Many organizations across the country are shifting their workflows to be more inclusive of their affiliates. The goal of this is to streamline coordination of care, improve patient outcomes and create overall healthier communities for which they serve. Does this sound familiar?
Independent affiliates often use EHRs in their private offices, and in many cases, the larger health system is working with them to support those provider affiliates on their own platforms. The significant push of interoperability and electronic communication between providers that the Meaningful Use incentives brought about made the strategy for large health systems to incorporate their affiliates a good investment. The independent provider was able to keep up with the fast-changing healthcare landscape with the support of their local community hospital. In addition, the health system benefitted by knowing that they would have similar capabilities with an EHR in terms of data collection, patient documentation and electronic exchange capabilities. It was a win/win for both the independent provider as well as the larger organization.
The Introduction of Epic Connect
In walks Epic. They create a platform for independent providers that is tied to a hospital organization’s instance of Epic. Increased data sharing, increased coordination of care, decreased delays in treatment, one patient and one record. The wave of change yet again.
An expensive endeavor to take on, but well worth the effort, time and money spent. The journey to get there, however, is bumpy and takes years of planning, building and strategizing. But let’s not forget the most important thing—it takes people. New people. Epic-certified people. The challenge of managing and maintaining the current system while learning a new system takes a toll on existing internal teams. How does an organization do that in a way that is cost-effective while the structure is maintained and neither the support nor employee morale suffers. Some health systems try to train existing staff and split the duties, some hire new staff to work on Epic, some cherry pick their best to work and get Epic certifications, but the fact remains is someone needs to do the daily maintenance work to keep things moving and working to make way for the future.
The goal is a seamless process of change, but that’s not the reality. The reality is hard, frustrating and sometimes puzzling because every organization carries its own unique characteristics or nuances that throw a wrench in the whole thing. There are many stories I can think of, and I’m sure you may have a few of your own. It’s not for the faint of heart. It takes good leadership that knows their people, their capabilities, their potential and the community to make the decisions that go into the implementation strategy and legacy support model that is chosen. The who, what and when of such a massive undertaking.
Alternatives for support do exist for organizations who want to manage the legacy system and the team that supports it. The question is, which one is the right decision for your organization?
- Staff augmentation – hiring on temporary staff to work beside the current support team
- Managed Services – hire a company to take over legacy support; includes Help Desk duties, end-user support and, in some cases, server maintenance and upgrades
- A combination of the staff augmentation and managed services
- Keep the existing support team and hire on new team members who already have the prerequisite Epic skillset
Determining what is done today for support and by whom and when is extremely important. What is included now and what will be re-evaluated or not included in the future?
- What will be the ‘must haves’ and what can be removed if anything?
- If outsourcing, what does that support model look like?
- What upgrades to the legacy system will be made?
- What will be the process for newly acquired affiliates? Will new implementations continue?
- What is the messaging to the end users of the legacy support?
- What is the implementation timeline for the legacy systems to move to the new system?
- What are the alternatives if the affiliates decide to not move to Epic?
- What is the roll-off strategy?
- What will happen to the existing support team?
Mapping out what exactly needs to be done and when, for both ongoing support and maintenance as well as the implementation timeline for the new system, is necessary for success. Be sure to answer the following questions before beginning the implementation process for Epic Connect:
- When will upgrades be stopped?
- When do new implementations cease to be done?
- When will legacy support cease? Is there a timeline for this? If so, what is it?
- When is the first implementation for the new system taking place? How many affiliates will be implemented at once? What resources will be needed for that?
These are just some of the questions to ask when implementing Epic Connect, along with hundreds more. Always keep in mind the people. It is the most precious resource of all. Without people, nothing is possible. There are some big advantages to keeping existing staff and training them in the new system. The existing teams will remain in play; they already know the organization and the nuances which may make for a better implementation and build experience during planning sessions. They know the history and why something is done a certain way. It also supplies an avenue for the existing staff to have an opportunity for professional growth which creates a positive, encouraging environment. It builds camaraderie from the beginning of the project as everyone learns together.
Final Thoughts on Implementing Epic Connect
There are also some serious considerations to think about as well. Existing team members will need to oversee and train those coming onboard whether they are new or temporary. There is always the added cost associated with hiring people (temporary or as an FTE). Most importantly, how the the legacy support structure will look like at the beginning, middle and end of the project needs to be determined. This allows for a ramping up period and then an exit strategy for the legacy support and moving to ongoing support for the new system.
The journey to implementing Epic Connect is a long and hard one, but in the end (if that’s even a thing), everyone will come out on the other side a little bit better.