How One Doctor Adapted To His Hospital’s Epic EMR Install

Here’s some words on coping with new hospital EMR installs — and the Epic Systems EMR in particular — from the pen of the thoughtful Dr. Bryan Vartabedian, who blogs at

Dr. Vartabedian, a pediatric gastroenterologist, works at Texas Children’s Hospital/Baylor College of Medicine. Apparently, Texas Children’s has just transitioned inpatient medical records to Epic, and Dr. Vartabedian is hard at work figuring out how to adjust his workflow.

How is it going for him? Dr. Vartabedian compares moving from paper to digital charting to his learning experiences as a medical student:

When I was a medical student…I was preoccupied with the mechanics of the exam and history.  Head to toe skin exam, cranial nerves, DTRs.  It was about pocket eye charts and tuning forks.  I was focused on my H&P at the expense of my connection.  It was only after I became familiar with the whole process did I relax and begin to focus eye-to-eye on the issues of the patient. 

Today, he’s going through a similar adjustment process, Dr. Vartabedian says. At first, he notes, he was obsessed with clicks and pulldowns, data and documentation, but he believes he’ll come out of his tech trance over time. “I suspect that as I customize the flow of how I work in Epic I’ll reemerge to connect eye-to-eye with residents, nurses and patients,” Dr. Vartabedian writes.

In an interesting side note, a fellow physician who’s been using Kaiser’s Epic system dropped by to comment that he’s had the same experience.  “Dermdoc” said that he typically uses the EMR just before he enters the patient room. He only ends up using it during the patient visit if he has something to research, and he shares what he finds directly with the patient.

Dermdoc seems completely sold on his EMR — and seems convinced that his colleagues will inevitably get on board. “Like the Model T, there’s no going back,” he says.


About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

1 Comment

  • I’ve been professionally involved with EMR Implementations since 2004, therefore my observations allow me to state – thanks to nurses, in this year of 2011, EMR system applications and their usage of them have come a long way baby! Many, many more nurses and other clinicians are leading the way towards more successful EMR adoption and usage. Back in 2004-06 most EMR System applications were designed, populated, implemented, and maintained primarily by those “nerdy” IT folks (like myself). Since an EMR system is a computer based application, we were the type of professional staff first looked at to be hired and trained for EMR Implementations. We (EMR pioneers) were the ones first sent out to the clinical community with all our well-meaning computer ‘lingo’ and IT technical skills and knowledge to “show” them how to use it…long story short… early on it was very challenging, at the very least, it was a kind of professional culture clash for both the IT professionals and the clinicians! But then and now slowly but surely more and more nurses (and other clinical professionals) are being recruited and trained by EMR vendors to complete the many, many EMR Implementation tasks, side by side with Healthcare IT professionals. I must say the past five years of this shift in EMR Implementation methodology has been a great professional, informational and educational exchange – nurses have become a little more “technical” and healthcare IT folks have become more aware and respectful of clinical workflows regarding how and what clinical professionals do on a daily basis (“fair exchange is no robbery”) and the true EMR Implementation purpose for the ultimate benefit of the patient’s care.

    From over six years of observation from my perspective, there’s a reason EMR systems (at least the particular EMR I’m vendor certified in by Epic Systems, Inc. ) are beginning to be more acceptable and usable by nurses, physicians and other clinicians. I feel it’s because of this much improved EMR Implementation “methodology” that includes the combined forces of IT professionals, clinical professionals, and educational professionals. Several months ago I wrote about this force in my blog titled “…It takes a healthcare information technology village.” (I’m a regulare blogger at
    The best EMR Implementation “teams” (what EMR Implementation staff are called), are a combination of IT professionals, nurses, physicians, physician assistants, therapists, lab technicians, patient service and financial billing representatives, and others! Today’s most successful EMR Implementations and subsequent usage by the clinical community are now being managed by many nurses from all clinical service units (…and I would not dare call them ‘crusty night shift nurses”) who are bringing along their hard-earned and much sought after experience. As a Healthcare IT professional I really appreciate the improvements the outcomes of their input brings to our EMR industry which includes several phases; data gathering, workflow analysis, design, build, validate, training, etc. Nurses are now a part of every step along this way! Thus – it’s nurses (and other clinical professionals) who are now more readily utilizing these EMR systems that have been managed, designed, and implemented by their peers.

    It’s my observation that nurses and other clinicians who use an EMR system directly on the computer, while the patient is in the exam room and/or hospital room, is more than likely the EMR system they implemented with the help of their peers!


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