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‘Epic-in-a-box’ makes powerful digital health system portable

Marie-Pierre Trempe registers a patient using Epic-in-a-box

Marie-Pierre Trempe, Registered Nurse at the COVID-19 Assessment Centre uses Epic-in-a-box to register patients in Epic – something that was only possible in hospital, until now.

Massive. That’s one way to describe the capabilities of Epic, The Ottawa Hospital’s digital health record. Since its launch on June 1, 2019 at The Ottawa Hospital and six regional health partners, everything from COVID-19 tests to x-rays to brain scans for hundreds of thousands of patients in the region have been fully digitized in the Epic system, bringing patient-centred care into the digital age.

And now, those massive capabilities that were originally only available in hospital have been shrunk to fit in a space no larger than a briefcase.

“The theory behind Epic-in-a-box was to open the box, open a laptop, plug in a password and not have to depend on a wireless network, or any other infrastructure, but be able to use full Epic functionality,” said John Trickett, Director at The Ottawa Hospital.

In other words, Epic-in-a-box is an innovation that makes the power of Epic portable – and that translates to even more benefits for patients.

“As long as you have power, you can open the box and away you go.”

One of the biggest benefits for patients is convenience. For example, Epic-in-a-box has been used in long-term care homes where residents and staff were being tested for COVID-19.  

“It means that those residents don’t have to travel to the hospital or the COVID-19 Assessment Centre to get a test,” said Rosemary Bickerton, Site Lead for the COVID-19 Assessment Centre at the Brewer Arena. “We can do exactly the same thing out of that box as we could do for you at Brewer.”

Health-care professionals who use Epic-in-a-box will be able to meet patients in their home or another location, register new patients in the Epic system, and be able to see their chart, order tests and use Epic as if they were at the hospital.

The technology works off of the LTE network, so all it needs is a cell signal and power.

Since Epic-in-a-box is also fully integrated with MyChart, Epic’s patient portal, patients who have a MyChart account can receive their results securely on their laptop, tablet or smartphone as soon as they are available.

Unlike Epic in the hospital that requires a lot of infrastructure, Epic-in-a-box uses the same kind of technology as your cell phone, only much more secure.

“Cisco Meraki is a solution that allows us to make a network mobile,” said Jim Makris, Manager of Network Services at The Ottawa Hospital. “It works off of the LTE network, so it works off a SIM just like a phone system. There’s no reliance on infrastructure required at any of the remote sites. All you need is power. You plug it in and it automatically makes a secure connection back to the hospital and provides connectivity for end devices.”

“It essentially creates a satellite unit outside the hospital with full hospital access,” said Stephen Roos, Manager of Client Services. “As long as you have power, you can open the box and away you go.”

Epic in a box, how it works

The system has numerous security and privacy measures built in.  All users must input their Epic credentials in order to access the system. The Cisco Meraki device provides full 256-bit encryption to The Ottawa Hospital over a fully-secure IPSec tunnel.  Should the box be stolen or lost, the hospital  can disable its connectivity. Moreover, no patient data is stored in the box itself; all patient data is securely stored in Epic, which contains its own robust security and privacy systems and protocols.

In the future, Epic-in-a-box could be used in many other environments, including remote communities in Nunavut, in a pop-up clinic, after a natural disaster or anywhere that does not have the full infrastructure of a hospital.


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