This is an in-depth exploration of the fifth topic covered in my initial blog post: Streamlining Your Epic Lab Transformation: A Strategic Playbook (thelabitguy.com)
Introduction
Implementing Epic Beaker LIS as an add-on to an existing Epic system offers your organization an opportunity to revisit and optimize your integrated areas. While the immediate focus may be on bringing Beaker online, a Beaker project is a great time to review and refine other areas of Epic. Although this post focuses on Beaker add-ons, the principles discussed here can be applied to any Epic enterprise implementation, whether it’s a fresh install or an extension to new sites. This blog provides a roadmap for tidying up your environments and aligning your system with current best practices.
Getting Back to Foundation: The Importance of an "Epic Refresh"
When adding Beaker to a mature Epic system, it’s common to find that certain areas have drifted a little too far away from Foundation. Deviation from Foundation isn't necessarily a bad thing, but customizations made years ago may no longer serve their intended purpose or they might have introduced complexities that now burden system maintenance. An "Epic Refresh" involves revisiting previous customization and realigning them with Epic’s Foundation system. With more frequent Epic upgrades, getting back to Foundation allows your organization to streamline support and reduce the burden of maintenance and future upgrades.
When you think about an area to refresh through your Beaker install, a great example is Order Transmittal (OTx), which dictates how orders move through your system. Over time, Order Transmittal can become messy and disjointed across environments. During your implementation, take the opportunity to work with your Orders team to audit and refresh these configurations. You might do something as simple as copying your production OTx settings to your lower environments or do a complete overhaul. Regardless of your approach, revisiting your OTx settings can reduce the risk of errors and improve the overall efficiency of your system.
Moving closer to Foundation will help your team see long-term success. Aligning with Foundation early or realigning through an "Epic Refresh" can prevent future discrepancies and maintenance challenges.
Order Set and Preference List Clean-Up: IT-Driven Optimization
Another area to review prior to you Beaker go-live are your order sets and preference lists. These areas have a significant impact on system usability, efficiency, and end user satisfaction. In both Beaker add-ons and enterprise implementations—including new site expansions—the organization and maintenance of these tools are important for supporting clinical workflows.
During your Beaker implementation, take the time to review how your order sets and preference lists are structured. Are they organized in a way that supports efficient order entry by providers? Should they be grouped by location, specialty, or another criteria? Engaging with your clinical teams to understand their needs can guide this process, ensuring that the structure you choose enhances their workflows.
This clean-up process is not only about reorganization but also about eliminating outdated or redundant items that could clutter the system and confuse users. By streamlining these lists and aligning them with current clinical practices, you can improve the efficiency of order entry and reduce the risk of errors. Whether you’re implementing a new site or refreshing an existing system, this step is vital for maintaining clarity and usability.
Cleaning Up SmartTools, Links, Phrases, and Lab Result Components
As your Epic system grows, so does the potential for clutter in SmartTools, SmartLinks, SmartPhrases, and other tools that rely on lab result components. This clutter can reduce efficiency and make it more difficult for users to find the tools they need. Start by auditing the SmartTools currently in use - identify outdated or redundant tools and consider how they can be streamlined or removed. This cleanup process not only improves the user experience but also simplifies future maintenance, as fewer customizations mean less complexity in the long run.
For both Beaker add-ons and enterprise implementations, ensuring that lab result components are correctly mapped to LOINC and SNOMED codes is critically important. Accurate data flow within these tools enhances the reliability of clinical information, supporting better decision-making and patient care.
OR Integration and the Specimen Navigator for Micro and AP
The Operating Room (OR) is an area where integration with Beaker can drive significant improvements. The Specimen Navigator tool is a powerful feature within Epic that streamlines the ordering of Microbiology (Micro) and Anatomic Pathology (AP) specimens.
For Beaker add-ons, integrating Specimen Navigator within the OR workflow ensures that specimens are correctly documented, tracked, and processed. This not only improves lab efficiency and provider satisfaction, but also enhances patient safety by reducing the potential for errors.
Blood Bank Workflows and Integration
Blood Bank workflows require careful attention to ensure successful integration. The connection between your third-party Blood Bank Information System (BBIS) and Beaker is needed for maintaining safety and efficiency.
During your Beaker implementation, review your Blood Bank interfaces and workflows to identify any areas where integration could be improved. It isn't uncommon to also upgrade you BBIS alongside your Beaker install. This can be an opportunity to implement some of the new features offered by Epic for blood administration.
Blood Bank build often requires the coordination across multiple teams, including Orders, your interface team, and your Blood Bank vendor. To read more about successfully integrating with Epic see my blog here: Epic and Beaker Connectivity: Best Practices for Epic Integrations and Instrument Mapped Record Testing (thelabitguy.com)
Reporting: Enhancing Insights with Optimized Data
Reporting is an important component in both Beaker add-ons and enterprise implementations, as it directly impacts decision-making and operational efficiency. When implementing Epic Beaker LIS, particularly in a mature Epic environment or when extending to new sites, start by reviewing existing reports that rely on lab data. Are they still aligned with your current workflows and clinical needs? Overtime, reporting requirements can change, and reports can become outdated or misaligned with new workflows introduced with a Beaker implementation. Use your Beaker project as an opportunity to audit and update your reporting framework, try to avoid "recreating" every legacy report, and think critically about what reports will be the most useful.
Consider integrating Beaker’s lab data with other Epic modules to create reports that provide a holistic view of patient care. For example, linking lab results with clinical outcomes or resource utilization can offer valuable insights for both clinical and administrative decision-makers.
Additionally, ensure that your reporting tools, such as Epic’s Reporting Workbench or Radar dashboards, are configured to support real-time data analysis. This allows your organization to respond quickly to emerging trends or issues, ultimately improving patient outcomes and operational efficiency.
To read more about Beaker reporting, see my blog here: Beaker Reporting: Untying the Knot of Lab Data (thelabitguy.com)
Conclusion
Whether you’re implementing Epic Beaker LIS as an add-on, rolling out Epic at a new site, or implementing Epic across your entire organization, the principles of tidying up and optimizing your integrated areas remain the same. An "Epic Refresh," focused on getting your system back to Foundation, is an important step in maintaining clean and more easily maintained Epic environments. By applying these best practices, you can ensure that your system not only meets today’s needs but is also prepared for future changes and challenges.
More about Kyle:
With 7 years of Beaker experience, I have been deeply involved in Beaker across 11 different healthcare organizations. My journey has taken me from entry-level roles to leadership positions, managing projects that span from initial implementation planning to post-live optimizations and ongoing maintenance. My expertise lies not only in the technical aspects of Beaker but also in leading teams to ensure successful a successful project.
While my experience has been rich with diverse challenges and learning opportunities, the insights I share in this article are drawn from my personal expertise and do not reflect the views or opinions of my employer or the healthcare organizations I have supported. They do not include or represent any proprietary information from Epic Systems Corporation. The content presented here is my own intellectual property, intended to guide and inform others in the healthcare IT community as they embark on their own Epic Beaker lab transformation journeys.