Nursing Informatics Education and Training Case Study

Sutter Health is a not-for-profit unified healthcare network providing comprehensive medical care in more than 100 Northern California cities and towns. Sutter has 53,000 employees and 12,000 physicians in their network, making them the eighth largest health system in the U.S. Annually, Sutter provides over 50 million moments of care and delivers 1% of all babies born in the U.S.

In March of 1999, a single allergist in Davis, California, became the first EpicCare user at Sutter Health. The first pilot at Palo Alto Medical Foundation (PAMF) began in June of 1999 at the Los Altos Center allowing “View Access” to see transcriptions and the physician’s schedule. Physicians were encouraged to begin the process of abstracting paper charts into EpicCare including immunization dates, problem lists, as well as past medical, surgical and family histories. Over the next few months, test results would show up through a new interface with our lab information system, Sunquest, and eventually pathology reports. The success of the Los Altos pilot, lead to “View Access” for every PAMF physician in December of 1999, and was soon followed with physicians gaining the ability to enter orders, use smart sets, fax prescriptions directly to pharmacies (a huge patient satisfier) and place routine, future and standing orders. Over time, Sutter partnered with Epic to implement their new health maintenance and other decision support functionality.

Our informatics journey continued with the acute care implementation of our Sutter EHR in 2007/2008. Each hospital was relatively autonomous, and variations in operations were prevalent. The EHR implementation was led by our Information Services (IS) division, who gathered over one hundred operational and clinical stakeholders in 2007 to help design the EHR. For a number of days, stakeholders convened in large hotel conference rooms and were asked to make EHR design decisions. We had no idea that this would be a journey, and not a one-time discrete event. This approach was likened to asking a person who has never seen water to build a bridge.