Epic Fast Pass for echocardiogram and endoscopy: an implementation report

Background In healthcare, access to care and efficient resource utilization are critical challenges often resulting in long wait times, even when appointment slots remain unfilled. Epic Fast Pass (EFP), an innovative feature within the Electronic Health Record (EHR), has been effectively implemented to optimize outpatient office visit scheduling, ensuring a more streamlined process that significantly reduces wait times and improves access to care. Objective We introduce a novel application of EFP that includes imaging and procedural services, specifically targeting echocardiogram and endoscopy services within the outpatient care framework. Guided by the principles of a learning health system, our expansion aims to assess the feasibility, strengths, and weaknesses of EFP in these specialized domains. Our approach involves developing tailored workflows for these types of visits and close monitoring of user behavior and outcomes. This strategy allows us to evaluate the effectiveness of the intervention and refine our processes to better meet the needs of our patients and healthcare providers. Methods We set to describe the process by which we developed the workflow and infrastructure of the implementation along with the challenges faced along the way. We collected user behavior of the implementation over the course of about 15 months for echocardiogram and 4 months for endoscopy. Using descriptive statistics and chi-square testing, we analyzed differences between patients who interacted with EFP and those who did not, providing insights into the tool's impact and effectiveness. Results EFP was successfully deployed in both echocardiogram and endoscopy outpatient service lines. 143 patients were enrolled in the echocardiogram implementation, with 1786 offers being made during the study period. 41.26% of patients accepted an offer with an average of 12.8 days acceleration in appointment date. 666 patients were enrolled in the endoscopy implementation, with 9338 appointment offers being made during the study period. 48.35% of patients accepted an offer with an average of 50.43 days improvement in appointment time. Patients who interacted with EFP did not differ by age. Conclusions The implementation of rescheduling tools for outpatient imaging and procedural appointments is both feasible and promising, with the potential to enhance patient access and optimize resource utilization in healthcare. Developing these interventions through a learning health system approach facilitates gradual advancements and broad improvements, while also supporting the individual success of each implementation. This method ensures that enhancements are continuously informed by real-world data and feedback, paving the way for more effective healthcare solutions.