With the flip of a switch at 4:44 am on March 3, all four locations of the Stanford Health Care-ValleyCare system shed their dependence on paper, and implemented the Epic Electronic Medical Record (EMR) system. While the cutover happened on March 3, it was preceded by more than two years of integrated planning, designing, building, testing and training to ensure that patient care and hospital and revenue operations would be enhanced with the move to an EMR.
“We are now a system that’s connected,” said Davis Gunderson, Manager of Strategic Initiatives, Stanford Health Care-ValleyCare. “This is an exciting milestone event that further integrates ValleyCare into the SHC network. It enables improved collaboration and communication across the Stanford enterprise.”
Readying ValleyCare for the Epic implementation required a complete overhaul of its digital infrastructure. The IT team deployed 3,800 new end-user devices such as computers, workstations, bar code scanners and printers throughout both of the ValleyCare hospitals and clinics. The network was also upgraded to maintain reliability for 166 different, integrated applications to enhance care delivery—everything from clinical care and patient charting to registration and scheduling and billing.
“We first had to enhance the environment and infrastructure to meet the minimum Stanford Health Care standards,” said Chiranjeevi Ikkurthy, IT Program Director, SHC-ValleyCare. “That meant deploying a reliable, predictable and secure infrastructure for the Epic EMR.”
Over the past two years, 50 to 60 percent of SHC’s IT staff have worked on ValleyCare’s large-scale EMR implementation. That’s about 600 people in all, said Ikkurthy, “Our role was to provide ‘soup to nuts’ IT delivery for ValleyCare.” Planning involved the creation of 35 workgroups, each with a clear scope, charter, timeline and detailed resource plan.
Design and Build
Across every department, workgroups formed to document current processes, and then develop new workflows for an electronic environment. In nursing, that meant looking at every row of every flow sheet, comparing ValleyCare workflows with Stanford Health Care workflows, and building documentation tools as necessary.
“The process took a year and a half to plan and build and test,” said Shannon Stewart, RN, Manager, Staff Development. Stewart worked as the nurse liaison for the Epic implementation. “We had subject matter experts and operational leaders from each department work with IT analysts to review all clinical documentation and workflows.”
Starting in January, ValleyCare began training 1,598 new Epic users—318 providers and 1,280 staff—an undertaking that required more than 3,200 hours of classroom training delivered in nearly 900 training sessions.
“The Epic Education department taught all staff in an eight-week period of time,” said Stewart. “They had classes going from 7am through 10pm, six days a week, with 13 classrooms running simultaneously.”
At Go Live, there was a team of support personnel on the floors to help staff as they logged in and used the live system for the first time. This included technical staff from Epic and IT, but also a team of Super Users—ValleyCare employees who underwent extra Epic training to help colleagues at Go Live. SuperUser Effie Mattison, RN, a staff nurse on 1 West, underwent 16 hours of training to provide elbow-to-elbow support for the nurses on her floor.
All of the planning and preparation for the ValleyCare Epic implementation paid off, said Ikkurthy. “There is a lot of pride around the hospital because the implementation went so well.”