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A recap of the EMR Best Practices Webinar presented by Angela Cessna on Oct 29 2013 This presentation is intended to give you a general overview of Radiant implementation processes as experienced by Greythorn contracted employees. For a more tailored and confidential discussion on how this will affect your business or your own career, please get in touch with us. Greythorn will not be reliable for any damages of any kind arising out of or relating to the use of this information.
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Epic Radiant Go-Live
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
Tips, Tricks, and Lessons Learned
Presented by: Angi Cessna, RDMS, RT(R)
Introduction
� Angi Cessna, Epic certified since beginning of
2007
� Involved in over 20 implementations
� Large 300+ bed facilities
� Critical Access Hospitals
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
� Critical Access Hospitals
� Ambulatory HOD radiant departments
� Ambulatory only radiant departments
What you can take away from today’s talk
� Better understanding of the approaches to taking Epic
Radiant software
� Big Bang and After-the-Fact
� You will understand if this process will it be easy or
difficult?
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
� Share lessons learned from different implementations
� Enhancements – Can we do this easily?
� Importance of staying engaged with other teams
� Surprises you may want to avoid
Why Radiant?
� Rules-based scheduling
� Documentation
� Results communication
� Chart/film tracking
� Detailed statistical reporting
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
� Detailed statistical reporting
� Unified system that is fully integrated with Epic clinical
systems
Could it be that simple?
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
Big Bang – 1st Approach
Learning a new
system
Streamlined care
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
Big Bang Go Live
(all Epic products together)
system together
Adding Radiant later – 2nd Approach
1• Other products are now live
2• Implement Radiant after the fact
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
2
3• Is this good or bad?
Adding Radiant later – contd.
Cons
� Difficult adjustment
� Training
� Testing
Pros
� Easier Go-Lives
� Familiarity
� One system
� Reduced cost
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
� Reduced cost
Enhance – 3rd Approach
Transportation Workflows
Minimal Functionality –
Initial Install
Enhancement
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
Workflow is RIS-centric
More Robust Scheduling
Enhancement
Some Recommendations
� Try to keep on a concise schedule:
� Use standard reports and work lists
� Use experienced analysts/builders
� You can keep costs down
� Users ownership in optimization process
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
� Users ownership in optimization process
� Integrated Rads vs. non-integrated Rads – support is
important
� Where can you help – support schedulers?
Heartburn
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
Some things to look out for
� 3rd party billing files if needed
� PACS driven vs RIS driven
� Interfaced results across time zones
� Security changes to existing users
� Radiologists’ support
greythorn.com | [email protected] | +1 (312) 853 6100
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� Radiologists’ support
Keep Engaged with Special Teams
� Team that manage shared Masterfiles
� Security
� Change Control
� User records (SERs and EMPs)
� ICD-10 Team
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� ICD-10 Team
� Meaningful Use Team
� Data Courier Team
Wow!
� DICOM – (lack of) testing concerns
� Where is the test box? TST or PRD only?
� Users security – inadvertent changes at go-live
� Results – coming from Epic RIS, vs. outside radiology
systems
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
systems
� Interfaces - test in appropriate environments
What do we do now?
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
Planning for the future
Enhancement Optimization Upgrade
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
Questions?
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
For moving data, we use Data Courier. Do you
think it’s best to have all members of team move
data, or just a set of users within the team?
� A subset of users is best, so they can be experts in the
manipulation of data, keeping up on any Data Courier
changes that comes with upgrades, etc.
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
changes that comes with upgrades, etc.
For supporting a go-live, do you like to use
analysts as hands-on Floor Support, or do you
prefer to use Superusers?
� Analysts are best utilized in the command center. Floor
support should be superusers so they can build that
report with the regular users, which will mean a better
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
long-term support and success
Have you ever ‘let’ non-Radiologists read in Epic,
like Cardiologists, or mid-levels that read stress
exams, etc? How did you manage support of
these reading docs?
� Yes, they just need Radiant reading security. They need
appropriate training, either reading from a Reading
Worklist or via the InBasket. You can train any support
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
Worklist or via the InBasket. You can train any support
staff, usually their preference, to be able to support
them, but I usually see it’s their staff, not Rad staff.
Do you import new EAPS and SERs (procedure
master file and provider master files) or manually
build them? Which is best?
� I recommend importing the data. It’s easier to document
the changes with the import spreadsheet used. It’s less
easy to make build mistakes too. You can even have
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
easy to make build mistakes too. You can even have
multiple teams enter data on a central import
spreadsheet, then have a daily import time, so all date
can go in at once, and not at various times of day.
Do you recommend a one-to-one Visit Type-to-
Procedure build?
� Yes I do. This way, you can specify where the exam is
scheduled, specific day and time restrictions, as well as
specific patient and scheduler instructions.
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
How long should we staff our command center?
� For a Big Bang, anywhere from 2-3 weeks may be
needed, using 24 hr shifts the for at least the first week.
� For adding Radiant after-the-fact, usually a 1-2 week
mini command center is needed, maybe only staffed 6a-
7p, with on-call availability. You will also need adequate
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
7p, with on-call availability. You will also need adequate
Super-user Floor Support after hours.
Disclaimer
� This presentation is intended to give you a general
overview of Radiant implementation processes as
experienced by Greythorn contracted employees.
� For a more tailored and confidential discussion on how
this will affect your business or your own career, please
greythorn.com | [email protected] | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
this will affect your business or your own career, please
get in touch with us.
� Greythorn will not be reliable for any damages of any
kind arising out of or relating to the use of this
information.