"The mere fact that I can sit here today on Wednesday and chat for 30 minutes after going live on Monday is significant," Rose Ann Laureto, CIO of Toledo, Ohio-based ProMedica, told Becker's Hospital Review in an interview last week.
ProMedica signed its contract to adopt Epic's EHR in March 2014. The health system started looking for a new EHR vendor because its previous, predominant EHR vendor was sunsetting its product line. After eight months of looking at other tools and products, the system selected Epic.
ProMedica took the system live Nov. 2 with a pilot of 21 providers.
Here, Ms. Laureto discusses the EHR implementation process, challenges, accomplishments and what ProMedica faces in the coming months.
Question: Can you talk about the process from selecting Epic to Monday's go-live?
Rose Ann Laureto: Epic is an outstanding provider, and has a level of rigidity in its processes, which is a good thing. Their process is such that you can't touch their software until you have a large percentage of your core [implementation] team identified and ready to go. Then that core team has to be sent to Verona, Wis., and they have to be trained and pass certification tests. That process for us went from March [2014] to September 2014. That's when I start the clock [of our implementation timeline] because at that point, our workforce is ready to start looking at the software, working with our customers and configuring and designing the software so it will work at ProMedica. If you look at that, it was a 14-month cycle, with ICD-10 squeezed in too!
Q: What were some of the challenges and success during the implementation process?
RL: The challenge is that in today's environment, you don't do one thing [at a time]. So we weren't doing just Epic. We were doing a lot of other things: ICD-10, meaningful use, supporting acquisitions, optimization of existing software so that we can drive improvements and more. Those are big things health systems are doing these days. All of those things have to continue while you're trying to do this major EHR change.
And, the EHR isn't one thing. For us, we bought the enterprise suite. It included clinical and revenue cycle applications. It's more than 30 applications. Since our pilot featured only ambulatory providers, we only brought up apps for clinical settings, which included billing, health information management and reporting apps.
Q: What were some of the successes and achievements during the implementation?
RL: The greatest accomplishment off the top of my head is ProMedica's ability to rally a team, stay focused and to just drive to consecutive milestones all along the way. This is truly a team sport, and we had milestones that were set up. One I remember is we were presented a document with operational and application type issues, about 400 of them. We needed resolution on them in a short period of time, 30 to 45 days. At first blush, you look at them and you think, you have a huge health system with 12 hospitals and 800 providers, and we're trying to drive a standard product. We've got to create a shared leadership structure where people can give us their appropriate direction. ProMedica just stepped up to that, put together the validation sessions, and we met that milestone.
And then you have another milestone ahead of you — you have to start configuring the software. One of our greatest accomplishments is pulling together a very good broad-based team, not only IT people but significant operational stakeholders and their leaders. Our leadership gave us great support in that accomplishment.
Q: What do the next few months of the go-live process look like for ProMedica?
RL: We have our next event in March of 2016, and then we do a bigger event in May 2016. In November 2016, we take our largest hospital live. The cadence and the rate of the work that needs to occur will be the challenge — keeping the team motivated and keeping the energy high. Supporting go-lives is hard. It's a lot of fun, though, and you watch teams gel and see their can-do spirit.
Through 2016, there will be a lot of end-user engagement, and a lot of training will be required. One of the things we're trying to make sure we keep our eyes on is working with our operational management regarding change management. [ProMedica CEO] Randy Oostra is just an outstanding CEO, supporter and champion of this transformational initiative. He has this saying that Epic stands for "Everything at ProMedica Is Changing." When everything changes, it causes stress and concern, so we're keeping our eyes on it.
I do think we're ready. ProMedica is very well-positioned right now. We took about 80 percent of the software live on Monday, so we still have some pieces that have been untested that [are scheduled to go-live] in our acute care environment in March. Several of our issues right now are associated with training. Did we train enough? Did we train on the right things? Should we have some last-minute refresher courses? And there are some workflow questions. With every install, you think the software is going to work one way and when you actually start using it, you realize it does work that way, but it's not going to work for you. We have a few of those, but the team has rallied and those [issues] were identified in the morning and fixed by the end of the day.
Q: What is one lesson you'd share with other CIOs from this installation?
RL: I would absolutely not underestimate the impact of something as broad-based as Epic. Let's find the value. Let's find the reason we're doing all those things and make them very visible.
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