6 care of her local pediatricians, her assigned pediatric rheumatologists at Seattle Children’s, and a nursing care team at Seattle Children’s outreach clinic in Missoula, Montana. Monthly lab work, infusions, therapies and follow-up appointments in Coeur d’Alene, Seattle and Missoula mean her family’s lives often revolve around her illness. A full-time job Stephanie said managing the sheer volume of chart information, results and insurance information felt like a full-time job. “I took it upon myself to keep her file with me at all times because there were so many hands in the pot. If I forgot something, or if something was lost, it’s just more waiting; maybe for days,” she said. “I felt like I had become her medical social worker.” Gracie’s current treatment plan calls for infusions every four weeks, which would have ordinarily required her family to travel to Seattle or Missoula. However, last November, the team at Seattle Children’s and Kootenai Health were able to put together a treatment plan so Gracie could complete the infusions locally, at Kootenai Health’s pediatric department. When the teams began this collaboration, they were reviewing her results, chart notes and care plans with cumbersome faxes and lengthy phone calls. But there was a change on the horizon. In March 2022, Kootenai Health completed a systemwide electronic health record upgrade to a new software called Epic. This update eliminated 11 separate electronic health records in use at Kootenai Health and put every test result and chart note into a single medical record. Even better, the Epic software is used at a majority of health care institutions in the nation, including Seattle Children’s Hospital. Now, Gracie’s information can be seamlessly and safely shared EPIC Journey Seamless care and commu ication: A single health record eases the stress of managing a chronic illness Gracie’s By Kelly Fry Photos by Jerome Pollos Almost a year after Gracie-Mai Coates was born at Kootenai Health, her mother, Stephanie Coates, noticed something wasn’t quite right. Gracie’s left knee was swollen without apparent cause—at one point swelling to the size of a softball. They had recently gone swimming, and Stephanie thought it might be an infection. After seeing many physicians for evaluation and spending a week in the hospital for tests and exploratory treatments, Gracie and her family didn’t have an answer. Her health care team referred her to Seattle Children’s Hospital for a more extensive evaluation. At 18 months, Gracie and her family finally had a diagnosis— juvenile rheumatoid arthritis, or RA. This was the beginning of the Coates family’s journey in managing a life-altering chronic illness. Now 11, Gracie completes a complex medical regimen each month with the goal of reaching remission. She is under the Gracie-Mai looks for her brother during a game of tag at a Post Falls park. Gracie-Mai attends a therapy session at Kootenai Health.
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