Your AI Wish List Has Some Prerequisites: Is Your Epic Environment Ready?

Jason Kulaga, RN, BSN, PMP, Practice Director, Healthcare Solutions, Medix Technology, recently shared his expertise and perspective to help shape the insights below.

The healthcare AI wish list is expanding fast.

Medical providers are eager for ambient listening tools that lighten documentation burdens and give them evenings back. Operational leaders want predictive modeling to optimize clinic scheduling and staffing. Meanwhile, healthcare IT executives are fielding questions from every angle about how fast the organization can turn these shiny new tools on.

Then someone asks what has to happen under the hood before kickoff, and the mood shifts.

Answering that question uncovers legacy configurations, custom workflows, data integration challenges, and intensive requirements. It can also bring initiatives like an Epic Refuel or a Cogito Cloud conversion into the conversation. While neither sounds quite as glamorous as an AI demo, both belong on the IT roadmap.

Start With the Capability You Want to Use

Treating “prepare for AI” as a standalone project is an easy way to get tangled in scope creep.

A practical plan begins with a defined use case. Ask the foundational questions early:

• What clinical or administrative problem needs solving?
• Which medical providers, nurses, or operational teams will use the tool?
• What is the anticipated recurring cost and return on investment?

Once the target is clear, work with Epic and operational stakeholders to confirm the exact technical prerequisites for that capability in your environment. Some features demand updated clinical workflows and screen redesigns. Others require clean analytics pipelines, specific access governance, or extensive model validation.

“Epic has hundreds of different AI capabilities that rely on the Foundation System. If you’re doing something like ambient listening, yes, the transcription’s easy. But if you want to cue up order sets or check medications and previous notes, you really have to have that standard foundation for it to build on.” 

—Jason Kulaga, RN, BSN, PMP, Practice Director, Healthcare Solutions, Medix Technology

Pinpointing exact dependencies gives your team an actionable starting line. It also helps healthcare IT executives explain why an appealing new capability takes more preparation than simply flipping a digital switch.

Where Refuel Fits Into the Conversation

An Epic Refuel centers on aligning an existing environment with Epic Foundation System standards. Over years of growth, acquisitions, and local optimizations, many health systems have built layers of custom configuration and workflows.

While those customizations solved urgent problems at the time, heavy customization created ongoing debt. When workflows stray far from Foundation standards, rolling out newer capabilities often requires extensive manual troubleshooting and testing.

An Epic Refuel helps teams audit existing configurations, retire unnecessary workarounds, and adopt standard pathways where it makes operational sense. However, Refuel should not be treated as a mandatory prerequisite for every AI project. The scope should be guided by your specific clinical goals, the state of your build, and Epic’s technical recommendations.

Where Cogito Cloud Enters the Picture

While a Refuel addresses workflow and application build, the analytics architecture requires its own evaluation.

Cogito Cloud becomes a primary discussion point as organizations modernize their data hosting to support scalable reporting, enterprise data warehouses, and compute-heavy clinical algorithms. Before committing resources, evaluate the practical implications:

• Will you do a full Cogito Cloud conversion or only the components required for supporting AI?
• What resources and timelines are required for a Cogito Cloud migration?
• Which existing custom reports, downstream integrations, or team workflows will need review and remediation?
• What testing and validation must be completed before the new analytics environment goes live?

Refuel and Cogito Cloud solve different operational puzzles. Keeping their scopes, timelines, and dependencies clear ensures a strategic vision does not devolve into disjointed, overlapping efforts.

Even when application builds and cloud migrations have separate scopes, they frequently compete for the exact same talent.

Your seasoned application analyst might be assigned to a Refuel track, pulled into upgrade testing, and tapped for an analytics conversion, all while managing incoming support queues. Meanwhile, clinical champions find themselves invited to simultaneous validation sessions across separate projects.

A unified roadmap brings these competing demands to the surface. Map your target AI tool directly against its confirmed prerequisites. Identify single points of failure, technical dependencies, and the specialized internal knowledge required at each milestone.

Seeing the full portfolio in one place enables leaders to sequence rollouts realistically rather than overloading their best talent.

Make Workforce Capacity Part of Technical Readiness

An approved technical architecture cannot deliver results without analysts who have the dedicated hours to build it.

Modernization requires specialized technical skills, deep institutional knowledge, and consistent maintenance of existing systems. When internal analysts must juggle high-priority modernization alongside daily support tickets, progress slows and burnout climbs.

Operational support during an Epic Refuel can help bridge that gap. By shifting routine ticket triage, maintenance, and change requests to additional Epic-certified analysts, health systems can give their internal experts the capacity to lead Refuel efforts and cloud migrations without sacrificing daily operations.

Artificial intelligence may dominate strategic discussions, but clear ownership, realistic timelines, and workforce support are what turn those goals into functional clinical tools.

Build the Team Capacity Behind What’s Next in Epic

Developing your health system’s Epic modernization and AI roadmap? Explore Medix Technology’s healthcare IT staffing solutions to see how we can help maintain daily operations while giving your internal analysts the capacity to tackle complex modernization projects.

Contact us to build your epic team