Top 5 Enhancements to Epic Beaker 2018

October 2018

Some organizations have viewed Beaker as an immature application that lacks the necessary functionality needed to efficiently carry out departmental workflows, including areas such a Microbiology and Molecular Diagnostics.  With each upgrade more functionality is introduced, but it seems to be at a slower rate than most laboratory operations desire.  This begs the question: how much has the 2018 upgrade enhanced Beaker?

Here is my compilation of the top five enhancements to the Beaker 2018 rollout:

1.) More Streamlined Microbiology Workflows
In areas such as Microbiology, Epic advertises a significant change, but most of the functionality was retrofitted into 2015 and 2017, which makes the enhancement a little less impressive.  While the added functionality from the past year did improve workflows by allowing users to mark isolates as “Done” or “Deleted” and to filter isolate views to track and document isolate level workups, the 2018 functionality for documenting plate level findings is a long-awaited upgrade  The new way to document plate level findings allows for:
• Plates to be added on the fly. In turn, media labels can be generated directly from result entry (so no having to trek back and forth between result entry and the setup bench!)

In addition, a workaround is no longer necessary to flag a gram stain as abnormal; it can be automatically set up to trigger a flag when checking the stain component result

2.) Molecular Diagnostic Testing Workflow Support
Initial full adoption of this functionality, including interfacing variant data is most likely not practical, but there is flexibility to take advantage of some of these new features.  In particular, the workflow utilizes a hybrid of AP and CP functionality that allows for:

• Workflow steps to be built for efficient tracking of the specimen’s progress, a template-driven result flow, and the desired flexibility when it comes to text formatting.
Full adoption of this functionality would also include: 
• An interface that will file genomic test data from an external system. Note: These external systems may not have the ability to interface directly out of the box, so be prepared to get creative. 
• “Enter/Edit Results” can be used to manually enter variant data, but it is questionable if this will work well in certain molecular workflows.  Utilizing this feature does, however, give the ability to view the variant result data in a side bar on the same screen the user is in while in edit mode, which allows for an efficient resulting process.

3.) Specimen Sharing Across Labs
The ability to share specimens across labs required Epic to completely rework the “under the hood” sharing logic.  For some labs with a robotic track, this may be an improvement.  For other labs that rely heavily on the minimum volume setup, this completely changes how specimen numbers generate.  In the new setup the system:
• Generates separate specimen numbers when the container volumes are exceeded and splits tests out across containers.  This requires manual intervention in the system to move the tests to specific containers, which can be cumbersome particularly when containers are shared in different areas of the lab. 
• Sets up automated “clean-up” of specimens that are:
1) Accessioned but never collected,
2) Collected but never received, or
3) Documented as expected to receive, but were never received
The parameters for when these specimens can be auto-cancelled are set up on the new “specimen cleanup” form in the Lab Facility record.

4.) Bridges and Beaker Interface Changes
The Incoming Ancillary Results to Beaker and Incoming Lab Instrument Results interfaces have also significantly changed in 2018.  This means that point of care, reference lab, blood bank, and instrument interfaces will change.  Although it is not required to make these changes right away, there are rumors that they will be required by the May 2019 release when the old versions will be retired.  Although this transition is not “owned” by Beaker, it significantly impacts Beaker.  Coordination with the Bridges team is critical.  Settings that lived in Beaker now reside in Bridges, so it will be important to be sure that the new setup mimics the old as much as possible.  Any change to the core setup of an interface requires significant testing and validation.  It is critical to test as many unique scenarios as possible because in certain setups the manner in which results file into Epic has changed.

5.) Enhancements, for Better or for Worse
Some “enhancements” don’t introduce much in terms of functionality improvements; they simply give the screen a different look and feel and require re-orienting end users to the new layout.  Some examples:
• Microbiology Setup bench
• AP Case Prep Worklist
• Separation of the labels and documents routine
• Verification review window
• New outstanding list view

While the 2018 upgrade introduces some much needed functionality, it seems that it still lacks in major functionality development.  One could argue that more true functionality enhancements would have been the preference over some of the cosmetic changes.  2018 also initiates Epic’s new quarterly upgrade schedule.  It will be interesting to see if this will lead to increased functionality faster or if it will lead to longer turnaround time for each enhancement due to Epic resources having to maintain several versions of software.

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About The Author: Nichole Malone is a highly experienced specialist in the implementation and support of information systems for ancillary and clinical applications who has worked for HealthNET Systems Consulting Inc. for over 8 years. She has served in a variety of different capacities in Epic, MEDITECH Magic, C/S, and 6.x implementations including strategic planning, design and build, coordinating, training, testing, and troubleshooting. She is Epic Beaker Clinical Pathology certified and has experience as Beaker Project Lead for multiple large scale implementations. Her well-rounded knowledge base of hospital processes and process improvement strategies adds value throughout all phases of implementations. She has notable strengths in clinical systems, laboratory operations, system integration, application testing, training and process redesign.

*Photo by Hans Reniers on Unsplash