Re-Installations – A trending approach to EHR system management

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Re-install projects seem to be a growing opportunity for consultants in the industry.  More and more clients are taking on this work that have been live on Epic for years, but implemented prior to the creation of model or foundation build. The idea of long term sustainability of a highly customized build is not realistic and thus driving this new approach.

Epic’s foundation build today represents the best and most common practices collected over years of lessons learned from multiple clients.  New implementations have been almost entirely based on the foundation, as it represents an opportunity for any client to take advantage of the predetermined model build. Before this was offered, workflows, master files, general build, and system functions were based on individual department requests (or requirements).  For those of us in the consulting industry for over 10 years, we remember the primary factor driving the consultant industry was customization and advanced build.  It’s certainly worth a look at this industry trend today that is driving consultant growth, but ironically is now all about the reduction of customization.

Epic calls re-installation to their software “Refuel.”  So why would a client want to consider Refuel? Over time, some clients have allowed for continued department customization and unique build by specialty or even by provider.  By doing so, client’s IT departments have had to grow in order to maintain the ability to manage these incoming requests while having upgrades and/or other system initiatives.  As hospitals look at cost saving approaches, the reversal of highly customized systems could result in the reduction of staff needed to maintain the system.  Thus the introduction of an opportunity to wipe the board clean and have a simplified and unified build across departments while also saving money.

The efforts here are significant.  Think of the individual master files impacted by such a change alone.  Plus end users will see variances in workflows, smart forms, visit types, order sets, and well…just about everything you can think of.  A Refuel project would impact all modules as well as impact change control processes moving forward. Expertise in foundation build is the primary need right now, and a growing opportunity in our industry.

Major systems are undertaking this Refuel project now. Cleveland Clinic just kick started, while others like Franciscan Alliance are well underway.  Don’t be surprised if your next engagement opportunity is a Refuel project.

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