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CA Nurses Sound Alarm Over Epic EMR System

Scott Mace, for HealthLeaders Media, August 16, 2012

A multimillion-dollar "go-live" implementation of the EpicCare EMR from Epic Systems Corp. came under intense scrutiny Tuesday when two nurses approached the governing body of a California hospital with patient safety concerns.

Those concerns stem from an incident at a Contra Costa County hospital clinic at the West County Detention Facility in Richmond, CA, where one nurse says the Epic system's recommended dosage of a heart medication "could have killed the patient."

"We're unable to document our medication administration correctly," said an emotional Lee Ann Fagan, speaking to the Contra Costa County Board of Supervisors in Martinez, CA.

A nurse familiar with the patient's medical history was able to override the system and adjust the amount of medication.

The story immediately spread via local media in the San Francisco Bay area, and highlighted concerns throughout the county hospital system about the Epic implementation.

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4 comments on "CA Nurses Sound Alarm Over Epic EMR System"


jltbdy (9/24/2012 at 11:31 AM)
Wow. sensationalism title. seems to me the content of this article has nothing to do with the title. Some other agenda? Simply because a facility's implementation has problems, doesnt mean the product is bad. I agree w/Andrew...mud slinging without any factual foundation. I'm a Hosp IT Analyst...my questions are: Why didnt the build issues get identified in testing? & Why can't the RN's work "with" IT instead of filing going around it?

Denise (8/27/2012 at 4:31 PM)
I have to agree in part with Andrew. Regardless of the system that is being used, ultimately nurses are the last line of defense to patients and the medications we receive. Computers will still have errors from time to time, but it does not mean that it is a bad system. We still have to mind our 5 "rights" (or however many there are now). Relying on computers to do the work for you will not serve you or your patients wisely. They are a tool to help and should not be seen as anything more.

Andrew (8/23/2012 at 12:08 PM)
Having worked extensively with Epic for the last 5 years, including several years actually at Epic, I feel your statement is incredibly unfair. In what situations have you seen where Epic doesn't hold up in challenging situations? What basic design flaws with the system are you referencing? I see you making broad statements without any real support or validation of your statements. Epic is a highly configurable system. The incident in question here is the result of a build error, not the fault of the application itself. There's nothing hard-coded into the system that would cause an incorrect dosage to be displayed. The incorrect dosage is 100% a build error on the analysts who was assigned to that particular build task. That's why Epic nor any other EMR, will EVER take the place of actual human review. Epic is installed to help make lives better, but that's very rarely without growing pains. What these nurses likely don't tell you or bring up is the insanely convoluted workflows, the mountains of handwritten and post-it notes that goes currently into meds admin [INVALID] I know, because I've seen it. The margin for error in a world-based on post-its is far far greater than that within a structured system.