Jordan Ruch, Vice President and Chief Innovation Officer
The Ultimate Goal of Change
What is the ultimate goal of change? It is often to achieve stability for the greater good. However, change itself requires periods of instability – this is the paradigm of change. Said differently, change is messy. Change is overlapping and unpredictable – perhaps nothing could have demonstrated this more than the outbreak of COVID-19 occurring just after we kicked off our Epic Together journey.
Navigating this paradigm of change is what our Epic Together team is in the middle of as we speak. We are working towards a common goal – to reduce instances of preventable harm, boost public health, and support our health system strategic plan. These are goals worth fighting for!
I am proud to say that our Epic Together team’s greatest strength has been our ability to adapt to change.
I would like to take this opportunity to recognize the Epic team’s accomplishments and thank the team for all of your hard work. Our application teams, as well as the training, testing, technical, and data integrity teams, have all been doing an amazing job:
Overall, we are 98% complete with Orion waves 0-6 and 22 teams are 100% complete! Each of our application areas under the Clinical, Ancillary, Medical Group, Access and Revenue Cycle, Project Support, Digital, and Data/Analytics teams have been making outstanding progress as we prepare for our first go-live in May 2021.
The training team led by Maria Moffa demonstrated amazing flexibility and adaptability in developing contingency plans in the face of ever-changing COVID-19 rules, regulations, and executive orders. This has been one of the biggest challenges our project has faced to date. The training team has created a training model that prioritizes our staff and team’s safety while also providing an environment that is conducive to learning.
Testing is not just a necessary part of the project – it is a core part of the Epic Together machine. Our testing efforts are complex and thorough – two such efforts are Parallel Revenue Cycle Testing (PRCT) and Mapped Records Testing (MRT). With PRCT, the output is built on real-life heritage scenarios – we took actual claims and built out scenarios, “replaying” patient visits in order to make sure heritage claims match Epic claims. MRT tests the integration of Epic to all of our third party systems, and ensures any data that integrates between the two systems is accurate and comprehensive.
We passed 83% of pass 2 PRCT scripts, as well as 68% of MRT. The way testing has been prioritized and the level of detail that we have gotten down to with testing for this project is far more labor-intensive, and more of a true test of the system, than anything we have done before.
Our technical team led by Mike Bianco has been ahead of the curve at every step of the way. Device inventory has been completed for waves 1 and 2 and we have already started on wave 3. Our hardware deployment is also now over 95% complete for wave 1. In preparation for future waves, the networking team designed and deployed an extension of the RWJBarnabas Health network into Rutgers. Over 800 workstations have also been renamed for the Epic standard. Technical Dress Rehearsal (TDR) is yet another great example of this team being ahead. We track our TDR completion on a daily basis – we have a daily target of devices and machines that we need to pass – and the TDR team has been crushing its targets.
Enterprise master patient index (EMPI) and Data Integrity
Our EMPI clean-up team led by Joe Galdi has taken the historical file of all duplicates and worked a duplication rate of 32 percent down to less than half of a percent. This is a phenomenal achievement! Our data integrity team, led by Jean Buble and Kelly Carovillano, is now actively working on duplicates on a go-forward basis with a target of getting us well below three percent overall by go-live. Combined, the historical clean-up and go-forward clean-up currently has us at about two percent overall duplication. This is the lowest our duplication rate has been in many, many years and has far-reaching impact on our Epic Together project and health system as a whole.
Overall project and operational playbooks
In the face of COVID-19 and a flurry of pivots and course-corrections, our overall completion rate is impressive. I would like to thank our operational team led by Rob Adamson, as we would never have been able to complete our build milestones without full engagement from the Workgroups and Advisory Committees. Our Operational Playbooks are essentially workflow and build decisions and can be thought of as the “recipe” for the Epic build. The build can then be seen as the mixing and cooking (or configuring) of the ingredients. The fact that our Operational Playbooks are 99 percent complete is truly amazing.
Change is not linear and should not be viewed as a single event. Rather, change is a continuous process. It is my view that COVID-19 has brought to light precisely why we need to implement one unified EHR platform now, and why our Epic project is so imperative, so that RWJBH patients and staff can be safer together in an unpredictable world.
Epic Together is more than just an important initiative – it is a fundamental component of our High Reliability Organization (HRO) journey.
Thank you all for your dedication, commitment, and support.