LRS has now supported more than a dozen Epic 2018 go-lives with VPSX software in place. For the most part, these have gone well. In several cases, this has occurred without our knowledge or assistance. It would be nice if we could say that this was always the case.
The key to a smooth go-live is, of course, testing. We are all aware of the challenges in this area, but because of changes in the underlying print infrastructure of Epic 2018, it is very important to deal with this issue. How important? Serious enough that LRS suggests getting executive sponsorship of the testing regimen in your organization. This is one way to make sure you get all the correct personnel appropriated to fully test the environment and shake out any problems lurking in the wings.
Here are some print-related factors to consider, which include lessons learned during previous go-lives (often the hard way). Think of it as a checklist to guide your testing process:
- Performance – Remember that with Epic 2018, much of the heavy lifting is being moved from the current VPSX arena and over to EPS. As such, care must be taken to ensure that the EPS environment is scaled to handle the load. We know of several organizations that needed to add multiple EPS servers to the farm right after go-live to deal with the additional workload. This can be difficult and stressful to do after the fact. Please do not use the number of VPSX servers as a guideline to determine the number of EPS servers needed, as the two are not directly related. Work with your Epic TS to carefully evaluate the best approach. It might even be worthwhile to add more EPS servers than you think are necessary, and scale back later as appropriate.
- Special needs documents – These are documents that are specific to the workflows in your environment. You need to carefully examine what special documents you are using and how they impact care-related processes. Some examples include:
- Documents pulled from specific trays
- Pre-printed forms
- Documents that use plain-paper copy protection
- Armbands where text may be used to specify size or content at print time
- Documents that land in file shares.
- Documents that use LRS-provided plugins
- Willow jobs (which could include XAML jobs, Willow Batch jobs, or both)
- Labels – There are a variety of ways that labels are handled today. Some of these require no processing, some require a lot. Here are some areas to consider:
- RAW labels that pass through EPR records that have DEVINIT tags. With Epic 2017 and earlier, these were pretty much a non-issue because LRS dealt with the DEVINIT tags during processing. With Epic 2018, if your EPR records associate PCL DEVINITS with ZPL documents, the label will not print. Be sure to test a number of different (read ALL different) types and models of label devices and their EPR records.
- SmartLabels – These may use LRS’ own PDF to ZPL transform, or they may use the Windows print mechanism. Be sure to test all models in your organization, with special emphasis on:
- Print direction – Some devices may need to have the labels printed inverted, otherwise your users will tell you that the labels come out backwards.
- Resolution – Remember that there are both 200 dpi and 300 dpi printers. Make sure these are identified by their device model, and that the ZPL transform is set up properly to handle this
- Label positioning – Because labels are coming across as PDF documents, the positioning almost always needs to be tweaked
- Beaker labels – The ability to pass raw ZPL through the process is a fairly recent addition. Make sure to test these jobs on all models of label printers.
All of these areas can be difficult to chase down while in the heat of a go-live, and all can affect proper patient care. Taking the time to comprehensively test these particular areas in advance of the go-live will make the process much smoother… for you, for the clinicians you support, and for the patients that rely on your success. As always, if you have questions about printing in your Epic environment, feel free to contact the Epic document experts at LRS and we’ll be happy to help.