Information Technology Articles

From Paper Records to an Epic System

Al Krider

Al Krider has worked on each EHR system Seattle Children’s has implemented and has been on the Epic team since 2006.

When Senior Solutions Architect Al Krider started working at Seattle Children's in 1974, the idea of an electronic health record (EHR) was almost inconceivable.

He remembers when the hospital opened the A, B and C wings (now part of the River zone) and each physician workroom had a computer outlet.

"People were not at all happy because 'what on Earth is a unit coordinator or a doctor ever going to do with the computer?'" Al recalls.

But Al knew where Seattle Children’s was headed. Over the next 40-plus years in Seattle Children’s Information Technology (IT) department, he helped design a clinical system that would set Seattle Children’s apart.

The move to digital records

In the 1980s, Al helped Seattle Children’s start transitioning from paper to digital records. Slowly, individual departments, including Lab and Radiology, received their own computers with unique systems for their data and workflows.

“By the early 1990s, we had a bunch of individual computers with individual systems on them, and then people started to think, ‘Wouldn't it be nice if we could at least get the information visible in one place?’” Al says. “So that's when we started looking at systems that could consolidate patient information.”

In the mid-90s, Seattle Children's launched its first EHR with read-only access to labs, radiology results, patient demographics and a subset of notes from other systems.

“To have them all on one terminal was a monumental achievement,” Al says.

In 2002, Seattle Children's moved its medical records to the Cerner system, and in 2008 it adopted Epic for registration and billing. For the next 12 years, Al and the Seattle Children’s Clinical Applications IT teams focused on making these two systems work together.

Setting the foundation for the future

That changed in October 2020 when Seattle Children’s joined other top pediatric healthcare institutions by adopting an integrated EHR with Epic to transform the way care is delivered. Epic offers a foundation with a standard set of pediatric tools for Seattle Children’s to build and innovate on to meet the needs of patients, families, clinicians, support teams and the community.

With a better set of tools and an integrated system, Epic team analysts are able to work directly with Epic users across the organization to configure the system to support their workflows. Al serves as a resource to help analysts with some of the more technical aspects of Epic.

They launched Epic with 23 modules and plan to introduce up to five new modules this year to support new and existing service lines, including Willow Inventory (a pharmacy inventory system) and Blood and Marrow Transplant. The latter will support Seattle Children’s plans to consolidate all pediatric bone marrow transplant care from the Seattle Cancer Care Alliance to Seattle Children’s in July 2022 and allow families to navigate one instance of MyChart.

Al and his colleagues have also maintained a 99.999% uptime and reduced downtime for upgrades from over two hours to just 18 minutes. This has reduced disruptions to patient care and allowed new features and fixes to be introduced on a much quicker timeline.

"It starts with a solid foundation that we can build on,” says Al. “What's most important to me is not telling you what we're going to do next — it’s realizing that we're going to think of things years from now that we haven't thought of yet and we can use this foundation and these tools to do those things."