Whether it’s because it’s been named #1 in KLAS every year since 2014, scholarly articles about successful implementations like this, this and this, or even just a sense of nostalgia for one of Jim Henson’s fuzzy creations, many organizations have decided to make the switch to Beaker as their laboratory information system (LIS). If you and your team are among those making the switch, this is how you should prepare for your upcoming Beaker implementation (short of camping out in Verona for an earlier implementation slot).
Similar to other Epic implementation projects, project artifacts such as a Charter, Budget, Timeline, Staffing Plan will need to be created. In addition, Laboratory Steering and Governance committees may need to be formed, if not already existing. A formal plan for rapid decision-making and escalation of issues needs to be developed to encompass both internal laboratory implementation issues and issues needing coordination with the existing Epic governance structure.
Documentation on current interfaces, third-party systems and external data sources should be accurate and up-to-date. In addition, inventories of existing instruments, satellite devices and other hardware (printers, scanners, workstations) will be helpful for pre-implementation planning.
A decision on Blood Bank functionality is an important part of pre-implementation planning because Epic’s Beaker does not include functionality for Blood Bank and Transfusion management. If possible, you will need to retain your existing Blood Bank vendor or install a new solution in parallel with the Beaker implementation. Epic and Mediware have an agreement covering the licensing and integration of Mediware’s HCLL Transfusion system with Epic’s Beaker.
Decisions on the use and integration of Epic’s Blood Product Administration Module (BPAM) and Positive Patient Identification (PPID) functionality will affect the requirements for Blood Bank software and integration.
While it’s technically possible to integrate all analyzers and instruments directly into Beaker, most organizations use one or more third-party middleware providers to interface lab instruments. A typical lab implementation may include direct Beaker integration, third-party middleware (such as Data Innovations, Dawning Technologies and others) and instrument manufacturer middleware. Pre-implementation planning will need to include formation of a strategy for instrument interfacing. Discussions will also occur during the implementation related to reflex testing, autoverification, quality control and other needs that relate to middleware decisions and functional abilities.
In addition to instrument integration, an integration strategy and planning will be needed for satellite labs, POCT, Reference Labs, outreach EMRs and other interface needs.
It’s never too early to develop a strategy for data conversion when preparing for an LIS implementation. Multiple technologies, strategies and vendors will be employed depending on the volume, age, source systems and scope of your conversion activities. In addition, anatomic pathology case and specimen tracking conversions introduce additional complexities beyond clinical pathology results conversion, requiring additional planning and execution time. Work with your conversion team, Epic and legacy vendors to determine a plan, timeline, staffing requirements and budget needs for conversion activities.
Assembling Your Team
When beginning resource planning and staffing your implementation team, it’s important to consider not just the dedicated Beaker resources you will need, but also the support that will be needed from other integrated Epic areas.
Your core team will include:
- Certified Analysts for CP and AP
- Integration Engineers and Developers for Devices and Interfaces
- Conversion Team
- Blood Bank Implementation/Integration
- Reporting Team
- Training Team
- Testing Lead
The integration and reporting needs are much higher for Beaker than most other modules, so ensure adequate staffing for these critical areas.
Additional Epic resources will need to be available to support the Beaker implementation. These needs will vary depending on whether Beaker is being included as part of an enterprise install or as an add-on module. Third-party integration (Blood Bank, instrument middleware), Epic integration (Rover for specimen collection, BPAM, PPID, external reporting) and other implementation decisions will also impact the need for resources outside the laboratory. Extensive coordination will be needed with the orders, clinical documentation and billing teams throughout the organization. Additional support may also be needed by the infrastructure, cache and web services teams.
Any LIS implementation is a complex process requiring resources and commitment from both the laboratory and the entire enterprise. However, seamless EMR integration, access to the full medical record at the bench, enhanced reporting capabilities and reduced maintenance requirements are significant benefits to be realized. Medix Technology experts are available to assist with strategic planning, project management and staffing of project, training and support teams.
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About the Author:
Jason Kulaga, Practice Director – Healthcare Solutions, joined Medix Technology to focus on leading and growing the consulting and advisory services practice. He is a PMP certified registered nurse with 25 years of experience in healthcare, including 4 years working at Epic in clinical implementation and 15 years overall experience in EHR implementation, project management, delivery oversight, and consulting leadership. Jason is primarily focused on mentoring and advising internal consultants and Medix Technology clients on topics including implementation planning, project management, community connect, interoperability, workflow, and system optimization, change management, project governance, and physician adoption.
I hate Beaker. I have worked in my hospital in Microbiology for 31 years and have been happy and productive. We switched to Beaker in May 2021, and it has been a nightmare for me. I have gone home in tears at least 3-4 times a week. I average at least 14 hours or more of overtime per pay period because everything done on Beaker takes fooooooorrrrrrreeeeeeveeerrrr!!!!!!! The labels are messy, the screens are crammed with everything BUT the information I need, and print on everything is too tiny for my 60-year-old eyes to read. I think that the best thing EPIC could do is hire people like me in my 60s (remember that half of all lab workers are older than 50 years old) I HATE BEAKER!!!!! I have three months to go before I retire, and I honestly don’t think I’m going to last that long. Beaker has turned my last year of working into sheer hell. The day I retire, I plan to burn an effigy of the muppet Beaker in my driveway to celebrate being free of this awful system.