Implementing a specialized electronic health record (EHR) module such as Epic Stork (Epic Systems’ obstetrics module) is a major task for any healthcare organization’s IT team. Yet even the most robust technology can fall short if it’s rolled out without the insight and buy-in of clinicians. In women’s health departments …
Overview
Implementing a specialized electronic health record (EHR) module such as Epic Stork (Epic Systems’ obstetrics module) is a major task for any healthcare organization’s IT team. Yet even the most robust technology can fall short if it’s rolled out without the insight and buy-in of clinicians. In women’s health departments (e.g., labor and delivery units, OB/GYN clinics), the distinctions of clinical workflows are vital.
In this article, we will explore why clinical input is indispensable when implementing Epic Stork, the pitfalls of leaving clinicians out of the process, and strategies to fix stalled provider adoption after go-live.
The Importance of Clinician Involvement in EHR Projects
Healthcare leaders have learned (sometimes the hard way) that successful EHR adoption relies on the involvement of physicians, nurses, and other providers from day one. In fact, one study noted that “obtaining the support of physicians — often by getting the backing of clinical leaders — can be helpful in ensuring successful adoption.”
When clinicians are engaged early, they feel a sense of ownership. Moreover, the system is more likely to align with real-world care processes. On the other hand, the exclusion of frontline providers may precipitate the misalignment of workflows and user frustration. As one health IT consultant stated, “A common mistake in many implementations is that the providers are not involved until much later… This leads to miscommunication and negative impressions of the system.”
Historically, many early EHR systems were built by software engineers with minimal clinical input. As a result, these systems weren’t naturally intuitive to the clinical workflow. As Dr. Lalita Abhyankar noted in a Nordic interview, “a lot of people [were] building out technology without clinical input”, which contributed to physician resistance and a “luddite” attitude toward clunky systems.
The lesson is clear. You need clinicians at the table to design EHR tools that genuinely work.
Epic Stork is A Specialized Women’s Health Module
To appreciate where clinical input matters, let’s briefly review what Epic Stork is and what it provides. Epic Stork is Epic Systems’ dedicated module for obstetrics and perinatal care. It is designed to support the entire pregnancy and childbirth journey. It simplifies prenatal care, manages labor and delivery workflows, and coordinates postnatal care.
This table summarizes the main features and benefits of Epic Stork:
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Epic Stork
Description and Benefit
Comprehensive OB Care Plans
Build, organize, and view obstetric care plans that cover prenatal through postpartum phases. Ensures each patient has a coordinated care plan from first visit to delivery and beyond.
Labor & Delivery Workflow Tools
Manage workflow documentation of labor and delivery across departments. Includes L&D-specific tools (e.g., grease boards, fetal monitoring integration) to track moms and babies.
Integrated Data Exchange
Pre-built integrations with other Epic applications (e.g., EpicCare, prenatal screening, NICU/Pediatrics modules).
Standardized Documentation
Tools to standardize OB documentation and routine care tasks for providers. For example, structured flowsheets for prenatal visits, delivery notes, and postpartum checks help ensure key data are captured consistently.
Epic Stork is A Specialized Women’s Health Module
What does Epic Stork “miss” without clinical input? In short: a lot.
Let’s delve into some of these pitfalls:
Misaligned Workflows
The most immediate issue is that the software configuration may not match actual clinical workflows. For example, perhaps the admission process for a woman in labor is built convoluted, or the documentation flowsheets don’t follow the usual sequence of care.
These mismatches force staff into workarounds and extra steps. This misalignment is a direct result of IT analysts configuring the system in isolation. As a best practice, providers should be at the table from the beginning. Failure to do so can make the rollout feel like an IT-imposed change rather than a clinical improvement.
Gaps in Safety and Quality Measures
Another thing that can be “missed” without clinical input is the built-in safety checks and best practices experienced clinicians know to insist on. Modern obstetric care leans heavily on standard protocols to prevent errors. Think of checklists for oxytocin administration or emergency workflows for shoulder dystocia and postpartum hemorrhage.
Epic Stork can incorporate these only if someone configures or activates the tools. Clinicians can identify where an EHR can enforce a safety step. For instance, electronic checklists in the EHR can serve as independent double-checks during critical events. In one study, researchers noted that these checklists in L&D EHR systems help guide providers through obstetric emergencies (e.g., hemorrhage) and ensure no important steps are forgotten.
Low Provider Adoption
Perhaps the biggest pitfall is poor user adoption. If Epic Stork isn’t built with the end-user in mind, the end-users (e.g., physicians, NPs, nurses) will be vocal about their dissatisfaction. In worse cases, they’ll find ways to avoid the use of the system to its full extent.
We’ve all heard of EHR implementations where clinicians still complain or revert to manual habits months after go-live because the system is cumbersome. The lack of clinical input is a main culprit in these scenarios.
Just think of how healthcare organizations now invest in roles such as physician champions and clinician advisory councils during EHR projects. This is because clinician buy-in has to be earned and not mandated.
So, here’s a rule of thumb:
Engage them early, and they’ll be allies. Ignore them, and you risk resistance.
How to Fix Stalled Provider Adoption After Go-Live
Let’s say your hospital implemented Epic Stork six months ago. The go-live checklist was completed, and the system is up and running. However, you’re noticing struggling in the Women’s Health department. You hear that several providers are complaining about extra clicks. You also hear that some OBs are even bypassing parts of the workflow.
Here are a few ways to fix this issue:
Conduct a Post-Live System Assessment (Epic “Refuel”)
It’s wise to formally evaluate how the system is being used after the dust settles. Epic itself advocates for a Refuel program. This is a strategic optimization initiative to realign and fine-tune the EHR after the initial implementation.
In a Refuel (or similar assessment), a combined team of IT and clinical representatives:
- Reviews workflow pain points.
- Observes end-users.
- Analyzes system data.
The goal is to identify where inefficiencies or misconfigurations hinder daily work. For example, you might discover that nurses created workarounds for a cumbersome medication charting process. Alternatively, physicians are flooded with messages that could be rerouted.
Re-engage Clinical End-Users
If clinical input was lacking initially, it’s never too late to course-correct. First, identify influential physicians and nurses in Women’s Health and bring them into an optimization task force. Re-establish a Physician Advisory Group if one doesn’t exist. The goal is to allow providers to voice concerns and suggest fixes in a structured way.
Just listening to end-user feedback can uncover quick wins. For instance, providers might say, “The postpartum note template is missing a field for estimated blood loss, so we have to add a comment each time.” Just think of how easy it is to fix this issue by simply adding that item.
Invest in Targeted Training and Re-Education
Stalled adoption is a sign that users have never fully mastered the system or don’t know “the tricks” to use it efficiently. According to a survey, 75% of medical professionals felt that they’d benefit from additional EHR training even after implementation. So, assess the training gaps. Perhaps the L&D nurses could use a refresher on the documentation of certain complications in Stork. Additionally, physicians might not realize there’s a quicker way to place postpartum orders. Consider the arrangement of role-specific and hands-on workshops to address these gaps.
It can be helpful to customize training by specialty and workflow. For example, a short session just for OB physicians on the optimization of note templates and order sets they use frequently.
Optimize Workflows and Configuration Based on Feedback
After the collection of data from your assessment and input from clinicians, prioritize a set of system and workflow changes. This might involve the configuration of new tools or the adjustment of existing ones. For example, if providers complain about too many irrelevant alerts, tune the alert logic.
If the documentation of a routine newborn admission requires 10 clicks, see if it can be streamlined or if default values can auto-populate. In one real-world case, a healthcare organization that had gone live on Epic found growing discontent with inefficiencies. The team discovered that some tasks physicians were doing could be delegated or automated. The update of roles and workflows, they “identified more than 58 tasks providers would no longer need to do,” and immediately began saving doctors’ time.
Provide Ongoing Support and Governance
Adoption isn’t a switch that is flipped at go-live. It’s an ongoing process. To prevent backsliding, ensure there’s a support structure in place. This might include a dedicated support team during the tail end of go-live and beyond (i.e., hypercare).
For providers, having at-the-elbow support even weeks after go-live can reinforce good habits. Many hospitals position super users or hire extra hands during go-live, but it’s wise to extend some level of elevated support for a longer period for physicians who may only now be fully using certain features.
Here’s a table that summarizes common pitfalls and solutions:
| Pitfall | Consequences in Practice | Solution with Clinical Input |
|---|---|---|
| Providers involved too late | Misaligned workflows. End-users develop negative impressions of the new system. | Engage clinicians from the start. Identify physician champions early and form advisory groups. |
| Out-of-the-box configuration | Important safety features and best practices are not built in. For example, no electronic checklists for obstetric emergencies. | Incorporate clinical best practices into the build. Use clinician expertise to implement safety checklists and decision support within Epic Stork (e.g., a checklist for hemorrhage management). |
| Minimal training (focused only on mechanics) | Users only learn basic navigation but not efficient workflows. Physicians and nurses feel unprepared. | Provide role-specific and workflow-focused training. Involve experienced clinicians as trainers or at least in training development to ensure scenarios are realistic. |
| No feedback loop post-go-live | Persistent usability issues or inefficiencies remain hidden or unaddressed. | Establish continuous improvement cycles. Conduct post-live assessments (e.g. Epic Refuel) to identify pain points. Create a mechanism (user group or ticket system) for clinicians to report issues or enhancement requests. |
Takeaway Message
In the field of EHR, many technicians learn the hard way that technology alone is not enough. It’s the partnership between the tech and its users that truly determines success. Epic Stork provides powerful tools to improve obstetric care. But as we’ve discussed, what Stork “misses” without clinical input is the understanding of care delivery. Remember, you will need the human element that ensures the software actually supports providers and patients. The active involvement of clinicians in the design, build, and optimization allows healthcare organizations to avoid common pitfalls (e.g., workflow misalignment, stalled adoption). Only this way, end-users can benefit Epic Stork to its full potential, which improves the documentation, safety practices in L&D, and frees up clinicians’ time for patient care.
For IT Application Directors and CMIOs that manage these projects, the requirements are clear. Make your OB/GYN physicians, nurses, and midwives co-creators of the system. Don’t just expect them to be forced to adapt. Ask for their expertise and feedback continually. In return, you’ll find greater buy-in, smoother go-lives, and ultimately a better return on the hefty investment that an Epic module represents. As one healthcare leader put it, when the clinicians are at the table from the beginning, it means “you will have a much more successful implementation.”
Finally, if you’re already past go-live and having adoption challenges, remember that it’s never too late to correct the existing issues. Adopt an approach that targets optimizations, training, and engagement to fix a stalled adoption curve and turn skepticism into enthusiasm.
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