Journal of Medical Systems

, 41:22 | Cite as

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

  • Tynan H. FriendEmail author
  • Samantha J. Jennings
  • Wilton C. LevineEmail author
Systems-Level Quality Improvement
Part of the following topical collections:
  1. Systems-Level Quality Improvement


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.


Electronic health records Epic Vocera EHR/EMR implementation Perioperative communication 



Massachusetts General Hospital


Statistical process control


Electronic health records


Electronic medical records


Operating room


Standard deviation


Voice-over internet protocol



All authors would like to thank the MGH Perioperative Communications Committee. T.F. thanks Joseph Szokol, M.D.

Compliance with ethical standards

Conflict of interest

Dr. Wilton Levine receives royalties for intellectual property licensed to Codonics, Inc., and Western Enterprises, Inc. Tynan Friend and Samantha Jennings declare no conflicts of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Massachusetts General HospitalBostonUSA

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