Tag Archives: EMR

IT takes a village

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GLRA is an acronym recognized by anyone who has been through a large-scale system implementation. Spelled out it is Go Live Readiness Assessment. It is typically done at the 90, 60, and 30-day mark before canstockphoto16594838 (1) hands puzzlea go live. At the University of Vermont Health Network (UVMHN), our 90-day GLRA for Epic Wave 1 was this week.

Dr. John Brumsted, UVMHN CEO, kicked the day off with a powerful message on how important the Epic project is to the network and our patients. He talked about why we are doing this for the region that includes six hospitals, a medical group, many ambulatory locations and home health and hospice in both Vermont and New York. He set realistic expectations saying it wouldn’t be perfect and there would be issues. But he expressed confidence in the project, and everyone involved in making it a success. His presence for a good portion of the morning spoke volumes about his support for this massive initiative and appreciation for all involved. The network CFO and the University of Vermont Medical Center (UVMMC) president, CNO, CMO and VP for Medical Group Operations were also there for a good portion of the morning.

Dr. Adam Buckley, UVMHN CIO, followed Dr. Brumsted by talking about how the journey to a common, fully integrated EHR began back in 2013.  A journey that included a Certificate of Need (CON) review and approval by the Green Mountain Care Board. He too set realistic expectations about how many tickets we’ll have at go live just like every other major EHR implementation around the country and thanked the interdisciplinary team involved.

Lori Boisjoli, UVMHN VP Application Portfolio, then framed the day for everyone. The morning would be focused on the UVMMC with revenue cycle and the full suite of specialty modules going live. The afternoon would be focused on the three affiliate sites where ambulatory clinical and revenue cycle are going live. She highlighted that GLRA is the time to raise any significant issues and risks so project leadership can capture them for follow-up. Continue reading →

Crunch time and why IT matters

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It’s crunch time. Every day counts. Can’t miss a deadline. All hands-on deck. Go live readiness assessments (GLRA). If you work in health IT and have been through a major EHR implementation, canstockphoto60328456 (1) EHR UVMHNyou’ve heard all these phrases.

At the University of Vermont Health Network (UVMHN), the Epic Wave 1 go live is less than 5 months away. The University of Vermont Medical Center (UVMMC) has been on Epic for inpatient and ambulatory core clinicals for years. Wave 1 includes the full revenue cycle, lab and anatomic pathology, radiology, OR and anesthesia, cardiology, ophthalmology, orthopedics, behavioral health, rehab, wound care, infection control, and predictive analytics at UVMMC.

Wave 1 also includes the first Epic implementations at three Vermont and New York hospitals in the network starting with ambulatory systems for billing and clinical functions. Waves 2 (2020) and 3 (2021) will be the full suite of inpatient systems at those same hospitals – Central Vermont Medical Center in Berlin, Vermont; Porter Medical Center in Middlebury, Vermont; and Champlain Valley Physicians Hospital in Plattsburgh, New York. Yet to be scheduled are Elizabethtown Community Hospital in Elizabethtown, New York; Alice Hyde Medical Center in Malone, New York; and Home Health and Hospice.

The core infrastructure is largely in place to support the November 1st go live though we have more to do at the device level. Over 10,000 users will be trained in a 6-week period. The first GLRA at 120 days pre go-live is coming up soon.

When I saw Epic on the agenda for the UVMMC quarterly leadership meeting, I assumed it was a project status update. How wrong I was. Continue reading →

What upgrade?

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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 canstockphoto13469755recently 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: Continue reading →

Evolving into the future

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In August 2014, I posted “Beyond the core Electronic Health Record” about our primary integrated vendor strategy at UMHS. We have already implemented the core suite of products from Epic. We continue to be committed to this strategy and it continues to serve us well.

We are in what we call MiChart Stage 4 which includes radiology, home care, and part of cardiology. We had agreed that anesthesiology and transplant would be in a future stage. As we plan for those future stages, we’re also considering ambulatory pharmacy, care management, infection control and other specialty areas.

Outside these major stages, there are ongoing needs to support strategic initiatives in capacity management, patient engagement and telehealth. We are planning for the Bed Management module to replace an existing third party product, Bedside in the hospitals that don’t already have a solution, and telehealth functions.

We are also discussing another critical area where Epic is building out functionality. Continue reading →

Our collective interoperability journey

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If you remember the CHIN (Community Health Information Network) attempts in the 1990s or the next incarnation in the mid-2000s referred to as RHIOs (Regional Health Information Exchange), you know we’ve been on this interoperability journey in health care a very long time. And it’s not over.

Creating sustainable Health Information Exchanges (HIE), not to be confused with a Health Insurance Exchange, is what we are all focused on now. The Office of the National Coordinator for Health IT (ONC) published “Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap” for public comments earlier this year. There has been progress over the years but we still have a long ways to go.

The ability to easily access and share data with other health care providers in Michigan is critical for UMHS – we are the only provider in the state that serves patients from every county. But HIEs are important for all providers regardless of their reach.  For example, when a patient shows up at an emergency room away from their primary hospital and physician, basic information should be readily available.  This includes a patient’s current problem summary list, allergies, chronic conditions, and medications.  Having this kind of information can make a qualitative difference in their care. And knowing that a certain test or procedure has recently been done along with the results can avoid duplication, saving both time and money.

Yet, unlike other industries where basic information is easily accessible and shared, health care lags far behind. Continue reading →

The power of learning from your peers

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I spent the better part of a day this week at the annual meeting of the Epic Michigan Users Group (we call it eMUG). But I don’t want to focus on Epic. I want to talk about the value of learning from your peers. It could be any vendor or any user group.

This was our fourth annual eMUG conference. Given space limitations, we had 200 attendees last year and with the venue this year we were able to accommodate 400, a significant increase. With 11 health systems in Michigan on Epic, that’s a good size group from each organization.

When asked for a show of hands on how many had been to Epic’s national user group meeting (UGM) before, only 25-30% of the attendees raised their hands. Local user group meetings like eMUG give many more staff a chance to attend and connect with their peers. National user group meetings are costly with airline and hotel expenses for a couple days.

This eMUG meeting was a content rich day: Continue reading →

Beyond the core Electronic Health Record

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Hospitals have been either implementing or replacing their core electronic health record (EHR) in recent years. The work has included the entire suite of applications that make up the revenue cycle, patient access, and advanced clinicals in both inpatient and outpatient settings. But as we look beyond the core EHR, there is much more potential for technology.

This week at UMHS, clinicians and staff did a two day “deep dive” into the next group of applications as we move forward with our EHR. Teams from transplant, anesthesiology, radiology, cardiology, and home care reviewed Epic’s capabilities so we can decide what will be included in our next phase of work – what we call MiChart Stage 4. These important assessments require an in-depth review of current capabilities, and an understanding of the product roadmap. Continue reading →

MiChart – the beat goes on

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Walking down the hall at our University Hospital last week, I ran into a UMHS senior leader I hadn’t seen in weeks. He asked me how MiChart was going – that’s the program name for our new integrated electronic health record. I said “very well.” I joked there are no picket lines outside my office and I’m not getting nastygram emails. I’m actually getting to focus on a lot of other things now, compared to those first few weeks after our MiChart Stage 3 inpatient go live two months ago. Our clinicians and other staff are adapting pretty well and, overall, things are going smoothly.

With this stage of our Epic implementation completed, we now have an integrated system across ambulatory, inpatient, hospital outpatient departments, and revenue cycle. Continue reading →