Epic team is ready to flip a big switch in February

Massive go-live will allow EMR to reach its full potential

Allen Hsiao, MD, in the pediatric emergency department, is among those preparing for the massive Epic implementation.

The “Big Bang” is coming on February 1. That’s the day when Yale-New Haven Hospital (YNHH) and virtually all remaining clinical practices go live with the Epic electronic medical record. As if that weren’t major enough, Epic’s billing, scheduling and registration applications will be implemented that day. (See related story.)

“This is a massive undertaking,” said Chief Medical Officer Ronald J. Vender, MD, one of the key leaders of the project since the Epic contract was signed in the summer of 2010. “What we’re about to do is on a scale that hasn’t been done before.”

For perspective, consider this: Before the switch is flipped on Big Bang Friday, all of YMG’s 950 doctors, as well as other providers and administrative staffers, will have to be trained on the appropriate Epic applications. At the same time, YNHH has been “knee deep” in training more than 9,000 people, said Allen Hsiao, MD, an emergency pediatrician who has long played a lead role in YNHH information technology.

“The intrepid pioneers who are already using Epic know that the EMR won’t reach its full potential until all of us are on the system,” said Dr. Hsiao. “So we’re all looking forward to this.”

Ronald Vender, MD

Lots of planning to get it right

Preparing for the Big Bang has required, said Dr. Vender, “an incredible amount of planning and communication.” Since the implementation began taking shape more than two years ago, Dr. Vender, in concert with Chief Revenue Officer Marianne Dess-Santoro, has attended numerous planning meetings. Chief among them is the twice-monthly Epic cabinet meeting, which includes senior administrators from YMG and all three Yale New Haven Health System hospitals. There are also meetings with the YMG Epic implementation team; a monthly meeting with the clinical advisory group, which is made up of clinicians trained to act as Epic advocates and engineers for their colleagues; and a twice-monthly meeting with Chief Information Officer Daniel Barchi, Chief Medical Information Officer Steven Schlossberg, MD, and various YMG clinical administrators.

A number of recent sessions have focused on what can be learned from the experiences of Greenwich Hospital, which went live last April—and from earlier YMG implementations, as well as on developing plans for the Big Bang and beyond, said Dr. Vender.

For his part, the CMO has been sending out a series of e-mails to physicians on a variety of topics, from advice on achieving the federally mandated “meaningful use” requirements to helping YNHH contact every physician who will need EMR training. On top of that, Dr. Vender himself successfully completed both the basic Epic coursework and executive leadership training.

Time to ‘dive right in’

As training continued through January at a furious pace, a small army of Epic implementation specialists—about 280 for YMG alone—has prepared to take up residence at the ambulatory practices and at YNHH.

“Dive right in, but make sure you’ve taught yourself how to swim first,” counseled Dr. Hsiao. “But once you’ve jumped into the pool, don’t be afraid to ask for help.” Dr. Vender seconded this advice and added, “We’ve learned quite a bit from prior go-lives at YMG and at Greenwich Hospital, and we have tried to resolve existing issues and planning for this day. It’s going to be a challenging couple of weeks in February, but when the system is fully implemented, and we have become more familiar with its usage, we’ll have the best, most integrated EMR available. Everyone will ultimately benefit from Epic.”