An Epic Project
In fall of 2015, Skagit Regional Health committed to build and implement a $75M electronic health record system called Epic. The Epic Project required a majority of the machines inside the system to be either replaced or updated, and impacted the workflow for nearly every staff member, provider, contractor, and volunteer.
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I joined the organization in spring 2016. Prior to my arrival, the only communication about this Epic undertaking was through a press release to the media when the commitment was announced. I met with the Chief Information Officer on my second day and began to formulate a plan for internal and external communication over the next 18 months.
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The Epic Project was a multifaceted, evolving, and stressful system change for staff and providers that required significant communication, coordination, and staff education.
Key Challenges
Timeline
The communication element of this project was not part of the project plan. I joined the team several months late, so much of my initial work was making up for a deficit of communication.
Stability
The Epic Project faced a number of leadership changes that significantly impacted the project timeline, foundation, and scope. This included a change in CEO, CIO, COO, and several application directors.
Information
The vendor provides tremendous resources on the clinical aspects, but not much for communication. This made information flow and scope clarity difficult.
Resources
Communication was not built into the project budget and this was not realized until my arrival six months later. This created obvious challenges, partnered with the lack of recommendations or resources from the vendor.
Project Portfolio
Setting Expectations and Timeline
Step one was helping staff understand what to expect and communicating the timeline. The Epic Project came with a strict "No Training, No Access" policy, so everyone needing access to a patient record or a process needed significant training and practice time.
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I created an Epic Roadmap for employees to understand the build process, training opportunities, and time commitments. We also created content in each issue of the organization newsletter to highlight different areas of the Epic system and keep a steady cadence of information sharing.
Attendance at Optional, Yet Important Events
The Epic Project had many required classes and events that seriously impacted clinical staffing schedules. Therefore, some of the other important steps were deemed optional, like deep-dive training, practice labs, and permission checks prior to go-live. These steps were important for a successful implementation so we launched an aggressive internal marketing campaign to encourage staff and providers to attend these sessions in their free time.
Branding Epic for Skagit Regional Health
Midway through the Epic build, employee fatigue was setting in and, with 2,500 employees affected, we needed to reestablish the importance of this commitment across the system. I created a campaign called "Epic Is" that simplified our key messages into one or two words each and connected them with our Executive Leadership Team. This connected familiar faces with the project and simply explained why Epic was foundational to the future of the organization. We leveraged every communication channel, and created a few more, to champion this message across 27 locations.
Generating Excitement for Go-Live
More than a year into the Epic build, staff were beginning to complete their training certifications and get "Epic Ready". We decided to have a little fun and created bright orange stickers to affix to employee badges. Stickers were handed out after training and we began capturing photos of employees to share the message "I'm Epic Ready!"
Go-Live Communication
It was expected that patients would be impacted during go-live, and for a few weeks following. Epic was brought online at midnight on a Saturday night across the system, so patients in the hospital experienced unusual activities, such as wearing two bracelets during cutover, medications scanned through both systems, and reconfirming their identities after midnight. This can be alarming for a patient that has been admitted for several days. On the outpatient side, the process was slower than usual as employees got comfortable with the system and began using new workflows.
In preparation for the impact on the patient experience, we printed and deployed nearly 12,000 pieces of signage and educational brochures to explain why this was happening asking for patience. We also implemented a concierge service that brought snacks and supports to staff on the front lines, as well as coffee and service recovery for patients experiencing frustrations and delays.
The third, and probably most important, element of go-live communication was a daily drumbeat of positivity and motivation for staff and providers. Epic has affectionately labeled the period following go-live as "the Valley of Despair", where staff are unbelievably frustrated and the system is stabilizing. The Director of Organizational Development stood up employee stress relief areas with treats and games, while my team spent time gathering positive photos and crafting motivational messages for emails and the newsletter.
Epic Apps and Additional Features
The Epic Project team has continued to optimize the system and release new features and applications. Each of these includes a marketing component as we release them to various audience bases.
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The MyChart Patient Portal was one of the biggest impacts on the general patient population. The previous portal moved to read-only mode at go-live and there was no way to transition patients in bulk. Each portal user is required to personally enrolled in MyChart. This was, and continues to be, a pain point for patients and requires ongoing communication efforts.
