Page 3 of 10: EPIC Project updates for our involved MDs: Training and Exemptions & Order Sets

*Sent on behalf of Trevor Jamieson*

- We are still recommending that even those MDs who feel they will get an exemption still sign up for a training slot.  There are a few reasons for this:

1. they may not actually get an exemption or they may not pass the end user proficiency assessment. In either of those cases, they will be stuck with regular training, and will need a timeslot that works for them

1. regardless of exemption, people will still need to complete a 2 hour "user settings lab".  These are currently tacked on to the training days.  By signing up for a training day, they will still be guaranteed a slot for that USL.  It's possible that we will need to release their training slots to make room for others who need full training and lack a slot, but by default we can assume they have that slot confirmed

Order Sets

- Unity is currently building more than 2 x the number of order sets than some peer institutions who have gone live (e.g. UHN 130, Unity current 278).  This is after reducing our prior lists by over 30% (we started at over 400 - thank you for the work to help with that rationalization)

  - This is putting a significant strain on resources to get them built and validated, and we will need to prioritize the work.  It also creates a significant downstream maintenance issue.

  - Many (many) of these existing order sets are used less than once a month - a number are less than once every 2 or 3 months or even less than once a year.  Quite a number were far, far, out of date (at times last updated in the early 2000s) - emphasizing the maintenance challenge of having such a large number of sets.

  - For go-live we are going to prioritize the build of order sets that have higher rates of utilization and/or involve higher risk meds/processes and others will occur later.  We will also ensure that all specialties have at least a number of core minimum order sets that they can leverage.

  - Many of these order sets also require committee review. They work to ensure that the orders conform to the professional standards of others, like nursing, and that medications included meet basic criteria (like being on the formulary)

  - As an org though, we also need to recognize that having such a large volume of order sets begets low utilization (as they become harder to know about and to find) and maintenance challenges and to strategize on how to continue to rationalize this work over time

Thank you for reading and for all your continued effort on the project.

Trevor