An Epic Refuel project is a targeted investment in an organization’s EHR to re-align functionality and workflows with current out-of-the-box Foundation System tools. The realignment reduces aging customizations and workflows, streamlines maintenance and support, enables upgrades, and supports agile implementation of new features and functionality.
Typically, organizations undertaking a Refuel project have been live on Epic for many years. As new system functionality is introduced, build recommendations evolve. Epic’s push to add new, easily enabled features makes aligning more closely with the Foundation System an increasingly attractive goal.
While these projects may appear straightforward, operational engagement and robust technical support are essential for success.
What Should You Expect During a Refuel Project?
Assessment
During the assessment phase, teams conduct system evaluations and outline future state recommendations within a Refuel companion packet. This effort can be augmented with additional system analysis, interviews, and workflow reviews with operational stakeholders to understand priorities. Recommendations are often sourced from the current Foundation System build or various Epic programs such as Gold Stars and Clinical and Financial Programs.
Planning
Once projects are identified, they must be sequenced into a plan that accounts for dependencies, and project resources must be secured. Operational input is crucial at this stage to determine which departments and teams are ready for specific go-lives. Additionally, teams responsible for the Epic build and testing need to be assigned. A change management strategy should be established to support Refuel changes and operational readiness issues, and a temporary hold on new enhancement requests may be necessary while the team concentrates on the Refuel initiative.
Refuel Implementation
Epic can perform a Foundation System migration to provide the most up-to-date content, after which teams focus on build, testing, training, and go-live activities. Large initiatives, such as new Epic module rollouts, can often fall under the Refuel program umbrella. Build items can be complex and span multiple months, for example, consolidating user templates to improve overall provisioning efficiency.
What Are the Keys to Success in Any Refuel Project?
- Define and Measure KPIs: Key performance indicators (KPIs) for each project should be identified and measured both pre- and post-implementation. Refuel projects represent a substantial time investment and can yield significant ROI that can be broadcast within the organization. Success metrics can be as simple as measuring productivity/time saved on a specific function or tracking the usage of a new feature.
- Establish Strong Governance: Strong governance and change management are essential to success. It is important to involve operational stakeholders early in the process so they understand the project and can provide input on necessary changes. One of the largest risks in Refuel projects arises when items are removed from scope due to operational readiness issues, which can have downstream effects on other in-scope items.
- Accurate Project Sizing: Project sizing and resource allocation may not be as simple as they appear on paper. For instance, while a department and profile consolidation might not seem like extensive build work, there may be numerous dependencies or years of historical build associated with those items.
What Are the Benefits of Any Refuel Project?
By reverting to documented industry best practices utilized by leading healthcare institutions, organizations can enhance clinical and operational efficiency, reduce costs, and streamline workflows, ultimately aligning their Epic EHR with current standards.
Additional benefits of Epic Refuel include faster implementation and upgrades, enhanced scalability for diverse healthcare providers, and easier access to Epic’s analytics and artificial intelligence (AI) tools. Organizations participating in Refuel often see improved recognition in Epic’s Gold Stars and Honor Roll programs, along with potential financial grants for maintaining high-quality Epic systems.
What Are the Challenges and Risks in Any Refuel Project?
While Epic Refuel projects offer significant benefits, they also present certain challenges and risks that organizations should consider. Implementing standardized workflows requires staff and physicians to adapt to new processes. While less disruptive than an initial go-live, this still demands effective training and change management.
Operational and IT teams may encounter technical complexities when updating older custom builds and templates, necessitating thorough gap analyses and careful planning to avoid complications.
Additionally, there is a risk of scope creep, where unplanned additions to the project can lead to expanded budgets and timelines. Competing organizational priorities—such as mergers or major construction—can further disrupt project progress. Ultimately, success relies on leadership’s readiness to drive and reinforce change, alongside active monitoring of adoption to ensure the intended improvements are realized.
What Are the "Lessons Learned" in Any Refuel Project?
Over the years, Impact Advisors has partnered with many healthcare providers and organizations to successfully implement their Epic Refuel projects. While every organization differs in scale and approach, we have identified essential lessons for ensuring the success of these initiatives. These key considerations are critical for any healthcare organization undertaking an Epic Refuel initiative:
- Secure leadership buy-in: Leadership across the organization must be fully on board, as the initiative will require significant time from staff and clinicians.
- Define scope carefully: Avoid trying to do too much at once. Set realistic goals and don’t attempt to revamp the entire Epic instance or implement new modules without proper time, budget, and resources.
- Establish program governance: Create a clear governance structure and guiding principles for decision-making and stick to the plan.
- Prepare for change: Understand the impact of the changes and ensure the organization is ready. A change-readiness team and adoption monitoring are critical for success.
- Commit to new processes: Once the Refuel is complete, establish new internal processes to prevent a return to old habits, such as stopping unnecessary customization.
- Measure before starting: Begin collecting metrics before the project to establish a baseline for measuring success.
- Benchmark progress: Use Epic’s tools to benchmark performance against peers, as executives want to see how their organization compares within the broader Epic community.
