Impact Insights

Merging Epic Instances – a Success Story

Andrew Rosenberg

I had the opportunity to serve as the project manager on the second-ever initiative to merge two Epic instances into one and the first project involving a full system conversion.  We encountered several critical questions and challenges along the way, but with the help of an amazing team we were able to exceed the client’s expectations.

Background:

In 2011, two of our clients merged to form the largest Catholic health organization in the state of Illinois, encompassing 12 hospitals, 27 senior care facilities, six urgent care facilities and numerous physician offices and retail clinics.   Prior to the merge, each organization had independently purchased and implemented its own Epic system.   They called on Impact Advisors to help determine how to best operate going forward and if it made sense to support two separate instances of Epic or consolidate into one.   We conducted an assessment, developed a plan and implemented a solution that best met the client’s needs – and that we believe will become valuable to the growing number of organizations engaged in a merger.

 Critical Questions and Decisions:

The first critical question was whether to consolidate the two Epic instances.  With confirmation that consolidation of the systems would help support the corporate merger goal of organizational alignment and performance improvement, the next decision to address was which organization’s Epic instance would serve as the new consolidated platform.   Because one facility’s instance was a comprehensive enterprise-wide system, we opted to merge the second group’s ambulatory instance onto the enterprise platform.   Our next big decision involved future state design: Would we adopt the existing build in the consolidated Epic instance, or would we seek to incorporate best practice between the two environments?   With the goal of making the project feel more like a “merger” and less like an “acquisition,” we opted to adopt best practice.   In the long run, this was the more difficult option to execute, but it allowed for enhancements to existing workflows and a build that would more broadly benefit both organizations.

 Data Conversion/Implementation:

After extensive gap analysis and detailed design reviews, we prepared the historical data for conversion, converted the data and loaded it into the new consolidated environment.   Planning and implementation took 12 months, concluding with a Big Bang go-live. As part of developing the interfaces, the team mapped new workflows and procedures, including for labs and radiology.  We also leveraged our implementation tools and methodology to develop automated and manual procedures for analyzing and comparing the two disparate legacy systems.  The team was able to extract and compare the masterfiles and, in just six months, complete the build portion of the new system. We conducted extensive testing, delivered training for affected users through the use of videos and webinars and provided onsite go-live support to ensure a smooth transition.

There were other challenges to overcome over the course of this groundbreaking implementation. For example, the system merger in some instances was further along than the corporate merger.  At the time of go-live, the medical group was still split between one for-profit and one non-profit legal entity.   This required the client to keep the finances completely separate, but by segregating the groups in two service areas, we supported shared clinical information but a financial split.

 Results:

Our team was able to consolidate the two disparate instances of Epic into a single system with minimal disruption.  Careful planning, deep subject matter expertise and our ability to work with the client to address critical questions and overcome challenges were key to the success of this complex conversion and implementation project.  The new unified clinical and financial capabilities will help the client achieve faster and more convenient service for patients, make scheduling easier for staff, enhance provider satisfaction, and provide better insight into operations.  I am so proud to have been part of the Impact Advisors team that supported this ground-breaking initiative!

For more information, download our case study on this project.

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