When Epic is unavailable, patient care does not stop. Clinicians still need essential patient, order, medication, and schedule information. Epic Business Continuity Access, commonly called BCA, makes approved downtime reports available from designated workstations.

The right report set is not every report the system can produce. Each department needs the minimum information required to work safely until normal access returns. BCA is one part of that plan, alongside policies, communications, training, recovery, and reconciliation.

Product names, configuration options, and available report types can vary by Epic release and organizational build. Confirm technical steps in current Epic documentation and follow local privacy, security, clinical, and change-control requirements.

What Is Epic Business Continuity Access?

Epic BCA provides an approved method for accessing downtime information when the primary Epic environment is unavailable. Organizations configure BCA workstations and reports around the needs of specific departments or service lines.

During a disruption, BCA helps staff answer immediate questions such as:

• Which patients are expected today?
• Which orders or procedures are pending?
• Which medications were recently documented?
• Which clinical details are essential for the next step in care?
• Which downtime procedures should staff follow?

BCA does not replace a complete business-continuity program. Health systems still need incident command, communications, paper or alternate documentation, patient identification, medication processes, order handling, security, recovery, and reconciliation plans.

How to Select Epic BCA Reports

Start with the work staff must continue, not with the report catalog. Clinical and operational leaders should describe what their teams need to know in different downtime scenarios.

For each report, define:

• Intended users and departments
• Business and clinical purpose
• Required data elements
• Maximum acceptable data age
• Report destination
• Access permissions
• Sort and filter logic
• Printing requirements
• Owner and review frequency
• Testing and approval process

Leave unnecessary sensitive information off the report. Extra data makes the page harder to use and increases privacy risk without helping staff make a decision.

1. Department Appointment Report

A Department Appointment Report can give a procedural or ambulatory department a view of scheduled patients during downtime.

The report should include the information required to identify the patient, understand the scheduled service, confirm timing, and follow the department’s approved downtime workflow. Additional clinical details should be included only when they are relevant and approved.

Design considerations include:

• Appointment date and time
• Patient identifiers
• Procedure or visit type
• Department and location
• Ordering or referring provider
• Relevant preparation or safety information
• Contact information needed for escalation
• Clear date range in the title

Print the report during testing. Too many columns, wrapped text, or duplicated rows can turn a difficult event into an even harder one.

2. Schedule Orders Report

A Schedule Orders Report can help procedural departments understand pending or scheduled orders during downtime.

Departments should determine which order details are required to continue approved work, assess urgency, and contact the appropriate person when clarification is needed.

Possible elements include:

• Patient identifiers
• Order or procedure
• Priority
• Requested date or time
• Patient location or class
• Ordering provider
• Ordering department
• Approved contact information
• Relevant instructions or clinical details

Sorting should reflect the department’s operational needs. For example, urgent work may need to appear before routine orders, with additional sorting by location or scheduled time.

3. Protocol Report

Procedural areas may need access to finalized protocol information when normal systems are unavailable. A protocol report should present the approved protocol clearly, including any changes that affect the planned procedure.

Important instructions should be obvious at a glance. A changed order, contrast instruction, preparation requirement, or other critical detail should never disappear inside a long block of text.

If local build requires a protocol report to be linked or delivered through another BCA report type, verify the current supported configuration in Epic documentation.

4. Medication Administration Report

A Medication Administration Report can provide authorized users with relevant recent administration information needed for an approved downtime workflow.

Organizations should determine:

• Which medication information is necessary
• The appropriate historical time range
• Which departments should receive the report
• How late, corrected, held, or discontinued information is represented
• How users will document new activity during downtime
• How downtime documentation will be reconciled after recovery

The report is an information source, not a substitute for medication policy, clinical verification, or local downtime procedures.

5. Recent Order Sets or Downtime Order Guidance

During downtime, users may need access to approved guidance for commonly used orders or order sets. The organization should decide whether a BCA report, controlled downtime forms, or another approved resource is the best method.

Any downtime order guidance should have:

• Clinical ownership
• Version control
• Approval and review dates
• Clear scope and intended users
• A process for urgent updates
• Removal of obsolete versions
• Reconciliation procedures after restoration

Do not depend on users recalling complex order sets from memory.

Epic BCA Report Design Tips

Keep Reports Focused

Include information that helps users perform the intended downtime task. Remove fields that add length without supporting a decision or action.

Use Clear Titles

The title should identify the department, report purpose, date range, and any relevant filter such as “Today,” “Tomorrow,” or “Urgent.”

Apply Useful Sorting

Sort reports according to workflow. Priority, time, location, patient, and status can each be useful depending on the report.

Design for Printing

Confirm page orientation, column width, wrapping, font size, page breaks, repeated headers, and the handling of long values. Test on the actual printers departments will use.

Minimize Duplicate Rows

One patient or appointment should not consume multiple pages because of poorly structured data. Review how comments, diagnoses, orders, and other repeating elements affect the output.

Verify Data Freshness

Users should be able to determine when the report data was generated. Downtime procedures should explain how the organization will communicate the age and limitations of available information.

Epic BCA Testing and Maintenance Checklist

• Assign an owner for each report and department.
• Document the report’s purpose and approved users.
• Define the acceptable age of available data.
• Confirm report destinations and workstation access.
• Apply minimum-necessary and role-based access principles.
• Test reports with realistic departmental scenarios.
• Verify that important information remains readable when printed.
• Test backup power, network, printer, and workstation dependencies where applicable.
• Train users on access, escalation, and documentation procedures.
• Record test results and remediation items.
• Include recovery, back-entry, and reconciliation responsibilities.
• Revalidate after material workflow, build, release, or infrastructure changes.
• Review reports on a defined schedule even if no downtime has occurred.

Testing Without Disrupting Clinical Departments

Organizations can establish an approved test process that allows analysts and operational owners to review BCA output without relying only on an actual downtime event.

Generating the report is only one part of the test. Review access, data content, timestamps, filters, sorting, layout, printing, staff instructions, escalation, and reconciliation as well.

Technical testing should follow the organization’s change-control and security practices. Use current Epic guidance when configuring test workstations, generating reports, or moving changes between environments.

Recovery and Reconciliation

Downtime planning does not end when Epic becomes available again. Departments need a controlled process for entering or reconciling orders, medications, results, appointments, documentation, charges, and other activity completed during the interruption.

Recovery planning should define:

• Who announces restoration
• When users should stop downtime procedures
• Which records require back-entry
• Which source documents are authoritative
• How duplicate entry will be prevented
• How discrepancies will be escalated
• How paper or temporary records will be retained or destroyed
• How the organization will review the event and improve its plan

Frequently Asked Questions About Epic BCA

What does BCA stand for in Epic?

BCA stands for Business Continuity Access.

Does Epic BCA replace a downtime plan?

No. BCA is one component of a broader downtime and business-continuity program that includes procedures, communications, training, alternate documentation, recovery, and reconciliation.

Which BCA reports should every hospital use?

There is no universal report set. Each organization should select and configure reports based on departmental workflows, patient-safety needs, privacy, approved procedures, and its Epic environment.

How often should BCA reports be tested?

Organizations should establish a risk-based schedule and revalidate after material workflow, build, release, infrastructure, or policy changes. Follow local continuity, security, and regulatory requirements.

What information belongs on a BCA report?

Include the minimum information required for the report’s approved downtime purpose. Clinical, operational, privacy, security, and legal stakeholders should participate in the decision.

BCA reports work best when users help design them, teams test them under realistic conditions, and owners keep them current as part of the broader downtime plan. For help assessing Epic continuity, reporting, or support needs, contact Healthcare IT Leaders.

Consultant Dane Patten is a veteran Epic builder and analyst with a deep understanding of the Epic procedural data structure. He has a decade of experience in radiology and cardiology-specific IT systems.