In 2015, Providence, RI-based Lifespan conducted what was, at the time, the largest “big bang” implementation of Epic’s electronic health record (EHR). The health system wanted to consolidate the multiple EHRs that resided across its five hospitals and more than 100 ambulatory facilities to a single EHR.

The goal was to eliminate a significant pain point. Physicians roaming from their practice locations to the hospital were unable to use a Web browser to access patient records from their EHRs, according to Tom Kane, Lifespan’s manager of client server engineering and Epic.

The secondary goal was to consolidate all the data from the existing EHRs into the single EHR to create one for each patient. In order to accomplish these goals, Tom pointed out, “We had to build a comprehensive record highly available and redundant infrastructure,” which would improve clinician workflow and therefore be sure to have a high adoption rate.

One of the first exercises Tom and his coworkers conducted was to reach out to the physicians and clinicians to hear their complaints and determine their needs. One physician who was working from home related that his son had upgraded his computer’s Explorer browser, which disabled the clinical apps he was using for work. “Our biggest challenge and goal was: how can we provide a streamlined single point of access, regardless of the device a clinician has or where he is physically located?” Tom concluded. “That’s the challenge we tried to overcome.”

Lifespan implemented a host of solutions – including Citrix’s XenApp, XenDesktop and NetScaler; PVS web interface servers; x86 server technology; and Imprivata’s single sign-on solution – to enhance its EHR and the user experience for its more than 6,000 users. A “big win” for the health system was to have the technology in place to be able to support the out-of-network physicians (not employed by Lifespan) but who have patients presenting at a Lifespan facility. These clinicians need secure access to the Epic EHR.

Another big win was enabling LifeSpan’s clinical staff to use their badges at any of the Lifespan hospitals to securely access patient information without the use of a keyboard. “I actually saw two doctors smile,” Tom noted as he described the capability. “That actually happened.”

Along the way, Tom and his team developed best practices for Lifespan’s big-bang implementation:

• Establish a relationship with all application owners in the organization – Know what changes have been made by application owners before go-live
• Build a team that wants to make a difference – Take note of and support the team members who are engaged with the initiative
• Work directly with your partners and vendors – Treat them as part of your team and part of your command Center, and not as vendors
• Establish an off-site command Center for go-live – Have a dedicated team comprising vendors, engineers, application developers, C-suite executives and IT staff that will work around the clock for two weeks to address issues in a timely manner
• Don’t underestimate the dress rehearsal for go-live – You will uncover devices and applications that you didn’t know existed, such as printers, which leads to the next best practice
• Build in capacity for upgrades and servers for failovers

With a dedicated, engaged team and the right technology in place, Lifespan met its goal of providing workplace flexibility for its clinicians and physicians and, as a result, better value for its patients.