emr best practices radiant webinar
Post on 12-Nov-2014
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Epic Radiant Go-Live
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@GreythornNA | EMR Staffing and Best Practices
Tips, Tricks, and Lessons Learned
Presented by: Angi Cessna, RDMS, RT(R)
Introduction
� Angi Cessna, Epic certified since beginning of
2007
� Involved in over 20 implementations
� Large 300+ bed facilities
� Critical Access Hospitals
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@GreythornNA | EMR Staffing and Best Practices
� Critical Access Hospitals
� Ambulatory HOD radiant departments
� Ambulatory only radiant departments
What you can take away from today’s talk
� Better understanding of the approaches to taking Epic
Radiant software
� Big Bang and After-the-Fact
� You will understand if this process will it be easy or
difficult?
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@GreythornNA | EMR Staffing and Best Practices
� Share lessons learned from different implementations
� Enhancements – Can we do this easily?
� Importance of staying engaged with other teams
� Surprises you may want to avoid
Why Radiant?
� Rules-based scheduling
� Documentation
� Results communication
� Chart/film tracking
� Detailed statistical reporting
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@GreythornNA | EMR Staffing and Best Practices
� Detailed statistical reporting
� Unified system that is fully integrated with Epic clinical
systems
Could it be that simple?
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@GreythornNA | EMR Staffing and Best Practices
Big Bang – 1st Approach
Learning a new
system
Streamlined care
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@GreythornNA | EMR Staffing and Best Practices
Big Bang Go Live
(all Epic products together)
system together
Adding Radiant later – 2nd Approach
1• Other products are now live
2• Implement Radiant after the fact
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@GreythornNA | EMR Staffing and Best Practices
2
3• Is this good or bad?
Adding Radiant later – contd.
Cons
� Difficult adjustment
� Training
� Testing
Pros
� Easier Go-Lives
� Familiarity
� One system
� Reduced cost
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@GreythornNA | EMR Staffing and Best Practices
� Reduced cost
Enhance – 3rd Approach
Transportation Workflows
Minimal Functionality –
Initial Install
Enhancement
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@GreythornNA | EMR Staffing and Best Practices
Workflow is RIS-centric
More Robust Scheduling
Enhancement
Some Recommendations
� Try to keep on a concise schedule:
� Use standard reports and work lists
� Use experienced analysts/builders
� You can keep costs down
� Users ownership in optimization process
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@GreythornNA | EMR Staffing and Best Practices
� Users ownership in optimization process
� Integrated Rads vs. non-integrated Rads – support is
important
� Where can you help – support schedulers?
Heartburn
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@GreythornNA | EMR Staffing and Best Practices
Some things to look out for
� 3rd party billing files if needed
� PACS driven vs RIS driven
� Interfaced results across time zones
� Security changes to existing users
� Radiologists’ support
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@GreythornNA | EMR Staffing and Best Practices
� Radiologists’ support
Keep Engaged with Special Teams
� Team that manage shared Masterfiles
� Security
� Change Control
� User records (SERs and EMPs)
� ICD-10 Team
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@GreythornNA | EMR Staffing and Best Practices
� ICD-10 Team
� Meaningful Use Team
� Data Courier Team
Wow!
� DICOM – (lack of) testing concerns
� Where is the test box? TST or PRD only?
� Users security – inadvertent changes at go-live
� Results – coming from Epic RIS, vs. outside radiology
systems
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@GreythornNA | EMR Staffing and Best Practices
systems
� Interfaces - test in appropriate environments
What do we do now?
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@GreythornNA | EMR Staffing and Best Practices
Planning for the future
Enhancement Optimization Upgrade
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@GreythornNA | EMR Staffing and Best Practices
Questions?
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@GreythornNA | EMR Staffing and Best Practices
For moving data, we use Data Courier. Do you
think it’s best to have all members of team move
data, or just a set of users within the team?
� A subset of users is best, so they can be experts in the
manipulation of data, keeping up on any Data Courier
changes that comes with upgrades, etc.
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@GreythornNA | EMR Staffing and Best Practices
changes that comes with upgrades, etc.
For supporting a go-live, do you like to use
analysts as hands-on Floor Support, or do you
prefer to use Superusers?
� Analysts are best utilized in the command center. Floor
support should be superusers so they can build that
report with the regular users, which will mean a better
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@GreythornNA | EMR Staffing and Best Practices
long-term support and success
Have you ever ‘let’ non-Radiologists read in Epic,
like Cardiologists, or mid-levels that read stress
exams, etc? How did you manage support of
these reading docs?
� Yes, they just need Radiant reading security. They need
appropriate training, either reading from a Reading
Worklist or via the InBasket. You can train any support
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@GreythornNA | EMR Staffing and Best Practices
Worklist or via the InBasket. You can train any support
staff, usually their preference, to be able to support
them, but I usually see it’s their staff, not Rad staff.
Do you import new EAPS and SERs (procedure
master file and provider master files) or manually
build them? Which is best?
� I recommend importing the data. It’s easier to document
the changes with the import spreadsheet used. It’s less
easy to make build mistakes too. You can even have
greythorn.com | epic@greythorn.com | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
easy to make build mistakes too. You can even have
multiple teams enter data on a central import
spreadsheet, then have a daily import time, so all date
can go in at once, and not at various times of day.
Do you recommend a one-to-one Visit Type-to-
Procedure build?
� Yes I do. This way, you can specify where the exam is
scheduled, specific day and time restrictions, as well as
specific patient and scheduler instructions.
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@GreythornNA | EMR Staffing and Best Practices
How long should we staff our command center?
� For a Big Bang, anywhere from 2-3 weeks may be
needed, using 24 hr shifts the for at least the first week.
� For adding Radiant after-the-fact, usually a 1-2 week
mini command center is needed, maybe only staffed 6a-
7p, with on-call availability. You will also need adequate
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@GreythornNA | EMR Staffing and Best Practices
7p, with on-call availability. You will also need adequate
Super-user Floor Support after hours.
Disclaimer
� This presentation is intended to give you a general
overview of Radiant implementation processes as
experienced by Greythorn contracted employees.
� For a more tailored and confidential discussion on how
this will affect your business or your own career, please
greythorn.com | epic@greythorn.com | +1 (312) 853 6100
@GreythornNA | EMR Staffing and Best Practices
this will affect your business or your own career, please
get in touch with us.
� Greythorn will not be reliable for any damages of any
kind arising out of or relating to the use of this
information.
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