Mastering Shadow Charting in EPIC Rollouts: A Comprehensive Guide for Healthcare Professionals

In the complex journey of adopting EPIC systems in healthcare settings, 'Shadow Charting' emerges as a critical transitional strategy. This article delves into the essence of shadow charting in relation to EPIC software rollouts, highlighting the indispensable role of physical tools such as clipboards and binders in this process.

What is Shadow Charting?



Shadow Charting refers to the parallel documentation process used during the transition to electronic health records (EHR) systems like EPIC. It involves maintaining traditional paper records alongside the new digital system. This practice is crucial during the initial phases of EPIC rollout, serving as a safety net to ensure continuity of care and accuracy in patient records during the digital transition.

The Role of Shadow Charting in EPIC Rollouts:

Ensuring Accuracy and Continuity: Shadow charting helps bridge the gap between old and new systems, ensuring no critical patient information is lost or misrepresented during the transition.

Training and Adaptation: It provides a hands-on training tool for healthcare professionals, allowing them to familiarize themselves with EPIC's functionalities while maintaining confidence in their conventional record-keeping methods.

Identifying System Gaps: By comparing paper and electronic records, healthcare teams can identify discrepancies and areas for improvement in the new EHR system.

Essential Supplies for Effective Shadow Charting:

  • Clipboards: Sturdy and portable, clipboards are essential for healthcare professionals to manage paper records efficiently during rounds and patient interactions. They offer a stable writing surface and ease of organization.

    Slimline Privacy Clipboard With Posts-1
  • Binders: Medical ringbinders are crucial for organizing and storing paper records. They allow for easy access and reference to patient histories, medication charts, and other critical information during the transition phase.


Manual Documentation During EPIC Transition: The Why and What

The Necessity of Manual Documentation:

While transitioning to an EHR system like EPIC, it's vital to maintain manual documentation as a parallel process. This practice serves several critical functions:

Backup for System Downtime: In the event of technical issues or system downtime, having manual records ensures continuous patient care without any interruptions.

Data Validation: Manual documentation allows for cross-checking data entered into the EPIC system, ensuring accuracy and reliability of patient information.

Training and Familiarization: For staff members who are in the learning phase of using EPIC, manual documentation provides a familiar method to fall back on, reducing stress and potential errors.


Key Information to Document Manually:

During the transition period, certain types of information are crucial to document manually, including:

  • Patient Identifiers: Names, dates of birth, and medical record numbers.
  • Medical Histories and Current Medications: To ensure continuity of care.
  • Treatment Plans and Progress Notes: Especially for ongoing treatments where immediate electronic entry might not be feasible.
  • Test Results and Orders: Until staff is fully comfortable with entering and retrieving this information from the EPIC system.

Traditional medical labels and alerts can make this manual process more uniform and efficient while using shadow charts.


The Importance of Manual Documentation as a Backup:

Implementing a new EHR system is a complex process that can encounter unforeseen challenges. Manual documentation acts as a safety net, ensuring that patient care remains uninterrupted and error-free during this transitional period. It's not just a fallback; it's a critical component of a responsible and patient-focused approach to healthcare technology adoption.



Shadow Charting is a pivotal element in the successful implementation of EPIC systems in healthcare settings. By understanding its role and employing essential tools like clipboards and binders, healthcare professionals can ensure a smooth, efficient, and error-free transition to this advanced EHR system.

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