September 13, 2018

In November 2018, VUMC launched eStar, a new enterprise electronic health record (EHR) , through the EpicLeap program. To help health care providers guide the optimization and development of eStar,  the VUMC Physician Builder Program was launched and the Department’s faculty members play a role in that program.

Jonathan Wanderer, MD, MPhil, leads this new initiative and explained that the Physician Builder program gives clinicians the opportunity to understand Epic with the same level of detail that Epic analysts have. “Additionally, it encourages health care providers to get involved with designing and improving the electronic health record (EHR) that they use day in and day out.”

Wanderer said he obtained Physician Builder certification early in the program to help build the test the anesthesia content before eStar went live.  He said he stayed on to help give other health care providers the same opportunity. “There’s a lot of good work to be done in both helping our HealthIT colleagues with system build as well as help our clinical colleagues understand how to best use our system.” The anesthesia department is also supported by other certified Physician Builders, including Ron Bell, CRNA, Randy Brenn, MD, David Edwards, MD, and Rob Freundlich, MD.

To establish the VUMC Physician Builder Program, Wanderer said his experience as associate medical director for perioperative informatics was very helpful in understand how problems in perioperative had been approached with informatics solutions. He also said working as medical director of VPEC gave him the clinical context to best define perioperative evaluation notes and to understand how those workflows can be supported with the new system. Also serving as medical director of VAPIR gave Wanderer the perspective of what research and QI questions commonly arise and how systems can be structures to prepare for future success in retrieving data to answer those questions. 
“VAPIR was instrumental in the early stages in helping to export data from our VPIMS program and bring that into our eStar system, which let us go-live with a lot of critical data available for patients who we had previously taken care of,” Wanderer said. “This was instrumental in getting our clinical decision support systems working from day 1.”

Not only do his roles within anesthesiology help him in his role with Physician Builder but the program has also helped him as an anesthesiologist. “It’s given me an appreciation for how our systems-based approach to providing anesthetic care applies well when taking care of our health care system.”

Wanderer said he would like everyone to consider how they can improve the system that we all work on. “While becoming a physician builder is one approach, there are lots of opportunities for folks to get involved as clinical champions to help spread knowledge through additional end user training and help identify the most pressing end user problems to focus on next.”

Wanderer explained the mission of Physician Builder is to give clinicians the skills to be active participants in improving the system in which they work. “It also supports the educational mission, as we work with our clinical informatics fellows to achieve their goals through the same training.”