Healthcare Expert Roundup: 10 Best Practices for Rolling Out Epic EMR
1. Prioritization, Leadership, Communication, Staffing, and having Fun“Here are my best practice tips for a smooth Epic EMR implementation: 1. Prioritization: remember that an Epic go live is only the beginning and that the operations will have opportunities post go live to make tweaks to the content further and implement the ‘nice to have’. So, the client hospital must prioritize items that are critical for go live success 2. Champions and clinical leadership: Appropriately involving the clinical leadership right from the start is critical to a smoother go live. Form a steering committee for each Epic vertical and staff it with all the key clinical leaders. Identify your project ‘Champions’ (usually they are highly influential clinical leaders) well ahead and involve them in core project planning and change management. Ensure the Champions feel adequately supported by the project management throughout the project. 3. Communications: Like any large project, an Epic project’s success relies on communications that reach the right audience, at the right time and through the right medium. As an Epic project could bring high anxiety among the front line clinical staff, having such a strong communication plan compliments a sound change management strategy for the project 4. Staffing: while many hospitals implementing Epic staffs a great proportion of the project with internal clinical staff, there could be a significant value in hiring Epic certified consultants with prior Epic experience though they could be more expensive. As there’s no guarantee that Epic’s implementation services team (i.e. Application Coordinator/Manager) provides adequate support to the newly certified project staff, it’s a smart move for the Epic Project Managers to have their experienced Consultants mentor rest of the team, as needed, and guide them when Epic staff is not immediately reachable for support. 5. Have fun: as it’s easy to get stressed out with an expensive and large scale EMR implementation, don’t forget to have fun! It’s important for the project leadership to recognize and celebrate small wins and continuously motivate your project team.” Karthik Seshan, Project Manager Epic EMR Implementation The Hospital for Sick Children
2. Need for healthcare IT professionals with a strong knowledge base“The biggest concern I can see now is that we have a lack of supporters who have solid clinical knowledge. This has a big negative impact for the clinicians to learn and manage the big change in their life. We need more health informaticians who know the system well and can also relate the functionalities to the workflow to increase the efficiency of adoption.” Eric Zhigang Tian, Epic Credentialed Trainer The Hospital for Sick Children
3. Engage and integrate stakeholders for an integrated system“One of the biggest oversights in EMR implementation can be disengaging certain stakeholders that work behind the scenes, such as finance and coding SMEs, when developing workflows for front end users. Be sure to engage them at the forefront when making decisions to ensure ministry funding opportunities aren’t compromised due to workflow decisions. Another piece of advice would be to have integrated groups where analysts from different applications can discuss upcoming build changes. With such a large project, it can become easy to work in silos, but it is pivotal to ensure a collaborative approach is maintained to build an integrated system.” Hibah Khan, Epic Certified Application Specialist St. Joseph Healthcare
4. Planning phase is key for successful EMR implementation!“Based on our implementation of EPIC EMR at Mackenzie Health, I would have the say the project planning phase (scope of the project) would be the most important prior to beginning the project. During the implementation phase, information gathering was very important to be able to gather all of necessary information from the legacy systems/processes needed to customize the EMR to Mackenzie Health’s requirements. Being the first Canadian hospital to implement the full suite of Epic EMR had its fair share of challenges that we needed to overcome. With Epic EMR the hospital went totally digital so there were a lot of new workflows and procedures that also needed to be created. Having a cohesive and talented team was the biggest reason that we had a very success go-live.” Amit Haror, Epic EMR Security Coordinator Mackenzie Health
5. Transfer of relevant data from old EMR systems to Epic EMR and archival of remaining data“When a legacy EHR system is retired or replaced by Epic, hospitals and providers are still responsible for maintaining the historical medical and financial records. Many states require this to be maintained for 6 to 10 years for release of information. Many hospitals and providers who move to Epic EHR, assume that all history records will be moved into Epic. This is not true most of the time. By the time they realize this, all budget is burnt out for Epic implementation. So, they end up continuing to pay annual support fees to the legacy EHR to retain access to historic information. So, they end up running two systems! Archival of the historic medical and financial information in the old system is the right solution for these situations. The history records need to be extracted from the legacy EHR and put in a safe, secure place and the information should be made available to those who need it. Some vendors specialize in extracting all data from multiple old EHR systems, migrating the minimal relevant data into new the EHR and archiving the rest. This data management services help hospitals and clinics to move to new EHR without losing historical data, and keep them compliant. Vendor neutral EHR archives cost only a fraction of maintaining the legacy EHR systems.” Sudhakar Mohanraj, Founder and CEO Triyam Data management solutions for healthcare
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6. Thoroughly trained staff and regular feedback from users“Generally speaking for a smooth rollout staff should be thoroughly trained on their specific job function within the system. Additionally, feedback sessions post implementation for each user/department is essential to ensure that any issues that come up after implementation are handled ASAP. Otherwise users may blame the system.” Patrick Foote, Principal Consultant ATLCG- Healthcare Marketing Consultants
7. Adequately customize the EMR, give clear and specific instructions“Some major things I have learned along the way are: 1. Allot adequate time for your workflow experts to spend time with the vendor to customize the EMR and create solid data entry practices, templates, workflows etc. before you go live. Trying to backtrack and customize later is a messy endeavor, and causes a lot of stress and change fatigue for your staff. 2. You will have but one opportunity to tell everyone exactly what to do, and how to do it. This will be the only time they will listen with complete attention and not fight you on it. So if you don’t give specific instructions on exactly how to do their tasks, they will create their own ways, and it will become a big mess. However, if you create all the customization beforehand and make it easy for people to enter discrete data and do things the right way, you will have a running start, and you will excel much more rapidly than a rollout without this structure. 3. Minimize the opportunity for free text as much as possible. If there are times when a narrative is required, have that alongside discrete data entry fields.” Bekki Tagg, EMR Specialist South Calgary Primary Care Network
8. Transparency and User Empowerment“There are two things that I would say are crucial in making go-live (a little more) stress free. From my experience, I found it was very important to have transparency with the progression of the project and that users felt empowered. End-users, for example, could be given access to open labs to practice, ask questions or provide feedback prior to go-live. This allows for “final touches” to workflows and within the system. Most importantly, it is a good idea to observe and learn from other organizations that have completed an implementation. Processes related to anything such as training, configuration or security can be modified to ensure that similar issues do not arise.” Ashley Ssali, Epic Support Analyst The Hospital for Sick Children
9. Dedicate adequate resources and logistics for training“Here are some points from my experience in 2 projects in Epic implementation: Finalize the decisions about work flow changes before the training and Go-live. Make sure of no missing build and have the complete build migrated to the training environments Have the super users engaged in training and support of their colleagues. Give high priorities to the epic implementation in terms of resources and logistics. Establish solid communication plans during the project lifecycle. Have the managers review the training curriculum and approve it before training. Have patient scenarios in training resembling real life with full details (results and documentation). Engage the site leaders to support the project at a high level. Build confidence among the users. Minimize the changes to the training environment once training starts. Plan for the cutover activities and data validation in terms of time and resources. Make use of the lessons learned from other sites.” Jadallah Alnasarat, Epic Trainer The Hospital for Sick Children
10. Adhere to project timeline and engage operations“From a project perspective, sticking to the project timeline is critical in order to meet the deadline. We found that many new requirements always came up during the implementation, and if we had pushed back the go live date each time, we would never have launched. There will always be things that are never fully complete or correct, and will need to be corrected after launch. Keeping operations engaged is very important to help keep excitement levels high, and to reinforce that this was not just an IT project, it was a clinical transformation that affected all groups.” Husain Kamadia, Epic Applications Analyst Mackenzie Health
Are you looking to make the switch to Epic’s EMR system in the future?Make sure you consider these ten expert best practices to enhance your implementation of Epic EMR and allow for a smooth and effective adoption!
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