University of Arkansas for Medical Sciences (UAMS) researchers and students can now experience the Epic electronic medical record system in a custom environment curated for their use.
The UAMS Institute for Digital Health and Innovation (IDHI), the Department of Biomedical Informatics, and UAMS Information Technology (IT) recently teamed up to create a novel copy of Epic, using synthetic instead of actual patient data, to allow users to experience clinical workflows without operational and privacy constraints.
The electronic medical record software has been used at UAMS for more than eight years, allowing UAMS physicians — at first just those in Central Arkansas — to better collaborate with other care teams. In 2020, all of UAMS’ regional campuses converted to Epic, allowing for the streamlined flow of clinical information across a fully integrated UAMS Health system. This made records accessible to providers across the network as well as transferrable for more than 65,000 patients across the state.
However, giving students and researchers the necessary hands-on experience to become adept users of the unified health record system while simultaneously protecting the privacy and welfare of actual patients has been tricky.
A trend toward using simulated electronic medical records (EMR) systems has been increasing at medical schools nationwide in the last four to five years, said Kevin Sexton, M.D., associate chief clinical informatics officer and division director of IDHI Innovations, and Joseph Sanford, M.D., director of IDHI, associate vice chancellor and chief clinical informatics officer. Sexton and Sanford are both faculty in the Department of Biomedical Informatics’ Clinical Informatics Fellowship, and Sanford is site director of the fellowship experience at UAMS.
“IT created an Epic instance using synthetic data — records that our teams created from a test environment — and it works exactly like our current system,” Sexton said. “Now researchers and students will have full access to current clinical workflows and can have the same experience as our current users. Research teams will be able to see first-hand how data is captured in the system and leverage that experience to optimize their studies.”
To learn how electronic medical record software works as a provider, students previously had to use a second product or open-source software that didn’t provide the same experience that they will use regularly as professionals.
“In a clinical production environment, providing an unqualified user with increased access is a recipe for errors and mistakes. You would never give a medical student attending physician access,” Sexton said. “In this environment, students can see what it is like to be a practitioner, and they can order tests, lab studies and write notes. This way they can make mistakes and learn without putting anyone at risk.”
Now, Sanford said, “Residents and medical students can pretend to be attendings, and they can feel, to some degree, the burden or responsibility of making their own choices, and how that affects the patient. We must impress upon them the significance of some of their decisions and the thinking processes that physicians go through.”
“In the simulated environment,” he added, “we want them to make mistakes, so we have an opportunity to correct those mistakes without risking a patient’s safety.”
For researchers, Sexton said, the simulated version of Epic allows them “to see how data is put in, how data moves to the warehouse and how the data is extracted when you do a request or query.”
Because the novel system mirrors the real one, it will flag any prescriptions that would cause an allergic reaction or interact dangerously with another medication in a patient’s records, just as the real system does, Sexton said.
“This adds another level of sophistication,” he said. “It’s different if you’re the one sitting at the consult and putting in the information and making all the decisions.”
“In informatics, we’re trying to improve people’s interactions with the health care system through the electronic medical record all the time,” Sanford said. “By standardizing order sets, care protocolization and making sure that the right data is in the right place at the right time, we’re trying to make that delivering care with these tools faster, more efficient, more enjoyable and less frustrating, with a resultant improvement in quality of care.”
To learn more about the system, please contact Kevin Sexton at kevin.sexton@uams.edu.