Resiliency Takes Center Stage
Epic Together is a force to be reckoned with. Since the March 13, 2020 COVID-19 shutdown, this project has bucked all odds: increasing productivity by 43% and remaining on track for implementation, while so many other healthcare organizations hit the pause button.
Now, people from across the state – and the country – are taking notice.
Four months later, senior vice president and operational project director Rob Adamson told the remarkable story of this team’s dedication and resiliency in a feature article in Healthcare IT News, an industry publication covering the people, policy and technology in the U.S. and throughout the world.
“The entire EHR build team converted to a remote work environment, bringing all their equipment from the centralized office to their home environment,” said Rob in the article which outlined the many strategic steps taken to ensure the success of the project during this unprecedented worldwide pandemic.
Recently, Rob and Jordan Ruch, VP & Chief Innovation Officer, shared the Epic Together story of resiliency and dedication in a full-length video interview with the medical staff at Robert Wood Johnson University Hospital.
According to Rob and Jordan, representing all aspects of the integrated delivery network has been key to the project’s success thus far. “We want to create something intentional and thoughtful, so that everybody shares in the development of the electronic health record,” said Rob.
Physician Advocates Boost Epic Adoption
Specialists Training Specialist (STS) is an Epic training program which uses staff physicians to train their colleagues on Epic workflow and documentation.
Because physicians have specialty specific knowledge of the workflows and clinical scenarios that are relevant to their specialty, they can communicate most effectively to their peers.
Specialty Champions have a broader role than the STS. Champions provide input during design sessions, help design the specialty curriculum, work with principal trainers (PTs) to update curriculum, and act as dedicated super-users during go-live.
Specialty Champions and “Specialists Training Specialists” provide the most effective and efficient training possible, laying the groundwork for long-term project success.
The Role of Specialty Champions
Specialty Champions increase the engagement of participating physicians during RWJBarnabas’ Epic Together implementation and ensure the specialty tools are tailored to the specific needs of each individual specialty.
Specialty Champions:
- Serve as a voice and advocate for other providers in their specialty as workflows and content are presented.
- Relay information from project team members to fellow specialists.
- Provide feedback from other specialists to project team members.
- Help develop, review, and present training curriculum to fellow specialists.
- Reduce classroom time necessary for physician training because peer-to-peer learning feels more like a partnership than a lecture.
Operational Workgroup Decision Making
The role of operational workgroups transitions over the lifecycle of the Epic project. During the early Workflow & Configuration phase the project, the workgroups focused on decision-making: design decisions, content decisions, and risk/issue identification.
- Timely decision-making enables the project team to:
- Complete Epic build
- Move forward with other dependent decisions
- Capture risks and issues in Workfront
Project teams should encourage workgroup members to focus on making the right decision for RWJBH and avoid delays trying to perfect the entire workflow or resolving all open issues at this time.
During the User & System Readiness phase, the workgroups will take a deeper dive into change management and policy revisions. The work of the operational workgroups insures timely and effective decision making, protecting implementation progress and timeline.
One Patient, One Record – EMPI to the Rescue
“One Patient, One Record” is critical to quality care and a successful Epic implementation. With that in mind, RWJBH is implementing a long-term plan that will maintain a duplicate rate of less than 3%, a gold standard in the healthcare field.
The Enterprise Master Patient Index (EMPI) is a database used to maintain consistent and accurate information about each patient registered in our health care system. EMPI software uses algorithms to continuously scan records to identify potential duplicates across all RWJBH heritage and affiliate record-keeping systems.
The EMPI ensures that every patient is represented only once, using a single Medical Record Number (MRN), regardless of where or when the patient received treatment.
EMPI: Quick Facts
According to Industry estimates:
- 5% to 20% of hospital records are duplicates
- The number increases to 40% for organizations that have merged with other facilities
- Treatment costs increase 20% to 30% due to unavailable medical histories
- An EMPI reduces duplicate records, providing a reduction in the variable costs of repeated tests and treatment delays, and eliminates the on-going costs associated with resolving duplicate records
Gold Star Rating – Epic Together Earns 9 out of 10 in First Six Months
Epic’s Gold Stars program helps RWJBarnabas Health’s Epic Together project improve clinical and financial outcomes.
Drawn from the experiences of industry peers, Gold Stars provides a snapshot of the Epic Together current system and feature usage, based on overall adoption of Gold Star feature items.
Tiers represent the varying levels of feature complexity and impact:
- Tiers 1-4: Core components of Epic and fundamental functionality.
- Tiers 5-7: Optimized use of Epic
- Tiers 8-10: Cutting-edge and leading practices in EMR use.
Our overall Gold Stars level is based on the number of all applicable Gold Stars items RWJBarnabas completes.
Epic Together’s Gold Star Level: 9*
Progress is based on the percentage of completed items various categories.
* RWJBH’s Epic Together Gold Star level is unofficial as of Fall 2020, and will be formally reviewed after all applications are live. New items are added yearly based on newly developed functionality.
Decommissions Save Money
RWJBarnabas Health’s Epic implementation is already producing enterprise-wide savings. A recent decommissioning of an obsolete mainframe application/database will save about $200,000 per year in maintenance and support costs alone.
“On a project of this size, the focus is usually on the amount of money being spent. Decommissioning outdated systems is just one way the Epic implementation will actually save money and improve user experience and data security throughout the enterprise,” said Jordan Ruch, VP & Chief Innovation Officer, who noted that this is just the first of many systems targeted for decommissioning and archive.
TDS/E7000 system, the pre-cursor of Allscripts at New Brunswick and Cerner at Community Medical Center and Monmouth Medical Center South, had been maintained as a “read-only” resource for the past 14 and eight years, respectively.
The Epic Together project provided the golden opportunity to finally end our contract with the TDS/E7000 system, extract data, and transfer it to Vital Center Online (VCO), our new web-based archival for all Heritage EMR systems. Clinicians will now be able to jump into VCO with single sign on, maintaining patient context while work is being done on our Enterprise Master Patient Index (EMPI).
Our Epic Together Digital team worked closely with Galen Healthcare, RWJBarnabas’ archive vendor, to complete the complex decommissioning project, made even more difficult by COVID-19.
Epic Together’s Ultimate Goal – Giving Our Patients a Voice
As the Epic Together team completed an important milestone, the completion of the Wave 4 Build in July 31st of 2020, RWJBarnabas Epic Together project leadership recognized the tremendous efforts taken by the team to reach yet another goal.
During the pandemic, which has profoundly affected both the RWJBH healthcare system and the personal lives of every member of this team, the Epic implementation team remained focused on the goal at hand: to give our patients a voice.
As the world continues to adjust to this “new normal,” which includes working from home while also surrounded by pets, partners, extended family, crying babies, and even homeschooling, the Epic Together team persevered. While other healthcare organizations contemplating an Epic implementation went on indefinite pause, the RWJBH team shattered productivity expectations by 40%.