Communication Patterns in the Perioperative Environment During Epic Electronic Health Record System Implementation

J Med Syst. 2017 Feb;41(2):22. doi: 10.1007/s10916-016-0674-3. Epub 2016 Dec 20.


In April 2016, Massachusetts General Hospital (MGH) went live with the Epic electronic health records (EHR) system, replacing a variety of EHRs that previously existed in different departments throughout the hospital. At the time of implementation, the Vocera® Badge Communication System, a wireless hands-free communication device distributed to perioperative team members, had increased perioperative communication flow and efficiency. As a quality improvement effort to better understand communication patterns during an EHR go-live, we monitored our Vocera call volume and user volume before, during and after our go-live. We noticed that call volume and user volume significantly increased during our immediate go-live period and quickly returned to baseline levels. We also noticed that call volume increased during periods of unplanned EHR downtime long after our immediate go-live period. When planning the implementation of a new EHR, leadership must plan for and support this critical communication need at the time of the go-live and must also be aware of these needs during unplanned downtime.

Keywords: EHR/EMR implementation; Electronic health records; Epic; Perioperative communication; Vocera.

MeSH terms

  • Communication*
  • Efficiency, Organizational
  • Electronic Health Records / organization & administration*
  • Humans
  • Patient Care Team
  • Perioperative Period / methods*
  • Quality Improvement / organization & administration
  • Wireless Technology*