Inside the West Health Accelerator at Mass General Brigham: Hardwiring Better Care through Epic

What if transforming geriatric care started before a patient ever reached the bedside? What if the safest choice was the easiest one because the system itself was built with older adults in mind? Through the West Health Accelerator at Mass General Brigham, leaders are making that vision a reality. They have redesigned the electronic health record, Epic, to automatically support age-appropriate care for adults ages 65 and older, embedding best practices directly into everyday clinical workflows.

“This is my favorite part of the Accelerator,” says Lynne O’Mara, MBA, PA-C, E-Care Clinical Director for the Accelerator. “Epic gives structure to very complex patients. Older adults are often taking many medications and living with several health conditions. They may also have trouble seeing, hearing or communicating. In a busy hospital, that makes it easier for important details to be missed. If we can use Epic to make it easier for clinicians to do the right thing from the start, that leads to safer, better care.”

Two major Epic builds have gone live since November 2025. Each rollout included staff training and communication to make sure clinicians understood the changes and why they matter. With each Epic go-live, the Accelerator moves closer to ensuring that every patient 65 and older—who make up 50% of inpatient admissions at Mass General Brigham—receives age-appropriate care that anticipates and addresses their unique vulnerabilities, such as delirium, mobility and medication-related risks.

Building Age-Appropriate Care into Everyday Clinical Practice

For close to a decade, O’Mara and other clinicians across Mass General Brigham had been developing and using a geriatric-focused order set—a checklist of best practices—to improve outcomes for older trauma patients. It helped reduce delirium and readmissions, but it required clinicians to remember to add it manually. “It was always a two-step process,” O’Mara explains. “You had to admit the patient, and then remember to add the geriatric order set. If you forgot, the safeguards weren’t there.”

Now, with the launch of the West Health Accelerator, many of those age-specific best practices are automatically included. For example, lower starting doses for high-risk medications, steps to prevent constipation, better sleep routines, regular oral care and aspiration precautions are just some of the orders that are now pre-selected for patients 65 and older.

“The care is baked in,” O’Mara says. “We reduced clicks and made it safer right from the start.” She adds that the Accelerator’s Epic updates preserve professional judgment, so clinicians can adjust defaults, and choose not to select the orders. “It’s like a tip screen. The recommended percentage is right there—clinicians can change it, but the safer option is easy to choose,” explains O’Mara.

Partnering with Epic to Build and Scale the Accelerator

Kimberly Rau, a consultant from Epic, is helping to bring the Accelerator’s innovative design to life inside Epic. Her role is translating the team’s vision into logic, age-based rules and scalable workflows. “If someone comes to me with an idea and we can’t do it today, it’s not a hard no,” Rau says. “It’s more about, ‘How can we achieve the goal within the system we have?’ This was very much a collaborative effort to make the software work for the clinicians—not the other way around.”

Rau says that one of the most critical elements of the project is how the Accelerator team integrates with frontline clinicians. “What I find special about this project is seeing a dedicated team come together around a common vision to improve care for older adults,” says Rau. “Lynne did a great job of presenting to many stakeholders across disciplines and specialties to get their feedback and approval. She really focused on the vision and how these changes make it easier for clinicians to provide safer, quality care.”

Early outcomes suggest the approach is already having a positive impact across the system. When more data is available, Rau hopes to share learnings. “Epic fosters and encourages collaboration across health systems,” she says. “We're excited to share this work with others so they don't have to start an implementation from scratch.”