NextGen 5.8/KBM 8.3.3
Upgrade
Tips, Tricks and Lessons Learned
Adam Cox, EHR Implementation Coordinator
Ginger Grass, Manager NextGen EHR Implementation
About us…
We are a group of 80+ Providers in eight specialties and their staff.
We are part of the IASIS Healthcare group that has hospitals and clinics across the
nation.
The Eastern Division of our group was a beta client for 8.3.3 as part of the Drive to
Live program.
We worked closely with NextGen to successfully test and implement the 5.8/8.3
versions in September 2013.
Tips and Tricks
What we did that really helped!
5.8 Upgrade
We split the two upgrades and held them five weeks apart.
Because the 5.8 upgrade had fewer effects on the user interface, we held several
webinar trainings and allowed users to attend at their preferred time.
We didn’t turn on several features until after the KBM Upgrade:
• Patient toolbar
• Immunization Module
KBM 8.3.3 Upgrade
Our team performed a gap analysis.
Allowed us to see all customizations.
Allowed us to see the last time and how frequently each customization was used.
We reviewed customizations with our clinics and decided which items to include in
the new version.
We had weekly “Train the Trainer” webinars before the Eastern Division upgrade
where each staff member presented a portion of the new template sets.
These were recorded for later reference as needed.
Gap Analysis Tool
Super User Program
We established a Super User program about a year before we upgraded.
There is at least one Super User per clinic.
Super Users receive additional training monthly on how to troubleshoot problems
and open tickets.
Super Users are the primary point of contact for their location.
Super Users are paid a monthly bonus.
We incentivize our Super Users with a quarterly reward for the best ticket.
S.T.A.R.
Super User
Ticketing
Achievement
Reward
Super User Training
We scheduled a five hour training four weeks before the upgrade with all of our Super
Users.
We began the training with a demonstration of the new templates.
We then broke our Super Users into groups by specialty and asked them to come up
with an ideal workflow and map it out.
This allowed them to learn from each other.
Several of the Super Users were able to point out areas where we were missing
orders, etc. before we upgraded.
We had LOTS of candy at this meeting!
Provider and Staff Training
We trained providers and staff over a three week period prior to the upgrade.
We scheduled trainings onsite at clinics.
We trained each provider individually.
We trained the staff members as a group.
We utilized Super Users as facilitators during the training.
We asked every person that attended training to sign off a checklist.
Hands On Room
This was held the week leading up to Go Live.
We had a room available and manned by a trainer where providers and staff could
drop in and practice.
The Hands On Room rotated locations.
Training materials, laptops and scanners were available.
Missed trainings were completed in the Hands On Room.
This also allowed users to ask questions on items that were not specific to the
upgrade.
Go Live
We flew in five additional resources for Go Live support.
Each person supported between 2-5 locations.
We had a call-in support line for Super Users, Practice Administrators and onsite help.
We kept a copy of the previous version (7.9.2) on a Demo server to refer back to for
questions regarding changes.
The decision to cut back schedules was left up to the individual locations.
The Go Live support team had daily conferences to discuss issues.
Have these somewhere fun with good food and alcohol!
Lessons Learned
What would have made our upgrade even more
brilliant…
Training
Our users would have benefited from more written cheat sheets that explained new
features.
Super User coaching on how to best triage problems and handle questions on the day
of Go Live.
Ongoing scenario-based training with the Super Users leading up to Go Live.
Testing
YOU CANNOT DO TOO MUCH TESTING!
Super User testing of the new version.
Have users with different system access test workflows.
Make sure to test all specialties and all visit types (configuration matters!)
Go Live
COMPLETE ALL ENCOUNTER NOTES BEFORE UPGRADE
We found that notes spanning the upgrade had so many issues we ended up hand
typing on the documents.
We told our providers it would cause problems, but we should have said, “…it will
make your life a nightmare if you don’t do this!!”
Factor in provider vacations and days off.
Increasingly frequent reminders of upgrade down time and chart completion
deadlines leading up to Go Live.
Go Live
If possible, make sure Super Users are not performing clinical duties on the day of Go
Live. (Good luck with this one!)
We had an issue with tasking that was related to two users having the same user ID.
Might be a good idea to check for this pre-upgrade.
Identify “problem providers” (you know who you are) and make sure they have extra
help.
Supervising physician signoff process changed.
Questions?
Answers free.
Good answers $5 each.
Contact Information
acox@iasishealthcare.com
ggrass@iasishealthcare.com