Oregon-based St. Charles Health System go-live with a $79.5 million Epic EHR implementation on April 7, after two years of planning and development. As EHR projects are some of the most challenging tech launches and Epic is known to be a complicated system, the planning stage was crucial to the project.
Before signing with Epic in 2016, St. Charles was running on two platforms: one for inpatient and the other for ambulatory services. EHR Project Director Chad Cagnolatti said that due to the organization’s strategy to have a more fully interoperable system, “Epic was a natural choice in that objective.”
The health system leaned on the Epic community in the region, as it’s “very collaborative,” said Cagnolatti. From the beginning, the implementation team met with health leaders in the area with Epic experiences to pull cooperative lessons learned from Epic implementations.
“We took those lessons learned and specific concerns to use in our organization,” said Cagnolatti.
To start, the health system spoke extensively with caregivers and providers who asked for a more robust, deeper platform that “could provide more efficient, more effective, real-time data,” said Cagnolatti.
In fact, much of the planning process came from these conversations with caregivers, explained Cagnolatti. They wanted a solution that served all avenues of care and supported interoperability, and officials shared the same goal.
Once the mission was established, the first step for St. Charles was to build its implementation team.
“We screened and vetted over 850 candidates and hired an implementation team of 85 caregivers to design, build and test the Epic system,” said Cagnolatti. “We had the team in place by August 2016: a month earlier than planned.”
Once the team was in place, work began on best practice system workflows, which were shared with caregivers and stakeholders across the organization. Cagnolatti explained the idea was to make those decisions on the best fit for users, which were then adopted “wherever and whenever” it was needed.
In total, there were “six months of testing and four months worth of training and operational readiness, and now we’re just days away,” said Cagnolatti.
Given the complexity of the Epic platform, user training is crucial to the success of the implementation. And Cagnolatti said that St. Charles approached training in a comprehensive way, as the organization really saw the “importance of thorough and relevant training for all care providers.”
In fact, Cagnolatti said the health system established a policy that everyone who would use the EHR in their workday would be required to complete all training. As a result, the team gave that staff access to the EHR, and “everyone was expected to complete role-based training.”
St. Charles employed the strategy and models from Epic, and all providers were trained by peers, allowing training to be more relevant to the user. And Cagnolatti said that not only did users say they felt training was more beneficial, they were also able to reduce the amount of time in training classes.
And training was provided to users at a wide range of available hours to fit staffing schedules.
One of the biggest challenges was making sure there was a standard method for work processes across the organization, Cagnolatti explained. “It’s a challenge, but a huge opportunity to improve.”
But readiness and planning have been key to planning for Saturday’s roll-out, which Cagnolatti said they’re prepared to handle.
“An undertaking like this is a transformative paradigm shift for an organization,” said Cagnolatti. “It really changes how the organization does business and changes their underlying fabric and philosophy.”
So the team has been making sure everyone is ready across all service lines. By checking for readiness, Cagnolatti said they can determine what they’re ready to take on.
“I can’t overemphasize taking the time to plan for staff and make way room for the time and effort that it takes collectively across the entire org to be successful,” said Cagnolatti.
But that extra time, Cagnolatti hopes will allow the organization to leverage the power of data through the interoperable, single EHR system to improve care delivery models and help the organization manage the population more effectively.
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