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There are many ways to use Beaker’s features in the wrong way and few “guardrails” to help, Dr. “But what we should have done is taken ownership of laboratory orders right from the beginning,” in the pre-Beaker days, “and it would have simplified a lot of our downstream efforts,” said Dr. “We could just use the Cerner names in our laboratory, so it didn’t affect the lab directly.” As the lab moved to Beaker, “it became an imperative to own laboratory orders because we were the recipients of the build.” Thus, even before selecting a new LIS, the pathology department spent several years harmonizing lab order names across the three hospitals. “And they started building things based on this interface.” The ambulatory systems were sending orders to the lab’s Cerner system and a mapping occurred. ‘It’s a very configurable system, but there are not a lot of guardrails that keep you moving on the right path.’ -Raj Dash, MDĪt the time, Duke had a laboratory orders team operating as part of an EMR and independently of pathology.
BEAKER MEANING SERIES
“Twelve characters for over 8,000 order ? You can imagine the series of letter combinations we had,” he said. The version of Meditech the hospital used had a 12-character limit for lab order names. “And we did not have the same names for most of our most commonly ordered tests,” he said. Standardizing lab test order names was tough as Duke prepared to transition to Epic EMR.īefore implementing Epic EMR, Duke’s three hospitals each used a different system-Meditech, Siemens, and a homegrown EMR-and a McKesson CPOE. “And I didn’t recognize the potential benefits or the potential workload of getting involved at the enterprise level.” “We were happy to just manage our area,” Dr. “They have gotten to learn Epic Beaker together,” he said, “and it’s a very collegial relationship.”īefore Beaker, when Duke implemented a new CPOE system, pathology was involved only from an interfacing perspective and not in designing decision support rules. Now, 60 Beaker super-users meet monthly, and LIS analysts meet on site in all the laboratories. In pre-Beaker days, Duke had only one director in the labs who worked with the LIS team. Dash, who is also medical director of laboratory information systems, Duke Health. Duke’s laboratories, having moved to an enterprisewide system, have “never been closer” with IT, said Dr. The 2014 version, however, included rich text formatting, a maturing CP module, workable microbiology and AP modules, and “solid” cancer synoptic implementation.ĭuke University went live with Epic EMR in 2013. Dash said, “wasn’t even as good as a glorified word processor.” On a technology hype curve, he said, “I think there is still a trough of disillusionment but it’s getting better for Beaker, and I’m here to, I hope, reset some of the expectations.” It’s about understanding what you have to put into the product, he said, to get what you want out of it.Īfter evaluating the 20 versions of Epic’s Beaker and installing the 2012 version at one of Duke’s two community hospitals, the laboratory decided to delay a systemwide implementation until Beaker’s 2014 version release. Dash, vice chair of pathology IT at Duke University Medical Center, shared what he called the blessings and curses of his department’s move in 2014 to a lab information system that’s fully integrated with the electronic medical record.