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CASE STUDY: GREATER BALTIMORE MEDICAL CENTER Pursuit Leads Technical Dress Rehearsal in Preparation for Successful Epic Go-Live Greater Baltimore Medical Center, better known as GBMC, is an acute care facility with 245 licensed beds in Towson, Maryland. GBMC is part of the private, not-for-profit corporation GBMC HealthCare which is associated with Gilchrist Hospice Care, the largest not-for-profit hospice organization in Maryland. GBMC went live, big bang, with Epic’s enterprise suite of applications (version 2015) on October 1, 2016. The scope of the implementation and Go-Live included ClinDoc, Orders, Radiant, ASAP, OpTime/Anesthesia, Stork, Beaker AP and CP, Blood Bank, Rover, Willow, Radiant, Beacon, Hospice, Home Health, Ambulatory, Cadence, Welcome, Grand Central, HIM, Resolute Professional, Hospital, Home Health and Hospice Billing, MyChart, MyChart Bedside, Care Everywhere, EpicCare Link, Video Visits, Orthopedics, Ophthalmology, and Wound Care.
The Challenge GBMC was struggling to conduct a Technical Dress Rehearsal (TDR) in preparation for the Go-Live of an Epic enterprise implementation at all of their locations. It was taking the build team at GBMC significantly more time than expected uncovering and correcting technical issues and printer mapping. Additionally, not all of the new hardware had been received, imaged, deployed, or mapped as needed. The impact of not having enough time or resources to commit to a comprehensive TDR would have severely and negatively impacted GBMC’s Go-Live and it could have affected each hospital area, ambulatory center, remote location, and every Epic user - particularly clinical staff.
The Solution GBMC initially engaged Pursuit Healthcare Advisors to supplement their team by providing several Implementation Application Analysts (Radiant, Hospital Billing, Beacon, and Clinical Documentation) and an Instructional Designer (Clinical Documentation). Pursuit then partnered with GBMC to assist with the management of the Go-Live support team and provide the resources needed for Help Desk/Command Center Phone and At-the-Elbow Support. Pursuit utilized a team approach to support the Go-Live with a Project Manager, two Site Leads, 150 experienced Atthe-Elbow and ten Help Desk/Command Center Phone Support Consultants to supplement GBMC’s Super Users and Credentialed Trainers. Since the Go-Live, Pursuit has provided ten Support Consultants to assist with abstracting 13,000+ ambulatory charts and four Application Analysts to assist with Post-Live application support (Radiant, Beacon, Hospital and Hospice Billing, Claims and Remits). Approximately two months before the Go-Live, Cindy Ellis, GBMC’s Epic Program Director, reached out to Pursuit requesting assistance with their Technical Dress Rehearsal (TDR) and to help them address their concerns about the level of preparedness of their hardware for the Epic Go-Live. Ms. Ellis shared “we seem to be struggling with technical dress rehearsal (TDR) and it is taking a large amount of time, much more than expected. It has been a challenge for the build team, as resources, to uncover and then correct the technical issues and printer mapping.” Pursuit brought extensive experience with technical delivery leading up to the TDR and was involved in managing TDR activities including: • Imaging, deploying, documenting, mapping, complete system level configuration, and testing hardware (including Windows, Citrix, Epic mapping) • Developing plan, scope, and schedule • Using Epic’s TDR tools and developing or modifying scripts to capture unique build, workflows, and equipment • Staffing and execution • Communication and documentation of status, issues, and changes • Issue triage, remediation, and retesting Additionally, because the team has extensive Epic application knowledge as well as experience with printer mapping, workstation set up, order transmittal, etc. they were able to effectively triage issues to determine if they were build, configuration, or hardware related. If they were build related Pursuit’s analysts did the initial diagnosis and worked with the client’s team to fix the issue. Pursuit’s team would then retest. If the issue was more technical in nature Pursuit’s technical resources worked to resolve the issue, then retest.
GBMC Case Study • January 2017
Pursüit Healthcare Advisors
In response to GBMC’s need, Pursuit brought in a technical lead and a small, dedicated team of Epic technical resources to focus solely on the TDR activities. Pursuit’s team partnered with GBMC’s to complete the deployment of new hardware including imaging, deployment, mapping, system level configuration, and hardware testing as well as performing TDR testing, documenting findings, and communicating issues, facilitating remediation and retesting once issues were resolved (see sample graph and summary). Pursuit also partnered with the GBMC team to provide field support during the first week of Go-Live, addressing and resolving any technical issues that came up particularly related to user devices and printing.
Scope included all inpatient, ancillary, and ambulatory departments and remote users. As such Pursuit completed the following: • Tested devices: - 1300+ computers and laptops - 300+ printers including Zebra, specimen and prescription label printers - All equipment used for order transmittal • Imaged and deployed 550+ workstations and laptops • Installed remote access on all devices • Assisted with enterprise-wide deployment of: - eSignature pads - Document scanners - Workstation on Wheels (WOWs) - Desktop and wireless Zebra printers - iPhones and iPads
Sample Weekly Report of TDR Issues (Graph and Summary)
ISSUE CATEGORY
The Outcome
DETAILS
Workstation Naming Issues
Workstations were well documented based on the mapping. There were few instances where either the workstations were new or the naming conversion was off by a digit or two.
Epic Mapping Issues
CLISUP status based on the fact that the workstation was within the Active Directory, but the Epic mapping was not available.
Server Printer Queues Issues
The print queues were defined within Epic, but TDR would return an error base on the fact that they were not on the server. Working with the team to verify that the queues are created and ready for the following day’s testing.
Default Desktop Printer Issues
Default desktop printer installation was a constant. With help from IT support the TDR team was shown how to run the batch files from the X: drive to install the needed printer driver. It has been determined that each user will have to select their default printer for each selected workstation that is used.
Citrix Client Issues
There were a few workstations that needed the newer 4.x receiver installed. Stability of the icon being available once a new user logs into the system is still and issue. Even after resetting the receiver it is still not available for the next user. The team is working on this.
www.pursuithealthcare.com
855.398.7949
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“The Pursuit team has been a true partner. The knowledge and skill set of the technical dress rehearsal (TDR) and support team has been a huge asset. They have helped our team identify issues and correct them quickly and the end users truly appreciate the sensitivity and patience they have. The talent that Pursuit has found for us to compliment the applications that were struggling through the build process has been incredible! Thanks for helping us to have a successful implementation!” – Cindy Ellis, Epic Program Director at GBMC
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