The following is a guest blog post by Heather Haugen & Mia Erickson from Atos
Epic continues to gain market share across the healthcare landscape. In 2019, they represent about 33% of the EHR inpatient hospital market share. Many of the largest healthcare organizations have implemented Epic and they remain a strong contender for new implementations and EHR replacements. Epic maintains a reputation for being clinician-centric, dependable and highly referenceable. Despite their impressive reputation and strong market position, however, implementing and maintaining a large comprehensive EHR still requires significant investment from the adopting healthcare organization before, during and after go-live.
We spoke to Mia Erickson to learn more about Epic’s go-live best practices. Mia has 30 years of Epic experience including work with Kaiser Permanente, WellStar Health System, Children’s Healthcare Atlanta, and many other prominent healthcare organizations. Mia also worked for Epic for several years, during which she gained critical insights working for Epic and with healthcare organizations implementing Epic. She also consulted on inpatient, ambulatory, revenue cycle, and community-based Epic implementations.
Because so many healthcare leaders find go-live support to be the most expensive and difficult to manage part of an implementation, we decided to explore those specific challenges with Mia first. Go-live support is often described by CIOs as “a necessary evil”, “an expensive insurance policy” and “managing chaos”. Yet some organizations do find value in go-live support and manage the complex logistics in a way that drives long term adoption of their EHR. What are they doing differently?
1. Understanding the logistics and having experience managing them: The EHR go live is an incredibly complex set of logistics involving every employee of the healthcare system, multiple vendors (even for Epic implementations), and consultants. Managing logistics spans communication, events, training, meeting space, transportation, housing, and resource allocation. Another area that can quickly lead to poor outcomes is lack of pre-go-live switch-over processes and conversion planning. Ensuring that you have adequate resources and efficient processes is critical for maintaining data integrity and successful go-live timing.
We recommend working with an experienced group to manage go-live logistics, especially those related to resource allocation, training, communication and travel. We often see significant portions of the budget wasted on travel, meal, and transportation inefficiencies that add significant costs to the go-live expense. Consulting with experienced colleagues, experts, and Epic around pre-go-live procedures and verifying the resources and timing of the workload will help the effort go smoothly.
2. Training Beyond Functionality: Training remains one the best predictors of go-live success and long-term EHR adoption. According to the Arch Collaborative (KLAS), “The single greatest predictor of user experience is not which EHR a provider uses and not what percent of an organization’s operating budget is spent on information technology, but how users rate the quality of the EHR-specific training they received.” (Longhurst et al. Local Investment in Training Drives EHR User Satisfaction 2019). Many vendors typically train on functionality, but organizations with the strongest outcomes educate users on workflow and ensure they receive role-based education. Healthcare organizations rarely use one vendor exclusively and will need additional training on how to navigate between applications to accomplish clinical tasks (for example, between Epic’s clinical applications and Cerner’s lab system).
We recommend training and education specific to the users’ role AND workflow. Don’t limit a user’s education to the vendor product because users must work across vendor applications to provide patient care, and they should be educated on the best practices for navigating among systems. Many vendors train on core functionality, but users need more education over time to achieve the highest levels of adoption and productivity.
3. Strategic Advisors: Some healthcare leaders have experienced multiple EHR implementations and have experience with go-lives that allows them to anticipate potential problems, workarounds and failures. These areas of focus can include preparation of super users, troubleshooting of common issues, communication about issues and workflow changes, managing the service desk, and considering effective remediation processes for issues that arise.
We recommend identifying colleagues from other organizations who have been through a recent Epic implementation and asking them about their experiences to gain insight on what might go wrong and how to plan for those challenges. Develop trusted relationships with your vendors and the consultants who can provide good advice before, during and after your go-live. Mia’s team has been through hundreds of Epic implementations, so she can work with leaders to identify potential issues and how to overcome them or even avoid them completely.
4. Epic Expertise: Epic requires all implementation and support resources to be certified and all trainers to be credentialed because they understand the importance of having experts available to assist their clients. The quality (not quantity) of resources is a strong predictor of the value you receive from go-live support services.
We recommend asking for Epic references and Epic experience when you seek go-live support. Your organization needs the right combination of technical, practical, and operational experience to provide guidance, mentoring and execution to assist with your Epic adoption journey.
Mia and her team shared the following client feedback based on their Epic go-live support work. They provide the expertise and outcomes that bring value to healthcare organizations!
About the Authors
Mia Erickson MPH, MSW is the Epic Practice Vice President for Atos.
Heather Haugen PhD is the Chief Science Officer for Digital Health Solutions for Atos. She is also the author of Beyond Implementation: A Prescription for the Adoption of Healthcare Technology.
Inbal Vuletich serves as the editor for Atos Digital Health Solution publications.
About Atos Digital Health Solutions
Atos Digital Health Solutions helps healthcare organizations clarify business objectives while pursuing safer, more effective healthcare that manages costs and engagement across the care continuum. Our leadership team, consultants, and certified project and program managers bring years of practical and operational hospital experience to each engagement. Together, we’ll work closely with you to deliver meaningful outcomes that support your organization’s goals. Our team works shoulder-to-shoulder with your staff, sharing what we know openly. The knowledge transfer throughout the process improves skills and expertise among your team as well as ours. We support a full spectrum of products and services across the healthcare enterprise including Population Health, Value-Based Care, Security and Enterprise Business Strategy Advisory Services, Revenue Cycle Expertise, Adoption and Simulation Programs, ERP and Workforce Management, Go-Live Solutions, EHR Application Expertise, as well as Legacy and Technical Expertise. Atos is a proud sponsor of Healthcare Scene.