E³ (as in electronic by year three) is an institution-wide project that envisions all outpatient clinics to become paperless in three years. E³ has special interest because of close alignment with Vanderbilt’s clinical improvement program and with a sweeping Vanderbilt Medical Group operations improvement project known as clinic redesign.

In aiming for paperless outpatient processes, Vanderbilt is building on earlier groundbreaking success in bringing information technology to bear in hospital settings. Last summer Vanderbilt University licensed rights for commercial development and marketing of WizOrder, the highly prized hospital electronic order entry and decision support system created and developed at VUMC. E³ continues Vanderbilt’s experimental approach, aimed at providing ubiquitous access to existing clinical knowledge, supporting continuous improvement of clinical outcomes and new levels of efficiency.

Under the leadership of Dr. Nancy Lorenzi, E³ has focused on communication among users and system developers, making it more likely that people across the organization will accept and value Informatics Center products. Several existing clinical tools from the inpatient side are being adapted and implemented for use in the outpatient environment, and new applications such as OPOC and Quill are being developed. Evaluation of organizational issues and change management are important parts of this project.