In early March, Tallahassee (Fla.) Memorial HealthCare went live with a $234 million Epic EHR.
Becker’s talked to leaders from the inpatient and outpatient sides who have been overseeing the switch — Ryan Smith, MSN, RN, vice president and chief clinical and nursing officer, and Jennifer Parks, president of TMH Physician Partners — about how the implementation has been going and the expected benefits of the new EHR.
This conversation has been lightly edited for clarity and brevity.
Question: Why did Tallahassee Memorial HealthCare decide to switch to Epic? What are the expected benefits?
Ryan Smith: Prior to our Epic transition, we had multiple systems. We had our financial system, we had Cerner on the inpatient side, we had Allscripts on the outpatient side. We really had the opportunity to look at what system was the best fit, knowing our ultimate goal was to have a unified record to benefit our clinicians and patients.
We did a lot of research. Our IT team led many activities to look at best in class, get reviews out in the market, see which systems had the top performance. We selected Epic for having advanced data and an integrated record on the inpatient, outpatient and financial side, and then the clinician experience reviews as well as the patient experience reviews. It was the clear leader for us.
Jennifer Parks: I was in the process of getting recruited here at the time from a larger healthcare system, have used Epic since 2016 in a couple of other organizations, and have been through transitions as well. So when I came to interview and they were discussing this, I definitely wanted to be a part of it.
Q: What went into the implementation process? How long did it take?
JP: There were a multitude of work groups. It’s very much an operationally led project, with upward of 30-plus work groups, from various and sundry areas across the organization, including as many providers as were interested in being engaged.
There were over 13,000 decisions that were made over the course of the project at the operational level, and then anything that needed to rise up would come to the steering committee, for which Ryan and I were the co-executive leads. Then we had a team of folks on the executive steering committee for any larger decision that had to be made. We started in December 2023.
Q: How have staff members and patients responded to Epic so far?
RS: We did something unique compared to what Epic recommended. We followed their path of having frontline super users as our super user model. One thing we did differently than most organizations, which was a huge benefit for us, was we actually required all leadership to be in super user training, and when we went live, they would be on the floor to help with the support of the frontline staff.
What we saw from a nursing clinical perspective is our leadership knew the system. They provided that support of change management. It was a great benefit to all the staff. They felt like we were invested in the success of this as well from a leadership level. We created command centers where we worked nights and weekends to support the clinicians, providers and staff.
We are still in the go-live, so we’re still doing a lot of optimization, which is as expected. From a change management perspective, our strategy to really immerse ourselves in this change helped support the staff. From an adaptability standpoint, nursing was very resilient. They grasped the changes relatively quickly.
JP: We actually used internal super users. So they were our own team.
Epic came in to help, certainly, and some other folks who have gone live recently came in to help, and we helped them. But 96% or 97% of the super users we deployed were our own teams, whether that was providers, frontline staff. All leaders were involved as well to help troubleshoot.
In talking with Epic, that’s a rarity to do that and actually have it stick. We are in the go-live, so we are still working out the kinks and the bugs, but my experience has been that this is probably the smoothest go-live. It’s still a go-live, so it’s still painful. But we’re only in a month, and we’re already looking at optimization at this point.
RS: One of the biggest helps to us was we had two hospitals in South Florida that went live recently, and they actually came on site. They were able to say to us: “Hey, if you do this or you change this,” or recommend this workflow here. We gained a lot of knowledge from them.
If we can support other hospitals with going live, there are things that we’ve done here that could benefit them just as these hospitals greatly benefited us and our IT teams.
Q: Are there any specific features in Epic that you’re particularly excited about?
JP: I’m glad to have MyChart back. I still have my MyChart app from 2016 that I still look at lovingly. It helps with patient access. We’re going to break a million visits this year with the medical group alone. So to not have them call for those million visits is already starting to make a difference for us.
RS: For us, it’s the data. The data is amazing. We can actually see the continuum of care from the outpatient to inpatient side. We never had that ability before. When you look at our financial system to see real-day charges: What is that impact? Are we performing? Where are our opportunities?
We’ve always been “information rich, data poor.” We now have data where we can make decisions and create outcomes based off what we can see across the whole health system. When you look at the robust amount of dashboards and analytics that’s available, it’s really, really impressive.
Q: What are any future plans for the EHR?
JP: We’ll be adding [ambient] AI in the next couple of weeks from a company that is integrated with Epic. That will roll out with a group of doctors and advanced practice providers, and we look to expand that.
And then there’s a CRM. There’s a nurse triage area module for the CRM portion of Epic that we’ll be deploying on the ambulatory side for our call centers.
