August 1, 2001 - A Day that Lives in Infamy

I toiled as a family doc at a Sutter Health. The main building was all on Epic. The family physicians, in our “satellite clinics” remained on paper. A patient would come in after seeing a specialist. The main building providers no longer remembered to fax over a note, as they all automagically had access. I apologized to the patient and picked would call. The staff would be annoyed at the work of answering the phone and sending the consult. I would fall behind; the patients were cranky at the delays. I was cranky at the delays. I begged to be up on Epic too.

August 1, 2001.

They flipped the switch in my office and I got Epic. In those prehistoric days, Epic didn’t have much in the way of templates, and doctors had godlike access to developers tools. “Easy” the analysts told me, make yourself a SmartSet! Make yourself a SmartText! Click here! Do this!

Grrrr! I was busy. Three daughters, all preteens. My panel size was pushing 5000. (That is not a misprint.) I was on the group’s board of directors and in line to be the hospital’s Chief of Staff. As physicians are wont to do I whined. I whined directly to the directors and CEOs. Sleep was optional.
I made SmartSets. I called my buddies in their specialties soliciting help. I was going to do it right. I looked to references to find the evidence. My SmartSets were da bomb.

Eventually, I termed out of other leadership roles. Before I took a deep breath, the CEO of the group made a personal visit to my office. That never happened. (I wonder who died.) He sat down. (I was really worried.) He asked me to be the Epic Champion. Oh. Heck. No.

“I am not good at that stuff”

“Precisely,” the CEO retorted, “you have credibility.”

“I want to do quality”.

“This is quality” he asserted.

I have a bad habit of saying “nooooookay.” I said: “nooooooookay but PROMISE me, promise me, promise me, that I won’t be pegged in a tech job forever.” He assured me it would just be for a few months.

Thus, it began. I was champion for a few months. That role rapidly evolved and I found myself the regional Epic Lead. I never looked back. My girls grew up and moved off to college. The timing was right for me to return home to my native Los Angeles and join Cedars-Sinai.

The lessons I learn continue. The EHR is not just a paper chart. Like a paper chart, it is a tool which should be used to effectively and efficiently communicate to our peers while meeting coding and compliance regulations. Yet, it is much more. The EHR is a means to help us prevent errors and offer clinical decision support and knowledge transfer. The EHR is the biggest change to medicine since the stethoscope, or antibiotics.

Advice is simple, wise, and oft repeated. Keep the patient central. Respect workflows. Listen to the physicians. Count clicks. Clicks are evil.

About the Contributor

Lisa M Masson, MD, MBA, Medical Director Informatics, Cedars-Sinai Medical Center is a current member of the HIMSS Physician Committee.