Osler to deploy Epic, with large suite of AI tools

William Osler Health System, a community teaching hospital serving 1.3 million people in Brampton and surrounding regions in the Greater Toronto Area, is embarking on a major clinical transformation that will introduce several time-saving AI capabilities to doctors and nurses. The changes are all part of a transition to the latest release of Epic’s health information system that makes extensive use of artificial intelligence.

Consisting of Brampton Civic Hospital, Etobicoke General Hospital and the Peel Memorial Centre for Integrated Health and Wellness, Osler is gearing up to retire its Meditech Magic information system and go live with Epic in October 2026.

“We spent the last six months redesigning our clinical workflows in preparation for the move to Epic,” said David Stankiewicz, vice president, digital transformation, chief information and privacy officer. “This has given us the opportunity to redesign those workflows with the AI tools that are available to us. Epic has a broad range of AI capabilities. We’re introducing AI to make our hospital operations more efficient and to enhance the quality of care.”

According to Stankiewicz, the project is unique in that it’s clinician-led, meaning doctors, nurses and allied professionals have designed the workflow and selected the AI tools that will be deployed. “Typically, we see many of these projects led from a technology perspective with the result that clinicians feel it’s being done to them versus our approach of engaging with clinicians to design the system themselves,” he said.

An executive steering committee made 5 percent to 10 percent of the overall strategic decisions for the project and an interdisciplinary committee made 30 percent to 40 percent of decisions affecting policies and procedures that cross boundaries between programs. Working groups from every clinical program accounted for the largest component of the decisions impacting the design of the project.

Of the three main types of AI tools in healthcare – predictive models, generative AI that produces content, and agentic AI that takes an output and acts on it – Osler clinicians opted to begin their AI journey with generative AI.

“We’re really focused on AI that will help clinicians with administrative functionality,” said Stankiewicz. “There will be no AI used in our environment in place of human decision making. In other words, there’s no way it’s going to make diagnosis determinations. All the AI that we’re going to use will focus on helping clinicians with clinical documentation and administrative burdens.”

Doctors, for example, will be able to use Epic’s generative AI tool to produce discharge summaries and patient-friendly instructions. They will also be able to produce a summary of a patient’s condition and past visit history in preparation for an appointment.

Nurses will be able to take advantage of generative AI at the end of their shift for the handover to the nurse replacing them. The AI tool produces a summary of what happened on a nurse’s shift from information that has already been keyed into the patient chart, reducing the amount of documentation required by Osler nurses.

“It’s really designed to reduce the administrative burden that nurses have had to deal with,” said Sharon MacSween, associate vice-president, health information system. “It’s a much more seamless way of being able to do the handover and it’s much better for patients because their needs are expressed to the nurse who is taking over their care.”

Currently, nurses are required to go to the patient chart and other sources to collect and document the information required to ensure continuity of care. Come fall 2026, AI will do it for them. All they have to do is review it for accuracy and sign off on it.

“The AI that we are choosing to use has been selected by the clinical programs themselves,” said Stankiewicz. “It’s AI that has been adopted through other Epic hospitals globally, so we are taking a risk-based approach to the AI we are going to use. We want to make sure that it’s safe, we want to make sure it’s proven, and we want to make sure it will benefit clinicians and patients. AI is moving so fast in healthcare. There’s always something new, so we’re putting the foundation and structures in place to adopt AI in a thoughtful, safe and responsible way, in line with specific AI frameworks and legislation that are shaping the regulatory climate for best practice use, but also in an agile way that allows us to take advantage of new AI applications that come up.”

One tool Osler is undecided about is AI scribe functionality, said Stankiewicz. “We’re still working through that. It’s likely we will move forward with a small pilot. We haven’t figured out which clinical program specifically we will select but we think we will have a group that trials an AI scribe at go-live. That will allow us to focus on our immediate goal of getting off our legacy platform and getting the broader Epic system in place.”

An AI scribe pilot will allow Osler clinicians to understand how the technology will work in a hospital setting before broader adoption at some point in the future, said Stankiewicz.

In the meantime, instead of the current third-party transcription service they are using for documentation, doctors will transition to dictating directly into Epic.

Osler will also begin using Epic’s MyChart patient portal, which will provide more comprehensive information than the patient portal currently in use. In addition to viewing diagnostic imaging reports, other test results and AI produced documentation, patients will be able to use MyChart to schedule follow-up appointments.

“This is something we’re really excited about,” said MacSween. “If you have a follow-up appointment at Osler, you won’t have to wait for someone to call you. You can proactively go in and book the appointment when it’s convenient for you. It will give you several options. That will save our team from having to call patients to schedule appointments.”

She added, “We’re also going to implement other tools that will allow patients to use MyChart when they’re admitted to hospital. If they’re not exactly sure what’s going on, they’ll be able to go into My Chart and see what’s happening to them as their care progresses.”

Osler will also be able to take advantage of Epic’s analytics tools to produce all of the reports required by government authorities as well as reports used internally to improve clinical outcomes.

“We have some limited reporting tools that are available within our existing Meditech system and other systems, but they tend to be inefficient and don’t link up very well, so that contributes to the administrative burden on our report writers because they have to go to different places to pull it all together,” said MacSween.

“We have a very smart team. They’re very good at what they do, and they’ve done really well with the tools they currently have, but this is going to take them to the next level.”

With the design phase of the project completed, Osler has moved on to a user readiness phase where it’s testing the system in the background to make sure everything’s working.

When they show up for training, any questions they have about what’s going to change will already have been answered and they can spend their time learning how to use the system, said Stankiewicz.