Epic Go-Live: Big Bang Strategy in Healthcare
“Big Bang” vs. Phased Approach to Epic EHR Implementation: A Summary
This article discusses the different strategies health systems are taking when implementing Epic, a popular Electronic Health record (EHR) system.the core debate centers around a “big bang” approach (going live enterprise-wide on a single date) versus a phased, region-by-region implementation.
Here’s a breakdown of the arguments for each:
“Big Bang” Implementation - Pros:
* Patient Safety & Caregiver Experience: Aligns with Epic’s methodology adn aims for improved patient safety and caregiver experience.
* Operational Simplicity: Reduces the complexity of running parallel systems.
* Single Patient Record: Accelerates the benefits of a unified patient record and billing platform.
* Consistent care: Supports more consistent, high-quality care across the entire system.
* Integration from Day 1: Reduces fragmentation and simplifies governance.
Example: Intermountain Health successfully implemented a “big bang” approach across 33 hospitals and six states, switching from Oracle Health.
Phased Implementation – Pros:
* Manageable for Large, Complex Systems: More realistic for systems with significant scale, geographic spread, and diverse operations (like UPMC and Northwell).
* Reduced Risk: minimizes risk to patient care and clinical operations.
* Controlled Transition: Allows for better management of operational readiness and business continuity.
* Learning & Refinement: Enables systems to build momentum,learn from each phase,and refine their approach.
* Handles Complex Data Migration: Easier to manage data migration, system integration, and user readiness.
Examples:
* UPMC: Consolidating from nine EHRs, UPMC is taking a phased approach due to its 40 hospitals and 800+ outpatient sites. Even a single wave of their implementation will be Epic’s largest user go-live.
* Northwell Health: A $1.2 billion project to unify 30 EHRs is being rolled out regionally due to the system’s size and diversity.
Key Takeaway:
The best approach depends on the health system’s size, complexity, and existing infrastructure.While a “big bang” offers potential benefits of immediate integration, a phased approach may be safer and more effective for larger, more diverse organizations.
Currently, 28 health systems have opted for the ”big bang” approach in the past year.