Epic Go-Live Planning: 4 Steps for Successful At-the-Elbow Support

Ever been frustrated with the computerized voice when trying to get help? Some troubleshooting situations are best handled person to person. This is especially true for busy healthcare teams going live on new functionality. I’ve walked dozens of clients through the planning stages for Epic implementations and having the right go-live support model in place can make or break the overall experience. You’ve invested time and effort to get ready for the big day. Now it's time to anticipate what your end users might need. How many go-live support staff should you plan for? What skills will they need? Where, when and how should they provide go-live support?      

Here are four areas to take into account when developing an at-the-elbow (ATE) support model for your Epic go-live.  

Consider the various areas you need to support. Where are your end users? You will need to map out how broad of a geographic area each support person can cover. If there are multiple nursing floors, you will want to consider whether your support person can cover them all or whether this will be too hard to maintain in order to have an adequate level of end-user support. A good support staffing guideline: You should plan to staff one support person for every six nurses/end-users.  

Plan a combination of “super users and “at-the elbow” support consultants, if possible. Each of these groups provide certain areas of knowledge that will prove beneficial during your go-live: 

• Super users from your facility will know your previous EMR but they will also have had training in Epic. They will be the bridge you need when users are asking how to perform something they did in their previous EMR and how to accomplish that task in Epic going forward. 
• Super users from a sister hospital who are already live on Epic will know how the implementation system is going to work. They have experience making the transition and will be more familiar with the new workflows. 
• Epic at-the elbow (ATE) support consultants have used Epic in multiple go-lives. They have a good working knowledge of how to use the basic Epic system as well as some bells and whistles that the Epic system can provide. They can also help with provider support and personalization. 
• Experienced super users, credentialed trainers or ATE support experts will understand the nuance of supporting providers in specialty areas such as: 
  • Laboratory 
  • Pharmacy 
  • Radiology 
  • Operating Room/Anesthesia/PACU 
  • HIM 
  • Hospital Billing/Professional Billing 
  • Infusion Centers/Cancer Centers 

Depending on your healthcare organization, you may also need to provide experienced go-live support for hospitalists, intensivists, surgeons, anesthesia, and other providers or mid-level healthcare professionals who care for patients at your facility.   

Below are some ideas we have seen work well when supporting providers during an Epic go-live: 

• Offer one-on-one training. Personalized training sessions for physicians are a great way to help them customize Epic, but in reality, not all will be able to attend. You will want to plan to have go-live support team members who can also provide one-on-one provider training.   
• Designate a place for provider support. Set aside a specific area in your location where providers know they can get personalized help such as physician lounges, OR lounge, etc.   
• Focus on provider workflow. Ensure your support staff can support multiple facets of a provider’s workflow: 
  • Haiku and Canto mobile apps.  
  • Integrating voice recognition software within their Epic workflows.  
  • Setting up patient lists, smart phrases, macros, customize order sets, and other Epic EMR settings. 

• Round with providers. If you are a teaching hospital, perhaps have a support person who can do rounds with your attendings and residents. This can help make the transition easier during the go-live.

Determine what the process will be for communicating to end users and to support teams. 

Training information. How are you going to communicate training information and tip sheets to end users and to support staff? 

Reporting issues. Before go-live, determine how your go-live support team will report issues. Clearly communicate the process so you can track and resolve issues in a timely manner.  

• Do you want to route all support issues through a central number?  
• Will support teams text or use group messages to communicate issues? A number of applications take advantage of smartphone features for quick communication.  
• Who will serve as a point person responsible for disseminating fixes/updated information to support resources? To end users? 
• Will support teams hold daily briefings to sync on high priority issues?  
• Do you have ServiceNow or some other system for reporting and logging issues? 
• How will you escalate high priority issues? What types of issues will be triaged as high priority? Typically, any access issues, system or hardware breaks would be flagged as high priority.  

Planning can go far to help streamline go-live support, and if your end users are transitioning well, you can always taper off support.  

More Epic resources 

If you are preparing for an EHR initiative, we are here to help — whether transitioning to a different EHR, getting ready for cutover, or needing to optimize your existing EHR investment. Check out these resources to learn more: 

• Epic Transition and Go-Live Planning: Cutover Essentials
• Healthcare M&A: Why Clinica Operational Readiness Matters
• Epic Hyperdrive: How You Can Prepare for the Transition
• Patient Portal Support that Helps You Take Care of Them