Much more than a just software replacement, eStar, the Epic-based clinical software platform replacing StarPanel, will be the backbone of a new information technology ecosystem for Vanderbilt University Medical Center (VUMC) that will usher in future successes and create the potential to better serve patients, said Jeff Balser, M.D., Ph.D., President and CEO of VUMC and dean of Vanderbilt University School of Medicine.
Speaking at the Summer 2017 Leadership Assembly, Balser spelled out how the conversion to eStar aligns with VUMC’s goals. The theme of the Assembly was “Blast Off with EpicLeap,” and focused on the massive training initiative underway for a smooth transition to eStar on Nov. 2.
The new Epic system will make work flow more efficient because it requires less toggling between multiple screens. It also allows patients’ medical information to be efficiently shared virtually anywhere among other Epic-based clinicians, hospitals and health systems who care for 190 million patients across the U.S.
“Through eStar we wanted to lay the right foundation for the future, a system that lets us interact with broad geographies, diverse care settings, and patients using a range of devices, from laptops to iWatches,” Balser said.
Two major goals aimed at patient satisfaction associated with the Epic install set the stage for elimination of paper forms in clinics, and widespread use of My Health at Vanderbilt to schedule return appointments online, Balser said.
“At ‘Go Live’ we’re going to have four of our major clinics — Internal Medicine/Primary Care, Women’s Health, Orthopaedics and the Eye Institute — market the use of My Health at Vanderbilt to schedule return appointments,” he said. “While this will soon be available for all clinics, we are going to market these four initially because they have high utilization of My Health. After Go Live, we will schedule for all other areas to begin marketing the opportunity to make return appointments online.”
Citing other enhancements, Balser said one hospital system in New York City that converted to Epic was able to shorten patient wait times by 25 minutes using the streamlined system that improved workflow, including gathering information from patients online before the clinic visit.
Balser summed up the move to EpicLeap with these words: “This is not a software replacement; this is a culture exercise.”
C. Wright Pinson, MBA, M.D., Deputy CEO and Chief Health System Officer for VUMC, also stressed the importance of a successful launch.
“Our Epic transformation is an enormous undertaking, and there has been a great deal of planning and a great deal of work,” Pinson said. “How Epic comes off is crucial because it will support our mission for years to come. It will be a defining moment for us.”
He asked all leaders to commit to three key actions:
• Set a professional tone — Bumps will occur. If concerns arise, reach out to executive leaders for guidance. For technical questions, rely on designated Super-Users who will be in place to support employees.
• Emphasize eStar’s benefits — Share with patients, clinicians and staff the benefits of switching to the new system.
• Activate and mobilize teams — Assuage any fears among employees about the change and rally them to the common cause.
“We’ll get the most from this significant investment of time, energy and finances if everyone in our organization is committed to making our implementation a success,” Pinson said. “It is to everyone’s advantage that we make this as successful as possible. It is also to our patients’ best advantage.”
Pinson noted several achievements from fiscal year 2017, including Vanderbilt University School of Medicine moving up two spots to now rank eighth in total research funding from the National Institutes of Health, and VUMC being listed on multiple best hospital lists. And he said VUMC has met its own benchmarks by achieving all its Pillar Goals for the 2017 fiscal year.
“I am delighted to share that we met threshold or better for all of the Pillar Goals,” Pinson said. “This is tremendous. All these goals require a great deal of problem solving, collaboration across disciplines, course correcting throughout the year and rallying your teams to get behind these common goals,” Pinson said. “This is what success looks like.”
He gave an overview of the 2018 Pillar Goals, which include all of 2017’s goals carried forward. There are two new goals related to case mix index and access performance. The case mix index goal focuses on better coding and documenting care that is provided. The access performance goal is tied to improvements in scheduling patient appointments and improving response times for responding to calls.
Pinson offered three takeaways: celebrate and share VUMC’s many achievements with your teams, focus and align with fiscal year 2018’s Pillar Goals, and make eStar implementation a success.
The keynote speaker, Michelle Schreiber, M.D., senior vice president and Chief Quality Officer for Henry Ford Health System in Detroit, spoke about her institution’s successful switch to Epic in 2014.
Schreiber said a key factor for success was engagement that empowered project leadership that came from all levels of their organization and not just from their information technology team.
“We were clinically and operationally led,” Schreiber said. “This wasn’t an IT project. For us, this was actually a quality project.”
However, lessons were learned, she said. Transparency during the training process is crucial, she said, noting that one department did not come forward about not being prepared for the rollout of the new system.
“Each area was responsible for accounting for their activities,” Schreiber said. “We think that was important, but more important was really being honest. There was one unit that came to the planning meetings and said they had done everything and really hadn’t. They were the unit that wasn’t successful. Transparency and really doing the work you are being asked to do is the key to success.”
The Epic community is expecting new innovations from VUMC as it implements and improves its eStar system, she said.
“It’s not about a computer,” she said. “It’s about transforming the entire organization with work connections, the culture, and how to enable this to happen. You have some of the greatest experts in the world around change transformation and you all know that successful transformations don’t just happen. They are planned.”
Kevin Johnson, M.D., M.S., chair of the Department of Biomedical Informatics and Senior Vice President for Health Information Technology, moderated a panel discussion on Epic that included Schreiber and two VUMC leaders —Lindsay Miller, R.N., MSN, manager of Patient Care Service for the Burn Center, and Victor Legner, M.D., M.S., associate professor of Medicine — who both previously worked at hospitals that switched to the system.
Johnson said that the Epic system lends itself to further optimization and continuous improvement.
“It’s not just a continuous learning by the organization,” Schreiber responded. “It’s a continuous learning of health information technology across the globe that I think you’re going to play a leadership role in.”