Mayo Clinic pulls off 25k-user Epic go-live: 3 questions with the consulting firm that helped them do it

On May 5, Mayo Clinic's main campus in Rochester, Minn., completed one of the nation's largest Epic EHR implementations to date, according to HCI Group — the health IT consulting and technology solutions firm that aided Mayo Clinic in the go-live.

"A typical go-live is somewhere between 500 to 4,500 end users at a single time, and a large implementation would bring up 5,000 to 10,000 users at once," Jason Huckabay, executive vice president of operational delivery at HCI Group, said during an interview with Becker's Hospital Review. "The Mayo go-live brought 25,000 clinical users live at a single time."

To support Mayo Clinic, HCI Group helped the health system plan for the go-live process and provided the campus with more than 1,400 resources, as well as training, activation and command center service desk support. The Epic implementation is part of a multiyear technology modernization project across Mayo Clinic, which officials estimate will total $1.5 billion.

Mayo Clinic has also tapped HCI Group to support in upcoming go-lives at the health system's Arizona and Florida campuses, which are slated for fall 2018.

Mr. Huckabay spoke with Becker's Hospital Review to discuss how HCI Group helped Mayo Clinic plan for the implementation and how the firm measures success following a go-live.

Editor's note: This interview has been edited for length and clarity.

Question: How did Mayo Clinic and HCI Group decide to implement the Epic EHR in a single go-live, rather than a gradual rollout?

Jason Huckabay: Mayo made the decision to go live in a single implementation on their own. It would be close to impossible to segregate out any piece of the Rochester campus from the others, as they all work hand-in-hand. Having part of the group live without the rest would have been riddled with challenges and workflow issues. It was a calculated risk to bring everyone up at once, based on the successful first waves that brought up the areas outside of Rochester. It helped to do those multiple smaller efforts and apply those lessons to be sure they could do a final larger push.

Q: Some news coverage has focused on temporary employees leaving the Mayo Clinic project, citing mismanaged assignments. How does HCI Group assign and manage contractors in various roles across the health system?

JH: When we come on site, the first thing we do is a needs assessment, and we do our best to match our support staff's skills with that of the people they will support. While we look at specific departments for their skills, we also look at their clinical background and how their areas use the software. Some skills are universal and will work for multiple areas. Therefore you might find a nurse from one area supporting nurses from another area because their use of the system is similar. All this to say HCI weighs their background and expertise along with the needs of the client when making staffing assignments.

Q: When assessing a completed go-live, what metrics do you use to evaluate its success?

JH: The ultimate metric is: Was the client successful? Were they able to use the new system to take care of their patients? The resounding answer for the Mayo project is, 'Yes!' We have other metrics we look at internally, such as was everyone able to complete their assigned shifts, did they all start on time, did our transportation schedule meet the work schedule demands, how many 'no shows' did we have and how many bench or backup resources were deployed, along with did we have enough backup resources for any no shows or cancelations? When we look at our data, HCI performed well and the HCI management and logistics team adapted quickly to changes and were able to provide top quality support to our client.

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