2. Ambulatory Overview July, 2016

3. What is Ambulatory? Ambulatory Overview EpicCare Ambulatory refers to all Epic applications encompassing an outpatient visit. There are also Ambulatory Specialty modules integrated within EpicCare Ambulatory for certain specialty departments. EpicCare Ambulatory integrates with EpicCare Inpatient to ensure continuity of care throughout a patient’s life in the Epic Chart. Team Structure The Ambulatory Team is made up of about 40 individuals with a variety of backgrounds, from Clinical to IS and beyond. They collaborate and interface across 10 teams making up Health Information Partners (HIP). Current State The Ambulatory Team completed the design phase and re-engineering sessions, where operational group members, subject matter experts (SMEs), consultants, and HIP team members made decisions to standardize the patient chart and experience for Epic EHR go- live. Next Steps The next step is to finalize the scope for the applications under the Ambulatory umbrella. The build phase for Epic began in January, and Operations Group meetings take place on an ongoing basis throughout 2016.

4. Ambulatory Team Structure

5. Overview of Ambulatory Applications

6. Ambulatory Core Overview Ambulatory Core supports Primary Care Providers and specialties in all ambulatory clinics, WUCA practices, BJC Medical Group, and Corporate Health. Ambulatory Core also supports: MyChart Patient Portal EpicCare Link Physician Portal (supports and maintains) Scope Ambulatory scope will be replacing these systems: Touchwork EMR in all WUSMs Outpatient Clinics at all locations and WUCA Practices NextGen and Agility in BJC Medical Group and Corporate Health MyChart patient portal will replace WUSM FMH, myBJC, and Next MD patient portals EpicCare Link will allow affiliated physicians to submit orders and monitor patients with managed care Outpatient PT/OT/Speech for BJC and WUSM will also go live on Epic replacing Chart Links and Connect Team Structure 19 Analysts 2 Principal Trainers Director: Michael Kriemelman Project Manager: Dee Jones (jonesdee@wusm.wustl.edu)jonesdee@wusm.wustl.edu

7. MyChart Overview MyChart is a part of Ambulatory Core and is an application providing patients with the ability to view their medical information and to communicate securely with their provider’s office. MyChart also: Allows for pediatric and adult proxy access Incorporates patient entered data to be sent to the Epic chart Provides educational materials for the patient Scope MyChart patient portal will replace WUSM FMH, myBJC, and Next MD patient portals Team Structure 2 Analysts Project Manager: Dee Jones (jonesdee@wusm.wustl.edu)jonesdee@wusm.wustl.edu

8. Timeline Ambulatory Core Clinical BenefitsImpacts Standardization on daily workflows Integration with Inpatient for better patient care Allows documentation across the patient spectrum Patient-entered data to flow to chart with communication Robust decision-support tools to aid in the care of the patients Patient participation in their healthcare through MyChart Patients and Providers Ambulatory clinics and staff Practice Management Systems groups Enterprise wide IT departments Current patient portals Touchworks Support Group Team Michael Kriemelman – Director Dee Jones (jonesdee@wusm.wustl.edu) – Project Managerjonesdee@wusm.wustl.edu 19 Analysts 2 Principal Trainers

9. Ambulatory Specialty Overview Ambulatory Specialty modules integrate with EpicCare Ambulatory (Core) and Inpatient to provide workflows and tools specific to areas including Ophthalmology, Orthopedics, Transplant, and Population Health. Scope Implement specific specialty-based modules in Ophthalmology with Kaleidoscope, and modules Orthopedics, Transplant with Phoenix, and Population Health Management with Healthy Planet. Team Structure 7 Analysts 3 Principal Trainers Director: Michael Kriemelman Project Manager: Eric Richards (Eric.Richards@bjc.org)Eric.Richards@bjc.org

10. Timeline Ambulatory Specialty Clinical BenefitsImpacts Offers specialized workflow and functionality for each specialty Diagnosis based auto-population of information in the chart Better clinical decision tools based by specialty Ability to be proactive with patient health care by use of Population Health Orthopedics – Adult and Pediatrics Ophthalmology – Adult and Pediatrics Transplant – Adult and Pediatrics Population Health initiatives across BJC and WUSM Enterprise-wide IT departments Current patient portals Touchworks Support Group Team Michael Kriemelman – Director Eric Richards (Eric.Richards@bjc.org) – Project ManagerEric.Richards@bjc.org 7 Analysts 3 Principal Trainers

11. Home Health and Hospice Overview EpicCare Home Health and Hospice are applications designed to specifically meet the needs of remote access for care given in the patient home, and required documentation for Home Health Care and Hospice. It allows improved communications among all of the patients healthcare providers. Scope EpicCare Home Health will supersede the current application with a more robust, remote capable, standard, and improved charting ability for the clinicians that both assess and document patient care within the Home Care or Hospice environments. These applications allow for an improved view of the patient and how their progress is measured once at home or hospice. EpicCare Home Health and Hospice includes: Medication Administration Home Therapy Hospice Care Bereavement documentation Team Structure 4 Analysts 1 Principal Trainer Director: Michael Kriemelman Project Manager: Lisa Aydt (laydt@bjc.org)laydt@bjc.org

12. Timeline Home Health and Hospice Clinical BenefitsImpacts Remote access to document patient care while in the field Easy to use documentation and charting Coordinates patient care with Inpatient and Ambulatory Improve communications with all providers involved in patients care Patient access to information by MyChart Patients and Home Health and Hospice staff All clinicians who provide care to the patient Team Michael Kriemelman – Director Lisa Aydt (laydt@bjc.org) – Project Managerlaydt@bjc.org 4 Analysts 1 Principal Trainer

13. Research Overview Ambulatory Research incorporates tools to assist research teams with enrollment and documentation of research studies and improves efficiency of clinical care for patients in research trials. It provides integrated clinical and research information for a comprehensive picture of the patient’s medical profile that easily identifies what orders and medications were part of a study. It provides an all-in-one medical chart that will identify patients for a research study and then tracks the specific study, the patient’s progress, any relevant documentation, and gives all providers an overall view of the patient’s health—both inside and outside of the research study. Scope Ambulatory Research uses MyChart for communication to the patients and to give them access to their own medical records. Team Structure 3 Analysts 1 Principal Trainer Director: Michael Kriemelman Project Manager: Heather Reed reedh@wusm.wustl.edu reedh@wusm.wustl.edu

14. Timeline Research Clinical BenefitsImpacts Tracks patient progress more efficiently Filters to review patient charts in order to identify research specific orders and medications, and pharmacy routing Electronic notifications to accelerate subject recruitment Area in chart to document current research participation Research and clinical information charted live in one spot Patients and Research Providers Inpatient, clinics, and emergency departments Practice Management Systems groups Research departments and their process flows OnCore Support Group Enterprise-wide IT departments Team Michael Kriemelman – Director Heather Reed (reedh@wusm.wustl.edu) – Project Managerreedh@wusm.wustl.edu 3 Analysts 1 Principal Trainer

15. Ambulatory Specialty Applications

16. Kaleidoscope Overview Kaleidoscope is integrated with EpicCare Ambulatory and provides the tools for adult and Pediatric Ophthalmology departments. It allows for special documentation tools for ophthalmology visits in pediatric and adult settings. Scope Kaleidoscope includes navigators, flowsheets, and templates specific to certain eye exams. Team Structure 1 Analyst 1 Principal Trainer Project Manager: Eric Richards (Eric.Richards@bjc.org)Eric.Richards@bjc.org

17. Orthopedics Overview Orthopedics expands on EpicCare ambulatory to inform and expedite orthopedic workflows. Scope It includes tools focusing on body locations and orthopedic medication documentation. Team Structure 1 Analyst 1 Principal Trainer Project Manager: Eric Richards (Eric.Richards@bjc.org)Eric.Richards@bjc.org

18. Phoenix Overview Phoenix is integrated with EpicCare Ambulatory and supports detailed workflows for solid organ transplants. Builds off of Ambulatory tools to provide specific documentation for solid organ transplants. Scope It includes pre and post-transplant documentation workflows. Team Structure 2 Analysts 1 Principal Trainer Project Manager: Eric Richards (Eric.Richards@bjc.org)Eric.Richards@bjc.org

19. Healthy Planet Overview Healthy Planet is the application within EpicCare Ambulatory used to populate health management records. Healthy Planet allows for population health management and incorporates tools into the Ambulatory module for population identification, risk stratification, outreach, and beyond. It helps health care organizations define, understand, engage, and track patient populations, as well as measure and improve care processes and outcomes over time. Scope Healthy Planet includes: The ability to define patient populations based on a variety of criteria (e.g. demographic data, chronic diseases, etc.) using registries within Epic The ability to understand populations through robust analytics, risk stratification, and benchmarking Through Care Management workflows, the capability to engage patient populations for proactive patient care, high-risk care management, longitudinal care planning, and interactive patient tools Patient outreach tracking and analytics to track population and help evaluate the success of clinical programs among patients Team Structure 3 Analysts 1 Principal Trainer Project Manager: Eric Richards (Eric.Richards@bjc.org)Eric.Richards@bjc.org