Epic Community Connect
Emerson Health is a not-for-profit, full-service regional health system headquartered in Concord, Massachusetts. Emerson’s core mission is to deliver high-quality, patient-centered healthcare to those who live and work in its community. The Emerson Health Physician Organization (EPHO) has over 300 hospital-employed and private providers spread across 67 practices in over 80 physical locations and 1,300 named users currently.
To advance the organization’s mission and ability to provide continuity of care for patients, Emerson Health signed a Community Connect agreement with a large, Boston-based health system affiliate to extend its Epic electronic health record (EHR) to the EPHO and all hospital ambulatory practices. (The hospital itself is planned for a phase 2 migration.)
New to Epic and the roles and responsibilities of a Community Connect recipient, Emerson engaged an Impact Advisors Epic Community Connect expert to represent its best interests and provide strong leadership and oversight of all phases of the program, including planning and organizational readiness for the practices, discovery and data provision to the host, training, go-live planning, and go-live. The program was to be implemented in waves, each involving different practices within the EPHO, which consisted of two large for-profit specialty groups, Emerson Health Employed Associates (EPA) and the private physician group.
Program Approach
To start, Impact Advisors’ program manager worked with Emerson leadership to set up a structured project methodology. This included creating a project charter with clearly delineated roles and responsibilities to set realistic expectations prior to kick-off. This is an important step, as it is not uncommon for Connect recipients to sign contracts without a full understanding of the support to be provided by the host during the implementation as well as future, post-live service levels. The project management structure also included a robust process for identifying, managing, and mitigating risks. The program manager shared best practices and lessons learned from previous Connect programs to help Emerson avoid pitfalls, in addition to managing the project timeline and deliverables.
One of the program manager’s roles was to work seamlessly with the different stakeholders (employed and private practice physicians and personnel) to ensure readiness—understand their current state operations, requirements, and nuances and plan for the future state within Epic Community Connect. As with any Epic implementation, aligning workflows to defined standards is key to successful adoption and use of the system. The program manager led workflow issue resolution meetings, helping define/understand the challenge, bringing the right people together to resolve, and ensuring appropriate training takes place.
Another key role was serving as a liaison between site-based resources and third parties to support account management and training. This involved helping to mitigate resource constraints, coordinating logistics, pairing site resources with trainers that had the right skill set and personality to be effective. Other responsibilities included advising on legacy system support, partnering with the Emerson CIO to keep the Executive Steering Committee informed of program status and progress.
Unique Aspects of the Connect Program
Prior to the Community Connect agreement, Emerson’s employed physician’s group outsourced its billing function to a third party. As part of the Connect contract, the host’s corporate billing office would assume this role—an unusual offering for a host. To enable this transition, the program director and Emerson pulled together the required coding documentation. This discovery process turned out to be fortuitously beneficial, as the team uncovered and rectified several process improvement opportunities.
The waved implementation approach, with the hospital not currently live on Epic, posed unique challenges. Certain “checks and balances” and interim workflows had to be put in place, particularly within Patient Billing, to ensure the appropriate capture of charges. For example, a reconciliation process had to be implemented to capture and enter technical fees produced from hospital-based clinics, since the hospital remained on the legacy system. Another step that would not have been necessary had the hospital gone live on the Epic system with or before the practices was the development of interface build and testing from the lab, radiology, and other hospital reporting systems into Epic. Impact Advisors program manager coordinated and tracked all of these activities to successful completion.
Another unique aspect of the Emerson project was the program manager’s involvement with data migration planning. The EPHO planned to outsource clinical content data migration of Problems, Medications, Allergies and Immunizations (PAMI) to a third-party vendor. Through Epic’s information exchange-enabling software, Care Everywhere, the third party could tee up the data for clinicians to validate in the Epic patient chart, decreasing the administrative burden on the provider. Impact Advisors’ program manager assisted with legacy data archiving planning by managing the third-party outsourcer selection process: conducted market scan, drafted RFP, coordinated interviews/demos, and set up scoring.
Results
Emerson’s Community Connect Implementation for its EPHO practices was completed on time and on budget, paving the way for the hospital migration to Epic in the near future. All interfaces are live, and Billing was successfully transitioned to the host. Lastly, a partner is being evaluated and data migration is slated to occur by the end of 2024 ahead of plans to sunset the legacy system. ■
“The knowledge and experience of Impact Advisors’ program manager helped us manage expectations, understand roles and responsibilities, navigate the technical requirements, and keep everything and everyone organized around our objectives.”