right time in the right setting, within a system that doesn’t make it easy to align patients with our selection criteria,” Dr. Wallace said. “But with our build of Epic, you will be able to flag patients in real time as eligible for a study across our enterprise. That’s a huge improvement.”
Equally important is the ability for research coordinators to now recruit patients directly within Epic using secure messaging.
Less friction
Important research also happens behind the scenes or long after a patient or group of patients has completed treatment. Other types of data, such as trends over time or population-level patterns, help guide how we deliver care – a field known as informatics. Epic makes these data easier to access.
“Epic will help us build registries that are actually usable without sorting or re-assembling somewhere else,” Dr. Wallace said. “Now, we can start answering questions sooner.”
Furthermore, Epic allows researchers to link out to a deidentified dataset with upward of 300 million unique patients through its Cosmos infrastructure. This mass amalgamation of data is the future of training for new health care tools.
Collaboration
Since Epic is used by academic medical centers across the country, it opens the door to easier collaboration within UAB Medicine and with other institutions.
“If we’re doing a multi-site study, and the other site is on Epic too, it can simplify everything,” Dr. Wallace said, adding that patients could also be more easily recruited and matched to studies at other study sites.
Within UAB Medicine, Sorenson said, “if you’ve got one platform, then investigators across different specialties can work together more easily.”
No matter your role at UAB Medicine, we are all part of an important research ecosystem. Among its other workflow improvements, Epic will make our research more convenient, compliant, and collaborative.
View the latest news on our Epic Journey.