Twenty years ago, Saddleback Medical Center embarked on a bold journey that would transform the way care is delivered, documented and coordinated across MemorialCare—the implementation of electronic medical records (EMR) with Epic. This decision positioned MemorialCare as a healthcare pioneer, setting the stage for two decades of continued innovation focused on improving patient care, safety and access to information.
From Paper Charts to Digital Care
Prior to Epic, adopting an electronic medical record was far from the standard it is today. Healthcare documentation was predominantly paper-based, with physicians handwriting orders, nurses transcribing information into various systems, and paper charts physically moving from one provider to the next.
At the time, few health systems on the West Coast had moved to EMR, and many organizations were still uncertain whether the technology could support the complex realities of patient care. Implementing Epic required significant investment, extensive training and a fundamental change in how physicians, nurses and staff worked every day.
“Epic was very new,” says Steve Beal, chief information officer, MemorialCare. “At the time, outside of Kaiser, we were the only ones to implement it in Southern California.”
Pioneers In a New Frontier
Saddleback was selected as the first hospital in the system to implement Epic because of its progressive leadership and clinical teams, and strong physician engagement. It took several years of planning and training before the implementation, according to Satinder Kaur, RN, Director, Campus IT, Saddleback Medical Center, who was a bedside nurse and Epic Super User during the initial implementation.
A key group of IT leaders, clinical staff and physicians helped design workflows that would improve efficiency, strengthen communication and support safer, more coordinated patient care.
“We conducted extensive training leading up to go-live, with additional support available throughout the hospital and a dedicated network of Super Users helping staff navigate the new technology,” said Satinder.
Launch Day – MC21 – July 24, 2006
To support the launch, called “MC21,” for taking MemorialCare into the 21st century, Saddleback Medical Center established a command center staffed by Epic experts and technical teams who were available around the clock to troubleshoot issues and ensure a smooth transition.
Another challenge was helping clinicians become comfortable with technology when they had been accustomed to manual processes.
“Epic didn’t have a hosted model back then, so we had to support our own infrastructure and data center, and we had to find a location for it,” said Kevin Torres, vice president, IS, MemorialCare.
The first core module implemented was EpicCare Inpatient, supporting the full continuum of inpatient care, giving clinicians a single patient record for documentation, orders, medication management, care planning, clinical decision support, and care coordination across the hospitalization. Then came Computerized Provider Order Entry (CPOE), which allows clinicians to digitally enter patient directives, such as medication, lab tests, and imaging orders, into the patient’s health record. By replacing handwritten orders, CPOE helped eliminate errors and expedite treatment plans for the patients.
Expansion across MemorialCare
Following Saddleback’s successful implementation, Epic expanded to Long Beach Medical Center and Miller Children’s & Women’s Hospital in 2008 and Orange Coast Medical Center in 2010, creating a unified electronic health record platform across the health system.
Saddleback quickly built in a revenue cycle module for electronic verification, patient scheduling, medical billing and claims processing—removing manual processes.
Over the past two decades, Epic has evolved far beyond a documentation system. As an early adopter, MemorialCare and Epic have worked closely to further enhance the tools as healthcare needs changed.
Today, the platform allows multiple caregivers to access a patient’s records simultaneously, provides clinical alerts, supports evidence-based decision making and helps reduce the risk of medication errors. What began as a primarily clinical documentation system has evolved into a comprehensive platform that now supports nearly every aspect of care delivery.
Additional Epic capabilities that have enhanced patient care include:
- Stork Obstetrics Module (2006)
Nurses and clinical leaders in Saddleback’s women’s services worked with Epic to develop a tool to create a more effective way to document and manage maternal and fetal information. The tool was developed from the clinical knowledge and experience of nurses who were using fetal monitoring systems at the bedside, according to Christine Huff, RN, clinical director, Women’s Services. This work eventually became the foundation for Epic’s Stork module, which now supports the continuum of maternal care, from prenatal visits through labor, delivery and postpartum care, and is used by healthcare organizations nationwide. - Care Everywhere (2008)
MemorialCare was the first health system in the world to electronically exchange medical records through Epic’s Care Everywhere functionality. The capability allows providers to securely access records from Epic organizations across the country, improving care coordination and reducing unnecessary duplication of services. Providers can access a patient’s medical history from other health systems around the country, which can help inform current treatment. - Community Connect (2009)
Community Connect allows MemorialCare to extend their EMR software infrastructure to community physician practices and affiliate clinics at a fraction of the cost of a standalone installation. For these providers, it eliminates the capital investment required for independent hardware, software licensing, and dedicated IT teams, and seamlessly shares patient medical history, test results, and treatment notes between the clinics and our hospitals. - MyChart and Connected Patient Engagement (2010)
One of Epic's most significant advancements has been its ability to connect patients more directly to their healthcare through MyChart. What began as a secure patient portal has evolved into a digital engagement platform that allows patients to access test results, communicate with their care teams, schedule appointments and manage their health information from anywhere. Today, patients can connect MemorialCare myChart with personal health applications, including Apple Health and Google Fit/Health Connect, creating a more comprehensive view of their health data. New capabilities also support remote monitoring, allowing information such as blood pressure readings to be securely shared with care teams to help manage chronic conditions between visits and support more proactive care. - BarCode Medication Administration (BCMA) (2014)
One of the most important patient safety advancements introduced through Epic, BCMA helps ensure the right medication reaches the right patient at the right time. - Beacon Oncology Module (2023)
This adult and pediatric oncology and hematology specialty offers tools to manage a patient’s oncology care, such as standardized protocols for ordering and administering chemotherapy and tracking radiation therapy. Saddleback was the first to implement in 2007 and the reimplementation in 2023 came with many improved features. - Laboratory Integration Through Beaker (2024)
More recently, MemorialCare implemented Epic's Beaker laboratory information system, further integrating laboratory workflows and patient information into a single electronic platform.
“Epic and the electronic medical record have evolved beyond just a clerical tool," said Dr. Vinh Nguyen, chief medical information officer, MemorialCare. “It can enhance care and surface knowledge and insights to help improve quality.”
Looking ahead: The future of Epic and AI
As MemorialCare celebrates two decades of Epic at Saddleback, we’re already looking ahead to the next generation of healthcare innovation.
One of the most visible advancements is ambient listening technology, which uses artificial intelligence to help clinicians in the ambulatory clinics document visits in real time. Rather than spending time typing notes, caregivers can focus on meaningful patient conversations while AI captures and organizes information into clinical notes.
“We can actually use technology to make medical care more human because it allows the physician to connect with our patients at a much higher level,” said Dr. Nguyen.
In the near future, these capabilities will be brought into the inpatient setting at our hospitals.
Within the next year, Epic will allow providers to use AI to access similar medical histories from millions of patients nationwide, analyze current symptoms and incorporate the latest clinical research—enabling them to develop more informed treatment plans—in real time.
“The goal for future technology is not to replace clinicians but to empower them,” said Kristine Macdonald, director, IS Clinical Design, MemorialCare, who was involved in the initial launch 20 years ago and continues to help lead the organization's digital transformation efforts.
Future innovations also focus on enhancing patient experience. One concept under development is the “intelligent” hospital room, where technology can help patients better understand who is caring for them. For example, as a physician or nurse enters the room, their badge could automatically identify them and display their name, photo and role, helping patients feel more informed and connected throughout their care journey.
Epic’s future also includes new ways to enhance the patient experience. Upcoming innovations include MyChart Central, which will allow patients to manage healthcare across multiple organizations through a single Epic ID and login, as well as expanded language support and digital engagement tools that simplify appointment scheduling, check-in and communication with care teams. Additional advancements, such as myChart Bedside, will help keep hospitalized patients informed and engaged in their care by providing access to care plans, medications, education and discharge information through their mobile devices. Together, these innovations will help create a more seamless and personalized healthcare experience.
“It's really not about more technology,” said Kristine. “It's about taking excellent care of our patients and their families.”
Twenty years after Saddleback’s historic go-live, Epic remains one of MemorialCare’s most important tools for advancing patient care. From paper charts and handwritten orders to artificial intelligence and research-backed clinical advisement, the journey reflects a deep commitment to innovation, care and safety—creating the best possible experience for patients and providers.