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Epic selected as EHR Vendor
Epic selected as Electronic Health Record Vendor. -
Board Approves Moving Forward with Electronic Health Record
The YRMC Board approves the Electronic Health Record to assist with the organizational initiative to improve quality, safety and service excellence. -
New Data Center Design Project Started
In September of 2009, YRMC first started researching and designing a new data center to become the primary support center for the hospital, corporate business center, and the area for storage of electronic health record systems. This new data center would have the newest technology advancements to increase availability, efficiency, security, and to ensure YRMC’s business continuity. The result was a plan for a 12,647-square-foot Tier III Data Center. -
Project Jane Staff Recruitment
We needed people with a vast amount of talent and expertise. In addition, we had to have every team member trained and certified in an Epic module. We instituted a three step process for hiring through assessments. We asked each applicant to develop a workflow from a simple task, write a whitepaper on a health topic, and complete a three-part assessment test. Each applicant completed and passed the three items before being interviewed. We have achieved a 100% success rate in Epic certifications. -
Phase 0 - Education and Planning
Epic provided executive education and project groundwork which included project planning and analysis. Project team members were identified for both Epic and YRMC. -
Current State Assessments
Representatives from the Clinical Informatics team held numerous meetings with directors, supervisors and coordinators to obtain each department’s current state, forms used, and processes. After the information was gathered, Epic representatives hosted site visit meetings with these departments for a more in-depth assessment. This information would help Project Jane staff better understand how to analyze and build the new electronic health record. -
Contract with Epic signed
On April 7, 2010, YRMC executive leadership signed the contract with Epic to mark the beginning of the build for the integrated electronic health record at YRMC. -
Training and Certifications
Information Technology and other YRMC staff were trained, tested and certified to set up and build the YRMCCare applications for YRMC’s users. 58 people were sent to Epic headquarters and took a total of 230 courses. -
Epic System with Training Data server build (SWTD)
The server which houses the System With Training Data (SWTD) was created to provide a self-contained Epic environment where Project Jane analysts could study, train, and work on projects required for Epic certification. -
Physician Town Hall
On June 9, 2010, the Project Jane Physician Town Hall was hosted at Yuma Regional Medical Center. This event was created to facilitate communications between local physicians’ offices and Project Jane’s ambulatory staff concerning the electronic health record system: benefits, risks, fears, and how they can best be reached for further communication. From this Town Hall, a series of eight FAQ newsletters were distributed to physicians addressing their expressed concerns and questions. -
EPIC Non-Production Build
The EPIC Non-Production Build environment, which consisted of 18 new servers, 5 server racks, and a dedicated Storage Area Network (SAN) where the electronic health record software could be built and configured prior to the Epic Go-Live, was constructed. The Non-Production Build environment has allowed the Project Jane analysts to build & configure the software from the Epic Model system. This allows the Epic software to be configured, validated, and custom-engineered for YRMC. -
Epic Site Visit & Phase 1 Discovery
Epic representatives spent three days on the YRMC campus, in meetings with department directors and subject matter experts, observing and collecting information on YRMC workflows and roles. This was the first opportunity for Epic and YRMC staff to meet and get familiar with each other and their respective roles in the upcoming project. The information gathered was then used to create initial workflows for the electronic health record system. -
Milestone Celebration
On the evening of July 28, 2010, Yuma Regional Medical Center celebrated the completion of Project Jane’s first milestone, the signing of the contract with Epic Systems to begin building YRMC’s integrated electronic health record system. To celebrate this momentous occasion, three years in the making, the Information Technology staff hosted a demonstration event at Arizona Western College’s Schoening Conference Center for YRMC’s leadership, board members, and executive leadership. -
Clinical Informatics Staff move into remodeled CBC Office
To accommodate the addition of Clinical Informatics staff, a new area within the Corporate Business Center was remodeled. This new space included cubicles for 52 staff members, eight offices, two conference rooms, and six modern training/meeting rooms with the newest computer and SmartBoard technology incorporated. -
Validation Sessions 1 & 2, Phase 2 Workflow Validation
During validation Sessions 1 & 2, Epic took the site visit information and model system standards and worked to combine these into workflows for YRMC’s staff. Epic staff was on site for 3 days to meet with YRMC staff for validation sessions. During validation sessions Epic and YRMC Staff demonstrated what the workflow could potentially look like in the new system to department directors & subject matter experts. Directors voted Green, Yellow, or Red, to indicate whether the workflow would work. -
Phase 3 - Build and User Adoption, Re-Engineering Sessions 1, 2 & 3
‘Red light’ validation points from prior sessions were resolved, workflow labs conducted and the system was initially built. Epic and YRMC Project Jane team members worked to fix/re-create workflows to meet YRMC’s needs. Department directors and subject matter experts gathered to meet with Epic analysts for a 3-day on-site meeting and view the new workflows for approval. Re-engineering sessions involve reviewing and revalidating any topic not given a ‘green’ approval on 100% of YRMC workflows. -
Construction Starts on Yuma Regional Medical Center Operations Center
Construction crews filled the dirt lot behind the YRMC Corporate Business Center during the week of December 13 to break ground on the future location of the YRMC Operations Center. The YRMC Operations Center construction took approximately nine months until the space was fully finished and could be occupied. -
Build Sessions 1, 2, 3 & 4
Once all the workflows were completely validated and approved from the validation and re-engineering sessions, YRMC and Epic worked together to build these actions, items, and steps in the Non-Production Build environment. Epic continued their three-day site meetings on a monthly basis to assist YRMC with system build configuration and follow-up meetings, until build was complete. -
ChargeMaster Clean-up Complete
YRMC’s chargemaster and nursing/charging units came together in a joint effort to both clean-up and consolidate the STAR FIM codes for integration into the Epic system. Over 20,000 charges were deactivated or consolidated into already existing codes. This initiative began in January of 2011 and completed in March of 2011. -
Master Patient Index Clean-up Complete
In order to convert our master patient index from STAR into the electronic health record, it first needed to be cleaned up. This process started in October of 2010 and completed June of 2011. There were over 8,300 records that had to be evaluated for possible duplicates and then merged within current applications (STAR, ChartMaxx, Lab). -
Phase 4 – Testing, Training, Go-Live - Application Unit Testing Begins
During Unit Testing, Project Jane teams performed internal testing on their build to ensure that individual workflows were complete, functional, and efficient. This was application-specific and the focus was centered on complete workflows that reflected best practices and efficient ways of working. -
End User Device System Selection Complete
YRMC staff and physicians participated in the selection process which evaluated multiple end user devices for clinicians to use for the electronic health record. 439 surveys were completed which asked for preferences of wall mounts, carts, keyboards, e-signature devices, wireless/wired barcode scanning and monitor sizes. -
All Application Build Complete
All application specific build was completed and ready for unit testing. -
Integrated Testing Begins
During Integrated Testing, all Project Jane applications and modules began working together to test their build items against other applications build items. Teams began testing workflows to ensure that users could effectively move through all parts of the system and seamlessly administer care to test patients through an electronic system, as well as use new electronic, system-integrated devices. -
Yuma Regional Medical Center Operations Center Complete
The Yuma Regional Medical Center Operations Center was completed and Information Technology staff moved in mid-October. The building houses a 3,000-square-foot, state-of-the-art data center and the Help Desk and Infrastructure teams to support it. -
Credentialed Trainer Program Started
Train-the-trainer education methodology will be used for the massive training effort needed to ensure all YRMC staff are ready for go-live on May 1st. A total of 29 credentialed trainers will be used for end user training and go-live support. -
Bio-Medical Device Integration Plan Complete
A plan was developed to determine what bio-medical devices would be integrated into the electronic health record. The plan addressed EKG devices, integration of endoscopy imaging, EEG monitoring, SpaceLabs monitors and infusion pumps. Timeframes for each of these points of integration were defined. -
Interface Testing Complete
A total of 58 interfaces, which are used to pass specific, formatted data between systems to prevent duplicate entry and maintain data integrity throughout all systems, were developed and tested for 25 downstream systems. These interfaces are comprised of the following types of data for exchange: admissions/discharges/transfers (ADT), charges, orders, results, bio-medical and vaccinations. 528 test scripts were successfully executed as part of the testing process. -
Data and Electrical Wiring Begins
To support the addition of workstations at each bedside, additional data and electrical wiring work is necessary. Over 400 data drops will be completed and emergency power outlets added in patient rooms. -
Report Build Complete
Reporting is a critical component to a successful electronic health record implementation. Reports will be used to validate data and provide ‘Meaningful Use’ measures for financial incentives. The build of over 1,990 reports was completed by December 2011. Testing these reports will continue through January 2012. -
Master Training Environment Build Complete
All Project Jane application principal trainers, as well as database administrators, worked to create an end-user training environment. This includes 5 application environments, as well as a 'playground' for after class practice sessions.
