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This page is dedicated to OnCore-Epic integration information and how-to topics to serve as a handy reference tool. Links to instructions are included below for new tasks related to OnCore-Epic integration as well as an overview of the timeline of the OnCore-Epic study activities. Please note that the information and instructions listed below are always subject to change and will be updated as necessary.

Table of Contents

 


 

Overview of Integration

At the beginning of 2018, the OnCore and Epic applications were integrated to allow the transfer of data between the two systems. Data linkages are described below, and information regarding new and ongoing integration-related activities for OnCore users is found in the following section.

Epic RSH and LAR Records

Make sure that when you are updating a subject status in OnCore that the Epic RSH and LAR records are NOT open. Having these records open in Epic LOCKS the records and may prevent the system from processing updates from OnCore. 

Patient Demographics

Patient demographic data is sent from Epic to OnCore so that patients from WUSM or BJC can be identified and selected for clinical trials. Because the patient records are linked across the two systems, the data from Epic flows to OnCore in real-time, removing the lag-time we previously experienced for brand new patients to show up in OnCore. When data is updated in Epic, such as an address change or a DOB correction, the patient demographic data in OnCore is automatically updated.

Clinical Trial Protocols and Subjects

In the other direction, clinical trial protocol and subject information is sent from OnCore to Epic.

Remember: A research study should go into Epic if it includes:

  • the use of investigational medications or devices,
  • ordering of services for research (e.g. labs, scans, etc.),
  • or a billing component or risk.

Please reach out to the Epic1 Research Team if you have questions about whether or not your study should go into Epic.

If an OnCore study requires or has an RSH record in Epic, it should be linked across the two applications. Once the study is open to accrual and is linked, patient registrations (i.e. date of consent) will be automatically sent from OnCore to Epic. Subsequent changes to subject statuses in OnCore will also be automatically sent to Epic and the Epic patient record updated. These activities are performed using the newly activated RPE Console in OnCore, as described in more detail below.

Important Message from the Epic1 Research Team: The OnCore-Epic study linkage will not automatically initiate the build of a medication or ordering tool in Epic. For oncology studies, please follow your department's specific workflow for initiating an Epic treatment plan build. For non-oncology studies, please contact the Epic1 Research Team or complete the Epic1 Research Intake Form to initiate the build.

Preparation for Epic Go-Live

The OnCore Support Team sent protocols and subject data to Epic in preparation for go-live. This means that all active protocols and valid subject registrations in OnCore were ready in Epic for go-live on 6/2/2018, as long as they study team successfully completed the Epic cutover process. In collaboration with the Epic1 Research Team, we ensured that study information was transferred to Epic based upon research teams' instructions. Any studies that research teams requested not go into Epic were not sent via the OnCore-Epic integration. We are also working closely with the Epic1 Research Team to address integration and other study-specific issues as they arise after go-live.

HRPO-Epic Link

In order to activate the protocols in Epic and successfully send protocol and subject details from OnCore to Epic, base information from the protocol MUST first be sent to Epic from myIRB. For older studies, or for studies that were closed to accrual at the time of Epic Go-Live, myIRB may not have sent the protocol to Epic. If you have an older study and you do not see the link of subjects to the study protocol in Epic, it is possible myIRB never sent the protocol. Please reach out to the Epic1 Research Team and the OnCore Support Team to identify whether they study has been initiated and activated within Epic. If it has, OnCore can assist with pushing the protocol through the RPE console. If it has not, the study team will need to work with the Epic1 Research Team and HRPO to have the study sent to Epic.

 


Integration Activities

New Activities Required Post Go-Live

Effective June 2, 2018, users with the Regulatory role in OnCore will be responsible for enabling the protocol linkage to allow the ongoing transfer of protocol and subject information from OnCore to Epic, as well as sending staff change updates. Users in this role were provided with new privileges in time for go-live, allowing them access to the OnCore RPE Console to perform these tasks. The workflow is simple, as described in work instructions for the next two topics.

New Protocols

Protocols must first be sent from OnCore to Epic in order to allow subject registrations and status updates to follow. This action is completed by Regulatory Coordinators, and is performed once the study is open to accrual. Note that the RSH record should be activated in Epic prior to performing this task in order to successfully link the studies.

Go to:  RPE Push for New Protocols Work Instructions


Updated Protocol Identifiers (i.e. Protocol or NCT Number)

Any protocol that has had an updated protocol identifier (i.e. Protocol or NCT number) must be re-sent from OnCore to Epic in order to allow subject registrations and status updates to follow. This action is performed by Regulatory Coordinators, and must be performed if a protocol identifier has been updated. Note that the RSH record should be activated in Epic prior to performing this task in order to successfully link the studies.

Go to: RPE Push for Updated Protocol Identifiers Work Instructions

Changes to Study Staff

The study staff list in Epic is populated based on the myIRB designated list. However, there is also a field for each study in Epic for the primary point of contact, and this field is populated based on the OnCore study staff role of Clinical Research Coordinator - Primary. If there is a change in the primary CRA after the protocol is pushed to Epic, this change must be pushed manually via the RPE Console. This action is also completed by the Regulatory Coordinator.

Go to:  RPE Staff Update Work Instructions

Important Note: OnCore and Epic both allow for more than one Primary Clinical Research Coordinator to be listed; however, we do not recommend this. There are a variety of automatic messages sent by OnCore, such as the ADE notification, that can only be sent to one recipient, and if there is more than one primary CRA listed, we cannot control to which contact the message will be sent. If there are multiple CRAs assigned to the study, please identify the main contact to receive notifications and updates from the OnCore system, and utilize the staff role of  Clinical Research Coordinator - Secondary for all other clinical coordinators who are assigned to the study. The same is true for the role of Data Coordinator - Primary, so we likewise recommend that only one primary data coordinator be listed and that the role of Data Coordinator - Secondary be utilized for all other data coordinators assigned to the study. Please note that this also means these automatic messages will be sent to two study staff - primary CRA and primary data coordinator - as long as these two roles are not the same person.

Current & Ongoing Required Activities

If your study involves local patients who were registered manually (such as healthy volunteers or parents/guardians of minor patients) and/or patients who did not have a valid Epic MRN in OnCore, and these patients require association with the study in Epic, their existing OnCore record will need to be updated/merged with their true patient record per the applicable instructions below.

New Patient Registration

What to Do if You Can’t Find Your Patient in OnCore

The patient demographic data that OnCore receives from Epic is updated in real-time. This means that if a brand new patient is seen at your site for the first time, the patient should be available in OnCore as soon as their patient record is created in Epic (e.g. as soon as the patient checks in for their appointment). In the rare event that you cannot find a patient in the system, please follow the work instructions to address.

Go to: New Subject Registration Work Instructions

Subject Updates

Subject date of consent information and status updates will be sent from OnCore to Epic automatically, as long as the protocol has been linked by the Regulatory Coordinator. When a patient is put On Arm for the first time, their arm information will also be sent to Epic when their On Treatment date is entered and automatically pushed. However, depending on specific circumstances, switching a patient from one arm to another while remaining on treatment (e.g. crossover studies) may result in a discrepancy of arm information between OnCore and Epic. If you notice discrepant information, please contact the OST to help resolve the problem. If you inadvertently transcribe an incorrect date for one of the subject updates (date of consent, date on study, date on treatment, etc) please contact the OST to manually push the information once you have corrected it. 

The charts below show what each OnCore status corresponds to in Epic. It also lists all possible subject statuses in OnCore and Epic. An n/a in the "OnCore Status" or "Epic Status" column indicates that there is no equivalent status in the OnCore or Epic system. The "Epic 'Research' Banner" column shows what the Epic Research banner (one of several patient banners in Epic) will display for each of the Epic Statuses. The "Creates End Date In Epic" column indicates whether each OnCore status pushed to Epic will populate an "End Date" in the research record for the Epic patient.

Remember: It is essential that you keep your patient's study status and lifecycle information current and up-to-date in OnCore. Though OnCore and Epic will now be integrated, the possibility of discrepant information exists. OnCore will always be considered the source of truth for research information.

Updating Epic MRN

If you have an OnCore patient record that does not contain a valid Epic MRN, and the patient needs to be linked with their Epic record, please contact the OST and provide the following information:

  • Patient’s correct Epic MRN
  • Patient's full name
  • DOB
  • Current MRN in OnCore
  • Protocol Number

The OST will assist with updating or merging the record, or, when applicable, work with the Epic1 Research Team to resolve any potential technical issues.

Merging Duplicates

On rare occasions, you may find duplicate patient records flowing from Epic into OnCore. If the patient requires association with the study in Epic, their existing OnCore record must be updated and/or merged with their true patient record. 

The following patients (among others) may result in duplicates:

  • Local patients who were registered manually,
  • Healthy volunteers,
  • Parents/guardians of minor patients,
  • Patients who did not have a valid Epic MRN in OnCore prior to integration.

In order for the two records to be merged in OnCore, they will need to be merged in Epic, which will feed over to OnCore. If they are only merged in OnCore, the duplicate will continue to occur as it is originating in Epic.

Go to: Duplicate Patient Work Instructions

OnCore-Epic Integration - Study Timeline

A visual overview of Epic-related study activities in Oncore. The green "RPE" icon to indicate new required tasks for Regulatory Coordinators.

 


OnCore-Epic Support

We know research teams are extremely busy learning the new Epic system and its research tools. The OST is here to assist you Monday through Friday from 8am to 5pm. If you have any questions about the OnCore-Epic integration as it pertains to your study or your role in OnCore, please contact the OnCore Support Team. To contact the Epic1 Research Team, email them at Epic1Research@wustl.edu.