Planning an EHR implementation is a significant undertaking that touches all areas of a healthcare organization and requires time, training, and support. All of these aspects are multiplied when the project is undertaken by an organization as unique as Avera Health. With more than 300 locations in 100 communities, Avera’s move to Expanse involved multiple hospitals, clinics, long-term care, and senior living facilities.
In an effort to minimize upheaval and build on lessons learned throughout the project, Avera opted for an implementation strategy different from the standard “big bang” approach when all sites go live at one time. We worked together and established a unique plan that would entail a series of Go LIVEs over several years, with all of the live sites simultaneously updating each time per geographical region.
We are always trained to expect the unexpected and be ready to adapt, especially when managing a multi-year project of this magnitude. Little did we know that midway through the Go LIVEs, we would be hit with a public health pandemic. Our strategy enabled us to adapt to these unexpected challenges and press on.
One of the goals of a multi-year project like this is to fine tune our formula for success so that each subsequent Go LIVE is systematically smoother. This can be achieved with four primary principles: communication, change management, collaboration, and agility.
From the beginning of the project, it was clear that frequent and inclusive communication for an implementation project of this size and scale was critical to its success. This included internal communication among Avera’s team, both operational and information technology stakeholders, within MEDITECH’s project and across divisional teams, as well as between both parties and third-party vendors.
As the Account Manager, I was the eyes and ears of Avera for MEDITECH. I spent the majority of my time on site, attending meetings, learning about organizational goals, and identifying and resolving potential issues before they could be implemented. By being on-site and working so closely with Avera, we were able to build on our existing relationship, ensure their feedback was heard, and respond quickly as needs shifted.
Change management was equally important to this project’s success and was spearheaded by Avera’s leadership and key stakeholders. Staff buy-in is critical to an organization's success, as added implementation work and resistance to change can at times undermine the goal of the project. A project of this magnitude required the executive team to clearly share their vision, why the project was needed, and how it would positively impact the organization.
Metrics can help illustrate the business case for implementation after a period of time, but what matters most depends on each employee and their role. Making sure each user is aware of the benefits to their specific job — before the implementation even begins — is key to building support and driving change. While a physician may be most excited to learn about Expanse mobility features, someone from the accounting department would care more about the improved transparency provided by the Financial Status Desktop. Leadership needed to reach and engage everyone in ways that were meaningful to them in order for the project to succeed.
Collaboration was also essential to this implementation. As a long-term MEDITECH customer, we have an established working relationship with Avera rooted in our similar cultures. From the project’s start, Avera was invested in working with our team, offering constructive feedback, and ultimately pushing us to be the best we could be. Together, we standardized and enhanced the system to meet their strategic goals. While implementing Expanse at its sites, Avera also opted to become an early adopter for several of our new offerings including High Availability Snapshot, Expanse Now, and Expanse Cam. This required additional planning but helped to optimize their EHR for peak performance.
Agility is the final key to a multi-phase implementation project. During one of our Go LIVEs, the pandemic shut down travel and in-person implementations, which prevented us from providing normal on-site optimization and education. Like most companies, MEDITECH shifted to a remote workforce for a period of time. In subsequent Go LIVEs, this transitioned to limited on-site support and then a hybrid model. Now, depending on the needs of an implementation project, we are able to leverage remote strategies and support as another tool in our toolkit.
While the Avera Expanse project has been unlike most implementations, the lessons learned are universal. Communication, change management, collaboration, and agility are fundamental to achieving implementation success.
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