This past weekend we did another major upgrade – this time the ambulatory EMR. It went extremely well and was met with smiles and kudos from our senior executives. While we’ve done several major upgrades recently including revenue cycle and acute EMR, this one had a lot of eyes on it. Those same senior executives have been rightly concerned about the performance of our ambulatory EMR while we worked through some significant issues during the past several months, including software, hardware and infrastructure. So, kudos to the team that turned the corner on those issues and pulled off a very successful upgrade with minimal issues and disruption to our physician providers and operational practice teams.

We called our 200+ physician practices before the upgrade to make sure they felt prepared.  A few actually said “what upgrade?”. Apparently they had not read the any of the advance communications. So we worked with each of them to make sure they were ready.

The command center was open all week and will close early today as we have fewer and fewer calls.  Over 62% of the reported issues had been resolved as of late yesterday. Our users gained a lot of new functions and features which has made everyone happy.

In addition to a strong and collaborative relationship with your vendor, here are some critical success factors for any major software upgrade:

On the vendor side:

• The “A” team has been brought in, including staff familiar with the client organization and the complexities of the environment
• A strong technical resource is continuously involved
• Weekly engagement of the account team
• Excellent communication with all
• Team members are present and engaged
• Project team is accommodating to meet demands and schedules

On the client side:

• Complete project dependencies and resolve issues well in advance
• A cross team leadership group focused solely on the upgrade project
• Upgrade is treated as a priority for the team with minimal distractions
• Extensive testing and end-user validation
• An application freeze enforced and respected
• Proactive communications including presentations at physician meetings throughout the system
• Leverage user peer network to improve communication and readiness of all practices and providers
• Triple check readiness including phone call to every practice 48-72 hours prior to downtime
• Engagement and preparation of physician organization operational leadership in concert with IT
• All IT teams engaged and present

We have over 2,500 ambulatory EMR users. With a relatively uneventful post go live week, maybe some of them have even said in the past few days “what upgrade?” When upgrades go well, we’re OK with hearing that question.