title: Implementation of Epic Beaker Clinical Pathology at an academic medical center.
abstract: BACKGROUND
  Epic Beaker Clinical Pathology (CP) is a relatively new laboratory information system (LIS) operating within the Epic suite of software applications. To date, there have not been any publications describing implementation of Beaker CP. In this report, we describe our experience in implementing Beaker CP version 2012 at a state academic medical center with a go-live of August 2014 and a subsequent upgrade to Beaker version 2014 in May 2015. The implementation of Beaker CP was concurrent with implementations of Epic modules for revenue cycle, patient scheduling, and patient registration.
  
  
  METHODS
  Our analysis covers approximately 3 years of time (2 years preimplementation of Beaker CP and roughly 1 year after) using data summarized from pre- and post-implementation meetings, debriefings, and the closure document for the project.
  
  
  RESULTS
  We summarize positive aspects of, and key factors leading to, a successful implementation of Beaker CP. The early inclusion of subject matter experts in the design and validation of Beaker workflows was very helpful. Since Beaker CP does not directly interface with laboratory instrumentation, the clinical laboratories spent extensive preimplementation effort establishing middleware interfaces. Immediate challenges postimplementation included bar code scanning and nursing adaptation to Beaker CP specimen collection. The most substantial changes in laboratory workflow occurred with microbiology orders. This posed a considerable challenge with microbiology orders from the operating rooms and required intensive interventions in the weeks following go-live. In postimplementation surveys, pathology staff, informatics staff, and end-users expressed satisfaction with the new LIS.
  
  
  CONCLUSIONS
  Beaker CP can serve as an effective LIS for an academic medical center. Careful planning and preparation aid the transition to this LIS.
authors.affiliation: Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Krasowski
authors.affiliation: Health Care Information Services, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Wilford
authors.affiliation: Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: Wanita
authors.initials: W
authors.lastname: Howard
authors.affiliation: Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: Susan K
authors.initials: SK
authors.lastname: Dane
authors.affiliation: Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Davis
authors.affiliation: Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: Nitin J
authors.initials: NJ
authors.lastname: Karandikar
authors.affiliation: Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: John L
authors.initials: JL
authors.lastname: Blau
authors.affiliation: Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Ford
keywords: Clinical chemistry; clinical laboratory information system; electronic health records; hematology; medical informatics; microbiology