The Anatomy of an Epic EHR Go-Live – Getting the Right Support at the Right Time

An Epic EHR go-live is a critical time. What is perhaps your organization’s largest technology investment in years must go off without a hitch. There are countless considerations to make around integration, staffing, training, and more. You’ll need to ensure legacy systems are fully integrated with Epic, you have the right IT staff to manage the technical details, and you have the expert training staff to provide pre-live and post-live support. Your success during this period goes a long way towards long-term end-user satisfaction.

Here’s the basic anatomy of a go-live with stages, components, and support details:

Pre-Live Stage

  • Data Conversion – Taking legacy data from myriad systems and pushing it into Epic. This is often performed by interface and conversion analysts.
  • Appointment/Case Conversions – Loading all visit appointments and surgical cases from legacy systems into Epic. This can sometimes be automated, but other times must be manually entered by registrars, schedulers, or temporary workers.
  • Device Deployment – Installing new printers, scanners, work stations, etc. and making sure they are functioning alongside Epic. This is often called a “Technical Dress Rehearsal,” and is always an IT function.
  • Training/Personalization – Training of key clinicians and other end users to prepare them for go-live. This is managed by principal trainers and curriculum designers and includes personalization labs, reference materials, and more.

Go-Live Stage

  • Interface Cutover – Making sure interfaces pointing to legacy systems now point to Epic, allowing a flood of third-party data to flow in. This is performed by interface analysts.
  • Command Center – Establishing the heart of the operation. The entire project team is stationed here, with an experienced project manager leading the way.
  • End-User Support – Putting your “super user” program to work to offer immediate support. Third-party firms are often used for support here.

Stabilization Stage

  • Billing and Claims – Establishing new, Epic-focused processes for billing and payment to avoid interruptions in collections. This is managed by revenue cycle staff.
  • Analytics – Measuring end-user trends and identifying areas to optimize, particularly once users are past the initial change and comfortably using Epic on a day-to-day basis. This is managed by the analytics team.
  • Targeted Support – Providing support to specific physical locations, specialties, and functional areas that require assistance related to configuration, workflows, etc. This is generally managed by “sprint teams.”
  • Organizational Metrics – Analyzing performance metrics related to finances and clinical quality, to identify deviations from expected post-live metrics. This primarily falls with the executive team.
  • Integrated Workflows – Mapping out new workflows which may have been overlooked during implementation. This is a joint effort between various users and support staff.
  • Training/Communication – Continuing to train end users and inform them of any updates to the system throughout the immediate go-live period. This is performed by support and training staff.

It’s important for your entire Epic project team to understand this anatomy, how each component is connected, and where they will play a role. Each stage is dependent on previous actions, and every component complements another one in some way.

During this time, there’s also a fair amount of onboarding and offboarding of staff. During the pre-live stage, for example, temporary workers brought on to help handle the appointment/case conversions likely don’t need to be retained once the full patient schedule has been transitioned to Epic. On the other hand, during the stabilization stage, it’s usually necessary to onboard additional staff, often in the form of Epic-certified contractors, to help with the high volume of targeted support and training/communication immediately after launch.

This mix of onboarding and offboarding requires a strategic approach, one that carefully balances costs and resources. As early as your original implementation planning, you should identify the resources that will need to be offboarded and onboarded during go-live, so that all parties have clear expectations and your organization remains on budget. You must also ensure that offboarding results in no major knowledge loss. It can be crippling for efforts related to analytics, targeted support, and training/communication if you lose too much staff at once.

Learn much more about onboarding and offboarding staff during this critical time by watching our on-demand webinar: How to Offboard and Onboard the Right People after Your Epic EHR is Live. You’ll hear Jason Kulaga, our Practice Director of Healthcare Solutions, offer more details about the anatomy and best practices for cost-effectively managing your Epic project team, without compromising performance.


The webinar is part of our Digital Healthcare Technology Virtual Summit, which you can attend here. It’s full of insights and best practices from our expert EHR team.

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