​When a nurse coordinator found out that lab orders could be faxed directly from the Epic electronic health record system, rather than needing to be printed and faxing a hard copy to lab facilities, she decided to test the functionality to make sure it worked correctly and accurately. She faxed orders to her hospital’s own fax number, but only received the first page of each order. Since sending incomplete orders puts patients’ safety at risk by delaying treatment, she contacted the EpicCare systems analyst for support. He discovered that her Epic department wasn’t the only one experiencing the issue—it extended to all departments throughout the hospital. However, he wasn’t able to resolve it internally, so he elevated the problem to the software manufacturer. The nurse coordinator emailed the systems analyst every few weeks for status updates until the bug was finally fixed several months later. If not for her commitment to patient-focused care and diligence in testing a software feature and reporting an issue, this problem might have gone overlooked for much longer, with adverse outcomes for the patients affected.

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