OU (The University of Oklahoma) Health is Oklahoma’s flagship academic health system, which includes the state’s only
comprehensive children’s hospital, a National Cancer Institute-designated Cancer Center, the state’s only Level 1 trauma center, and Oklahoma’s largest and most advanced group of specialty and subspecialty physicians.
OU Health began an enterprise-wide Epic implementation in early 2020, just as the world was being introduced to COVID. Along with the early discovery that the organization needed certain infrastructure upgrades to accommodate the new electronic health record and financial revenue platform, OU Health leadership decided to pause the implementation temporarily.
About a year later, the implementation team resumed where they’d left off to take OU Health live on Epic. To do this, the
leadership team needed dedicated expertise to focus specifically on adoption, operational readiness, change management, and communications to “get OU Health ready for Epic.” Impact Advisors was chosen through a formal selection process to support the organization’s readiness for and adoption of its Epic platform. As the Epic implementation planning and delivery took place, Impact Advisors’ consultants focused on ensuring the highest probability of implementation success.
Approach
Engaging the organization’s clinical and business operations staff and helping them understand the importance of an
operationally-owned, process-driven program is essential. Impact Advisors’ team included an experienced operational readiness project manager, two clinical readiness specialists (one for InPatient areas and one for Ambulatory), two communications analysts, and a revenue cycle specialist who partnered with executive leaders and worked collaboratively
with OU Health personnel and Epic. Leveraging OU Health’s existing change management tools and methodologies where possible, as well as those used by Epic and our own proven methods, we executed a three-phase, structured program to help OU Health prepare for change, manage the change, and reinforce the change. Key elements of our approach included:
- Change Readiness Assessment to evaluate the readiness of OU Health departments and employees to successfully go-live, adopt, and utilize the Epic EHR to its fullest potential.
- Epic Adoption and Change Management Plan describing the steps needed to mitigate gaps identified in the readiness assessment, pinpoint the most significant workflow changes resulting from the Epic implementation, as well as adoption management efforts required for each change, and the recommended steps to prepare OU Health staff for change and ensure they stay engaged and committed to the change.
- Communication Plan for establishing change management awareness (e.g., audiences, key messages, modes of delivery) that aligned with the Epic implementation schedule.
- Sponsorship Plan for identifying key leaders or change agents who can “walk the talk,” set expectations, remove barriers, and provide education and coaching where needed to reinforce efforts of the change management team.
- Coaching Plan for OU Health leadership in change management principles and methods specific to Epic projects.
- Adoption Resistance Management Plan for minimizing, diagnosing, and managing resistance to change.
Results
OU Health went live with Epic on time as planned, and it was considered by all involved to be a major success, especially considering the challenges faced at the start. A post-live survey captured several comments like, “I have never seen a Go-Live go this smoothly. In our command center, we were able to send people home early during the first week of Go-Live
because things were going so well.”
Keys to Success
The clinical and revenue cycle operational readiness specialists assigned to OU Health are certified in multiple Epic applications and have held operational or clinical roles in healthcare organizations, so they truly understand Epic’s workflows and how people will be impacted by them. Leveraging their experience and expertise enabled them to lead the
change activities with precision and more predictable outcomes.
Impact Advisors also brought to bear our well-established project/ program management structure that includes a robust project dashboard, governance, a meeting/escalation structure, communication tools, and an issues and risk management approach, among others. The output of this structure is a near-time clear view of program status along with a proven approach to quickly address concerns as they arise. This helped the team stay in lockstep with the Epic deployment team.
Challenges
Implementing an enterprise-wide EHR is challenging under the best circumstances. The resilience of OU Health was tested early by several internal and external pressures, so rebuilding confidence among its employees that they could and would
be successful was a major hurdle. To overcome it, the team continually reinforced “the why” for the project. They also communicated the schedule of key milestones and celebrated each achievement to show progress.
Another big challenge was not overstepping our role. Having successfully led over 100 Epic implementations, Impact Advisors was well-equipped to offer guidance beyond the scope of our contractual engagement. However, to avoid jeopardizing the collaborative relationship that is essential to programs of this magnitude, we only raised concerns when we felt an activity or missed opportunity was putting the overall project at risk. For example, a survey response indicated training was not focusing enough on specific workflows, that it was too generic, and not granular enough for specialty groups and roles. Although training was not part of our assigned scope of work, it does play a critical part in getting users ready for the system, so we had candid conversations about the training approach and were able to find a solution that worked for all.