Hi Ken,
For the past 3 1/2 years I have been employed as an EHR clinical analyst for implementation of Epic at the Sutter Healthcare sites in Sacramento and San Francisco areas.
Sutter utilizes Elsevier for discharge instructions, as their ambulatory, ED, and inpatient units.
This allows for standardization of instructions, across the enterprise.
One great feature is the ability of the RN or other clinician to "preview" the instructions, prior to attachment to the record and printing.
In other words, the instructions for wound care are available in a simple or more complex option, diagrams or not.
The text can be printed as is, or modified through its functionality as a word-type document.
A variety of languages can be utilized, also.
The instructions can be accessed at any time during the hospitalization, for real-time teaching, or of course, at discharge.
By attachment to the discharge instructions, there is electronic capture they were provided.
Sutter has had the Elsevier reps come to the sites, within about 30 days after go-live, to walk the units and assist the RNs with the functionality if needed. I have also seen in-services and "drop-ins", in other words, whatever support the site believes is needed, the Elsevier folks have been most accommodating.
Hope this is helpful, let me know if you need any other information.
Nancy Gosnell (formerly Gardner)
Carlsbad, CA