The stakes of replacing or consolidating an EHR for a hospital are high. A messy rollout to a larger platform like Epic or Oracle can slow care, frustrate staff and erode patient safety. For many health systems, the work of avoiding that chaos begins months before the switch is flipped, as teams prepare clinicians to navigate the transition from day one.
Few people know the process better than Lincoln, Neb.-based Bryan Health’s chief medical information officer Scott Heasty, MD. In September, he helped lead Falls City, Nebraska-based Community Medical Center’s EHR go-live.
“Change is uncomfortable,” he said. “But if you front-load the work, the payoff is huge.”
Preparation began nearly a year before launch. The first step, Dr. Heasty said, was identifying the right people to bring on board early — department chiefs, respected physicians and other clinical influencers who could set the tone for the transition.
“If you get the right folks at the table, everyone else follows,” he said. The ensuing conversations weren’t about software. They were about expectations: what was coming, what would change, and why the shift mattered.
From there, Community Medical Center’s leaders hosted a series of offsite fireside chats in the months leading up to training. Clinicians gathered to hear timelines, see demonstrations of Epic’s interface and ask questions in a less formal setting.
The chats also gave leaders a way to air skepticism early. At small hospitals, where many staff have spent decades working in the same system, it can be hard to budge.
“You don’t win people over with emails,” Dr. Heasty said. “You win them over with conversations and honesty. If something’s going to be harder, say so. If something’s better, show it.”
Once that groundwork was laid, the focus shifted to training and personalization. Community’s clinicians were assigned e-learning modules before attending small, specialty-based classes. Trainers built in time for personalization on the spot — setting templates, configuring order preferences and adjusting diagnosis lists — so that when clinicians opened Epic for the first time, the system reflected their routines. Trainers shadowed clinicians in clinics and hospital units after training. Thirty-, 60- and 90-day follow-ups gave staff space to revisit challenges after hands-on use.
“It’s like a firehose at the beginning,” said Dani Woodward, who leads training for Bryan’s Epic Community Connect sites. “People absorb things differently over time, so you need to build in checkpoints.”
Dress rehearsals were another key step. In the weeks leading up to launch, clinicians walked through mock admissions, rounds and discharges using test patients. These exercises were designed less to test clinicians than to ensure that Epic’s build matched real workflows.
For support planning, Community structured go-live assistance so that physicians had access to one-on-one help during the first week, while ancillary staff received assistance in smaller groups. Bryan’s trainers, vendor support staff and subject matter experts staffed dual command centers — one local, one at Bryan’s headquarters in Lincoln — to triage issues. Leaders constantly rounded to identify problems early.
When the system finally went live, the months of preparation paid off. Nurses adopted Epic Rover for bedside charting almost immediately. Provider order entry rates surpassed expectations. Patients began using MyChart to manage appointments within days.
“One clinician told us it was the first time they’d worked without paper in 40 years,” said Jen Kimmons, a customer success manager who helped oversee rounding strategies.
Other hospitals have taken different approaches with similar goals. The team at Ithaca, N.Y.-based Cayuga Health spent three to four months on user readiness and change management before launching Epic. Every configuration decision received a change-impact score — low, medium, high or critical — to inform communication and training strategies.
“We spend that time asking a lot of questions about current workflows,” said Cody Baldwin, vice president of applications at Xtensys, which led the project. “That impact data helps us decide how to prepare people for what’s changing.”
Cayuga held roadshows, day-in-the-life simulations, dress rehearsals and required personalization labs for all providers. Monthly readiness surveys tracked gaps by role and department, while joint IT–operations assessments ensured issues were resolved before launch. Afterward, the team monitored “pajama time” — after-hours charting — to identify who needed extra support.
Midland-based MyMichigan Health, which completed its Epic rollout earlier this year, anchored its preparation in organizational culture. Incoming staff shadowed experienced colleagues before training, and leaders rounded during and after go-live.
“From day one of integration, we clearly communicated plans and milestones,” said CMIO and senior vice president Pankaj Jandwani, MD. “We emphasized our culture of safety and patient-centeredness, built into policies, procedures and Epic workflows.”
