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Guiding Principles


  • Provide safe, effective patient care
    • Create a lifetime, patient-centered medical record. One patient-One record.
    • Right information/right time/right person
    • Prevent errors
      • Removing the ability to make an error is better than warning that one is occurring
    • Make the right thing to do, the easy thing to do
    • Provide relevant and evidence-based decision support
    • Anticipate other data uses – plan for secondary analytics
  • Engage patients and families in their care
    • Care takes place at the bedside
    • Always encourage patient interaction
    • Document within the visit
    • Provide patients online access to scheduling, billing, and clinical information
    • Deploy the patient access portal ,MyChart, on day 1
  • Help caregivers be efficient, engaged and productive
    • No paper - There is only one place to go for the record
    • Encourage communication between caregivers
    • Avoid information overload. Provide just enough.
      • Use decision support only when it is likely to be acted on
      • Provide links to supporting information when it is needed in the workflow
    • Simplify
      • Eliminate wasted action
      • Automate workflow where possible
      • Standardize
      • Enter data once
      • Intuitive navigation
      • Available everywhere with device flexibility
    • Charges are captured at the point of documentation
  • Make WakeMed an efficient, effective organization
    • Anticipate other data uses – plan for secondary analytics
    • Accurately and appropriately charge for care that is delivered
    • Plan for scalability and anticipate growth. Allow the organization to be nimble.
    • Maintain the ability to easily add new facilities, acquisitions, service lines, and affiliates
  • During implementation:
    • Get live quickly. Commit to post-live improvements.
    • Stay on time. Adopt an “urgent culture”
    • Stay within budget
    • Leverage the work of others:
      • Extensively use and contribute to the Epic Community Library
      • Follow Epic recommendations
    • System build will take into consideration ease of use for clinicians, patient centered care and future system viability
    • Measure success by setting and tracking metrics. Focus on outcomes


  • Implement Foundation System as much as feasible
  • Use Epic instead of other vendor products where possible
  • Executive and Operational ownership of the project
  • Subject Matter Experts available when needed
  • Dedicated project resources to meet timeline commitments
  • Team Training
  • For access to Epic, Training and education are require not optional
  • Staff interacting with Epic and other electronic systems, will be held accountable for ensuring the integrity of the data entered into the electronic system
  • Use of Epic for documenting patient encounter is required for all staff and providers involved in the care of the patient
  • Computerized Provider Order Entry is required for all patient encounters
  • Dates and timelines are enforced


  • Participation and attendance at meetings is required – if you can not attend accept and embrace decisions made
  • Decisions are made and supported at the lowest level appropriate
  • Do not revisit decisions – avoid analysis paralysis
  • Agree to disagree, but understand decisions made, are done so by the group – Avoid saying “that is not what I wanted”
  • Use the five why’s of problem solving to challenge current thinking – status quo is not an option
  • Avoid “we can’t” statements – should be replaced with “additional information will be required before…”
  • Avoid trap of “it is regulatory”, “we’ve always done it that way” – make sure statements / request are validated before finalizing decisions
  • Decisions are made with use of foundation system and best practice recommendations in mind
  • If agreement cannot be reached, escalate the decision and abide by the result

Improve the health of our community through the implementation of an integrated Electronic Health Record that provides information to caregivers, patients, and families when and where it is needed.

Within 2 years, WakeMed will be a HIMSS Stage 7 organization which means…

  1. The organization no longer uses paper charts to deliver and manage patient care and has a mixture of discrete data, document images, and medical images within its EMR environment.
  2. Data warehousing is being used to analyze patterns of clinical data to improve quality of care and patient safety and care delivery efficiency.
  3. Clinical information can be readily shared via standardized electronic transactions (i.e. CCD) with all entities that are authorized to treat the patient, or a health information exchange (i.e., other non-associated hospitals, ambulatory clinics, sub-acute environments, employers, payers and patients in a data sharing environment).
  4. The hospital demonstrates summary data continuity for all hospital services (e.g. inpatient, outpatient, ED, and with any owned or managed ambulatory clinics).



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