All Insights Bringing Physicians On Board With EPIC – Introducing a New Electronic Health Record Program Introducing a new EHR is complex and disruptive. Physicians must shift from paper to electronic systems, learn new workflows, comply with policies, and meet Meaningful Use requirements. Most physician groups need support to navigate these extensive changes successfully. Case Study When a major health care organization was ready to invest in a new EHR, they hired Freed Associates to help them maximize the value of their investment. “We had resistance from all directions,” said the Chief Medical Information Officer (CMIO). “But Freed came up with solutions that encouraged buy-in and kept the transition moving forward.” Bringing disparate groups and systems together The organization is a leader in health care in its region, with multiple medical centers and a number of primary care and outpatient services throughout the community. Before their EHR implementation project began, ambulatory care, emergency room, and acute care physicians were utilizing different paper, electronic, or hybrid systems for maintaining patient health information. In order to share data efficiently and ensure seamless communication across the entire continuum of care, they needed a single, system-wide, standardized EHR system. They chose Epic Systems. Freed Associates was tasked with helping the organization engage, prepare, and support physicians through the go-live and beyond. Their first challenge was to ensure that physicians from all departments were involved in the design, validation, and build of the new system. The doctors’ participation would maximize buy-in alignment and standardization of the EHR across the health system. According to the CMIO, “Because of the size of our health system and the various ages and backgrounds of our caregivers, we were experiencing a range of opposition to the transition, despite the fact we had a general agreement that electronic records and computerized physician order entry (CPOE) would provide a more engaging patient experience and better health outcomes.” Many of the challenges the organization confronted were unique; but others may be familiar to larger health care organizations facing similar transitions: Disparate systems from department to department Lack of standardization across campuses Demand for data conversion, which was technically difficult Resistance from certain older physicians Resistance from medical groups already using an electronic system Resistance to participation in build and training activities Moving to an entirely new workflow for some accustomed to paper forms Effective work-streams, team building, and communication promote buy-in Freed worked with the CMIO and other key doctors to build the team infrastructure and multiple work-streams required to support EHR implementation. They developed a governance structure, drafted an RFP process for go-live support, created order sets, designed a physician communication strategy, developed a training registration campaign, designed note-taking templates, and implemented key applications, workflows, and policies. Freed forged collaborative relationships with physician champions, EHR application teams, communication and training managers, operational readiness owners, physician analysts, EHR leadership, and IT leadership. Provider outreach was critical to support change management and facilitate a smoother transition. Freed also helped develop forums for physicians to provide input, ask questions, and test the system. They supported a large at-the-elbow support team and provided 24/7 physician coverage in the Command Center. After go-live, cross-functional focus groups addressed opportunities for improvement in core workflows. A win for the organization “After over two years of strategic planning and program development, we have successfully deployed Epic to over 1,000 physicians across outpatient and hospital locations,” said the CMIO. “We now have an integrated EHR system that provides the best options for doctors, patients, and our organization as a whole.” With Freed Associates’ help, the organization was able to: Recruit and orient over 100 Physicians Super Users to champion the program Validate the content of over 300 order sets Design and validate over 150 note templates Achieve over 90% CPOE in week one of go-live Optimization and process improvement continue as the organization works to deploy the program to additional community physicians.