SEEKING THE RIGHT APPROACH TO CLINICAL CONTENT MANAGEMENT
By Sherry Broussard
During the design phase of an EpicCare Inpatient system implementation one of the major
and critical tasks is the management of clinical content. Many mistakes that occur are not
only with the processes, but deciding what approach is taken. Clients need to look at all
the available options to build the Epic clinical content. One option, you may consider, is
manually building the workflows using your paper or electronic data. The other option is
to use vendors such as Zynx Health for their clinical content. Now is the time to step
back, review your current process and content, and determine the best approach for creating
and maintaining the content of your assessments, care plans, and order sets for your
organization.
A word of caution regarding processes: an essential skill often overlooked is the
management of the content process, and unfortunately, it is oftentimes found in the wrong
hands. This task needs to be performed by a committee and/or individuals who have the
expertise, skill, knowledge and motivation. This is not to say that the IT system analysts
should not play a viable part (they are quite capable and essential from an Epic
application and technical standpoint), but rather ownership should be the physicians,
nurses, and other clinical stakeholders who have the aptitude for patient care treatment
decisions and quality of clinical information. As a blended team working together the
result will be a successful implementation with positive acceptance by the end-users.
Several options for developing this content are available without reinventing the wheel. Options available are:
- the Epic Model system,
- the availability of the Epic community library which provides content from many other customers,
- and third party vendors such as Zynx Health who has partnered with Epic and offer evidence based solutions which can gain buy-in and acceptance from the clinicians.
Looking further into these options will provide a better understanding for deciding
what may work best for your organization.
Epic Model provides basic starting points for order sets, documentation flow sheets,
and basic care plans and assessments. The model is a culmination of best practices from
other clients and utilizes an evidence-based foundation. The client can review the content
and make the necessary modifications, and/or use it as a guide. The basic outline for
standardization across the application is already in place, and all that is required is to
tailor it to the needs of the organization. The advantage to using the Model starting point
is that it is a blend of best practices from other clients, and offers a guide for
structure and naming convention and any special considerations. In addition, Epic provides
starter sets for some applications and specialty areas, and within these starter sets are
order sets, and documentation flow sheets.
The Epic community library provides clinical content from other clients who have done
the “leg work”, and are currently using the content in live production
environments. Using other clients as a basis will reduce the amount of time spent
designing and building order sets, and clinical documentation. Many of these resources are
exportable into spreadsheets that will allow for making updates and modifications that can
then be imported into Epic.
Lastly, there is the third party vendor option. ZynxHealth offers an array of products,
but specific to our topic, are the ZynxOrder™, and ZynxCare™ applications.
Advantages to using ZynxHealth are standardized care, evidenced-based, interdisciplinary
plans of care, and order set management. These applications allow multiple reviewers
(via a web link) to review, and add recommendation comments, after the initial build.
Giving access to multiple clinicians to review at their convenience eliminates the need to
schedule specific times that may or may not fit into their busy schedule. One thing to
note is that the use of ZynxHealth is a project within itself that must be managed prior to
the final import into Epic, and after go-live and during on-going maintenance
In conclusion, regardless of the option an organization decides to utilize, an important
point to remember is that the content development process must include clinician
involvement (nurses, physicians, and interdisciplinary clinicians) during the
decision-making, design, build and validation of the content and workflow. But best of
all, you no longer have to reinvent the wheel when developing your content!
For more information on ZynxHealth visit
www.zynx.com