Epic Enterprise
Implementation
Kick-off Meeting
September 19, 2012
1
Today’s Agenda
Welcome and Opening Remarks
 Meet Epic
 Organization and Charter
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2
Application Project Teams
Timelines
Program Scope
Key Performance Indicators
What to Expect in the Short Term
Adjourn
Robert Warren, MD, PhD, MPH
Chief Medical Information Officer
3
Health Care in Transition
Engagement Competition Regulation Reimbursement
“Care Delivery Factories”
OLD MEDICINE
“Home Sweet Medical Homes”
NEW MEDICINE
Patient as Disease
Patient as Partner
Disconnected care; limited access
Facilitated access to care
Real-time connection with patients and
community physicians and services
“Isolated” experts; care variance
Evidence-based care
Real-time clinical decision support
Unrelated Clinical Research
Integrated Research Driving Best Care
$$ for service
“No Margin, No Mission”
$$ for outcomes
“No Outcome, No Income”
PriceWaterhouseCoopers (adapted)
4
MUSC Health Strategic Plan
Patient-engaged, evidence-based best care
Responsive to community needs and regulatory
requirements
Efficiently provided and reported
Informing health care education and research
Integrated electronic patient record
expanding our outpatient success:
Epic Enterprise: July 1, 2014
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A New Record
… a cultural shift from adoption to ownership
6
7
A Few Words from our Sponsor(s)
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Etta Pisano, MD
◦ VP Medical Affairs & Dean, COM
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W. Stuart Smith
◦ VP Clinical Operations & Executive Director, Medical Center
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Stephen Valerio
◦ CEO MUSC Physicians & Associate Dean for Finance, COM
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Frank Clark, PhD
◦ VP Information Technology & CIO
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And Now…….
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Meet our
Representatives
Jim Pfleger, Implementation Manager
Ryan Marshall, Implementation Coordinator
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Who is
?
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Founded in 1979
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Located in Verona, Wisconsin
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Private & employee owned
◦ 275 “customers”
◦ 70 academic medical centers
◦ 6200 employees
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Almost all employees engaged
in R&D or customer support
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Named # 1 overall software
vendor for 2011 by KLAS
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> 40% of the U.S. population is
cared for using Epic software.
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Flight Plan Install Process
Education &
Planning
Education & Analysis
·
Testing,
Training, &
Go-live
Build & User
Adoption
Implementation
Support &
Optimization
PHASE 1
PHASE 2
PHASE 3
PHASE 4
PHASE 5
FLIGHT PLAN
BOARDING
WHEELS UP
IN FLIGHT
FINAL APPROACH
LANDING &
ARRIVAL
Executive
education and
project
groundwork
Groundwork
phone call
·
Project
planning and
analysis
Project team
identified
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·
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Scope defined
Site visits
completed
Model System
variances
determined &
documented
Building in copy
of Model
System
Customer team
attends training
at Epic and
completes
certification
·
Workflow
validation
sessions
·
Stoplight
evaluations
completed
Rollouts &
Upgrades
Adoption & Transformation
PHASE 0
·
·
Workflow
Validation
Discovery
·
·
“Red light”
validation
points from
validation
sessions
resolved
System is built
out
·
End users
trained and
prepared for
go-live
·
Workflow labs
conducted
·
System is
finalized and
tested
·
Go-live
PHASE 6
NEW
DESTINATIONS
·
System is live
and optimized
·
Preparation for
rollout
·
Epic team
completes
post-live visits
·
Rollout
·
Evaluation of
future scope
Timelines
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August – September 2012
◦ Phases 0 & 1:
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October – November 2012
◦ Phase 2:
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Testing and Training
July 2014 – August 2014
◦ Phase 5:
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System Build and Preparation
September 2013 – June 2014
◦ Phase 4:
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Workflow validation
December 2012 – August 2013
◦ Phase 3:
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Discovery and Planning
Go-Live / Support
eCareNet
Committee
Executive
VP Group
EHR Development
& Operations
Council
Enterprise
Executive Sponsor
Dr. Bob Warren
Epic Program
Administrator
Melissa Forinash
PMO, Dan Furlong
Revenue
Cycle
Steering
Committee
Communications
Periop
Steering &
ED IT
Steering
Committee
Analytics
Development
& Operations
Council
Inpatient
Steering
Committee
C. Carr
S. Russell
S. Harvey
K.Weaver
Gail
ScarboroHrtiz
R. Freeman
K. Davis
S. Miller
J. Kratz
C. Liddy
Revenue
Cycle
Inpatient
Clinicals
Ambulatory
EMR
Training &
Support
D.Northrup
T.Walsh
Enterprise
Reporting &
Analytics
Infrastructure
& Technical
Support
M. Daniels
K.Nendorf
J.Dell
M.Balassone
Legend
Advisory &
Steering Groups
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Admins &
Clinical Leads
OCIO/IT
Leads
N. Whichard
Emergency,
OR, &
Anesthesia
B.Seyfried
Application Project Teams
Approximately 150 people assigned full or
part time
 ~ 40 additional people hired within OCIO
to staff project teams
 33 people currently certified in one or
more Epic modules
 >80 people currently in training /
certification process
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The “Charter”
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Overall Governing Document for Epic
Enterprise Program
Defines overall scope & timelines
Defines activities at various phases
Establishes Key Performance Indicators
for program success
Approved by eCareNet Committee 8/13
Sign-off by Executive Leadership
Program Scope
Enterprise-Wide Patient Access &
Revenue Cycle
 Inpatient clinical systems
 Enterprise-wide Analytics & Research
 Continued enhancement of Ambulatory
clinical systems
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Enhancement of Ambulatory EHR
and integration with Enterprise
2012
Aug
Sep
2013
Oct
Nov
Dec
x
x
x
Jan - Mar
Apr - Jun
2014
Jul - Sep
Oct - Dec Jan - Mar Apr - Jun
Ongoing Optimization
Meaningful Use Stage 1
EpicCare Link (referring MDs)
Version Upgrade to 2012
Kaleidoscope Ophthalmology
ICD10
Phoenix Transplant
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~1/15/13
6/1/13
6/1/13
6/1/13
6/1/13
~6/15/2013
6/15/13
6/15/13
Jul - Sep
Oct - Dec
Patient Access & Revenue Cycle
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Welcome
Cadence
Prelude
Identity
Resolute
HIM
BedTime
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Patient Kiosk
Scheduling
Enterprise Registration and ADT
Enterprise MPI
Professional & Hospital Billing
ROI Deficiency Tracking
Bed Management
Inpatient Clinicals
◦ EpicCare Clinical
Documentation & Stork
◦ EpicCare Physician Order Entry
◦ Willow
◦ Radiant
◦ Beacon
◦ ASAP
◦ OpTime & Anesthesia
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ClinDoc and L&D
CPOE
 Inpatient Pharmacy
 Radiology
 Oncology
 Emergency
 OR & Anesthesia
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Analytics and Research
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Administration over all reporting platforms:
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“Workbench” reporting at the application level
“MyEpic/Radar” Dashboard
“Clarity” analytic reporting
Other 3rd party platforms
Reporting Analysts – write Crystal Reports (Clarity)
and collaborate with SME’s for all reporting needs
 Manage Enterprise Information Request process
(formerly Hospital Data Request)
 Coordination with the Research community
regarding resources for research build and reporting
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Other Modules Licensed
(currently not in scope)
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Cupid
Willow Ambulatory
Beaker
Cogito data warehouse
Tapestry
Cardiology Info System
Retail Pharmacy
Laboratory
Enterprise Data Warehouse
Claims Management
Existing departmental systems not
expected to be replaced
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Diagnostic Image Archives
◦ PACS in Radiology, Cardiology, OB, GI, etc.
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Document scanning (McKesson HPF)
Niche specialty systems
◦ EKG, Sleep Lab, Fetal Monitoring, Ped Card,Vascular Lab,
Meducare, RescueNet, PaceArt, Radiology systems such as
PenRad, PeerVue, TeraRecon, etc.
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HR, General Accounting, General Financials
KPI’s – Ten for Overall Program
Determined by eCareNet Committee
 Examples
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◦ Implementation by 7/1/14
◦ Average weekly cash posted for hospital and
professional billing
◦ Utilization of Epic by external stakeholders (MyChart,
EpicCare Link)
◦ Percent of new patients seen within 1 to 5 days of
initial contact
◦ Successful attestation Stage 2 Meaningful Use
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KPI’s – Application Specific
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Each team will identify KPI’s specific to their
application as a measure of success by
September 30
Examples:
◦ Days in AR for hospital / professional billing
◦ % of regulatory requirements reportable through
Epic
◦ OR – prophylactic antibiotic medication
compliance
◦ Admission medication reconciliation compliance
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Measuring Success
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MUSC Health leadership support and active
participation
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“Ownership” by the project teams and operations
◦ Interdisciplinary Teamwork and Workflow
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Engagement and empowerment of physician and nurse
super users as well as departmental “SME’s”
Timeline Management
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Set go-live dates and stick to them
Control scope closely
Stick closely to Epic’s ‘Model System’
Expect post-live adjustments
What’s Next?

Kick-off and Site
Visits

Validation Sessions
◦ October 16-18
◦ November 6-8
◦ November 27-29
◦ This Week
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Reengineering Sessions
◦ December 18-20
◦ January 8-10
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What can you do?

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Help us make sure we have the right people
at the table
Help make decisions in a timely manner
◦ Revisiting decisions will cost us time and
If you have a concern, voice it – don’t
assume we already know
 Be Cheerleaders!!
 Check our hearing!!
 Help us stay focused on the big wins
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Growing Pains
Change, Change, Change
 Super-user and “SME” time commitment
 Training: 10-15 + hours of physician and
nurse training/competency testing
 Standardizing workflows where possible
 Electronic and paper workflows
 Backup / downtime procedures
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Realizing the Benefits
Volumes of discrete data for reporting
 Easy access to patient data in a single
database
 Interdisciplinary Record
 Better charts lead to
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◦ Better care
◦ Better reimbursement
◦ Increased patient satisfaction
◦ Improved quality of care
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Questions???
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