MedSys Group was engaged to manage planning and implementation of the Cerner Millennium Clinical EHR System for a mid-sized hospital system. The system encompassed one 270-bed hospital and 15 associated clinics in the Midwest. For the hospital, the project entailed replacing their current Soarian clinical system with Cerner Millennium, and keeping Soarian for their financials in place. For the clinics, the plan was to replace the existing NextGen installation with Cerner Ambulatory and Soarian Physician Revenue Management.
MedSys Group was engaged by the client just prior to signing a contract with Cerner in early 2016, and managed the project from that point through several months post go-live in late 2017.
Early in the engagement, MedSys staff integrated with the client to learn their leadership and culture. Replacing an EHR is a transformative project that touches all areas of a health system, requiring strong leadership support and meticulous execution. Our first priority is always to ensure that our clients are ready from this crucial organizational perspective.
As we integrated the team, we began the work of implementation. After confirming the detailed project scope, and following a thorough assessment of the client’s own staffing, MedSys assisted with the definition of the project plan and timeline. This was unusually complex because Cerner’s purchase of Soarian was still fairly recent, increasing the challenges of coordination between multiple parties. Through several months of pre-implementation planning, MedSys also worked with client leadership and Cerner staff to create a detailed governance structure.
Governance is a complicated and extremely important part of any project plan. It includes technical components such as the charter, the resource matrix, and the steering group structure. More critically, it includes contingency planning, risk and issue tracking, and strong links to the organizational governance of our client. Assembling this was a crucial part of the early work of the project team.
After completing this early work, we kicked off with the full project team. By sequencing it in this way, and particularly by establishing governance and communication structures prior to kick-off, we were able to share critical information about the project and its structure, exercise and test communication pathways, and address project team cohesion.
As the project progressed, MedSys staff drove the implementation, keeping team members accountable and following the project plan. We established a strong cadence for issue management and risk mitigation, helping ensure key decisions were made using the best information available. Bidirectional communication kept everyone involved and included.
Throughout the project, MedSys also helped keep the focus on organizational transformation and clinical care. We highlighted critical workflows, presented best practices for change, and led testing and validation for these new practices. It’s easy, in the heat of an implementation, to forget transformational goals. MedSys experience and leadership kept those goals fully in sight.
As the application build and test neared completion, we helped design the training plan to incorporate our client’s decisions on workflow and scope. Following testing, the training plan was designed not only to teach users how to use Cerner, but also to teach them how to follow the improved workflows available in the new Cerner applications.
Even though the client’s revenue cycle application was retained, clinical transformation always prompts revenue cycle optimization. MedSys recommended many changes to the client’s current state revenue cycle operations as a part of our intensive focus on workflow. This not only helped the client prepare to work smoothly with the new clinical systems, but also helped capture far more charges than before the transformation. We helped establish a revenue reconciliation process that started in every clinical area and followed all chargeable activities as they flowed from the clinical system into the financial system. Once established, this effort was led directly by the client’s Chief Financial Officer, who ran weekly meetings with all department.
Throughout the project, MedSys advisors also made recommendations to improve crucial areas of the client’s operations. We assisted with refocusing IT operations in the context of the new Cerner systems, and helped the client establish a clinician and physician informatics team. These teams assisted with clinician use of the new system, gave a badly needed physician sounding board, and ensured that clinical IT questions were answered by clinically trained and experienced staff. The clinical informatics team reported to the client’s Chief Medical Officer, and worked heavily with IT and Education to ensure communication flowed freely around all clinical system concerns, issues, and improvements.
The project was seen by our client as hugely successful, both from the clinical and revenue cycle perspectives. The project team met their initial planned timeline, and achieved a live, stable system with relatively few issues for such a transformative project. In the process there was no significant negative impact to revenue. The new IT organization and clinical informatics team, along with a strong EMR build and expert client staff, will be ready to support improved clinical care and revenue management for years to come.
