EOB approves simultaneous rollout of CareConnect

Everyone will begin using some form of CareConnect a little more than a year from now, according to the new schedule for implementation of our electronic health record system approved on March 13 by the program’s Executive Oversight Board.

The board voted unanimously to roll out much of CareConnect’s functionality simultaneously in a single go-live in March 2013 for:

Hospitals* (Ronald Reagan, Mattel Children's, Resnick Neuropsychiatric, Santa Monica):

• Scheduling, registration, billing, ADT, HIM, health plan management, pharmacy, CPOE, documentation, radiology, rounding lists, etc.

Clinics:

• Scheduling, registration, billing, ADT, HIM, and health plan management
• CareConnect Lite (cView replacement)
• June 13-February 2014: Epic Care Ambulatory (e.g., CPOE and documentation) and MyChart patient portal will be implemented in waves over 9 months. Schedule expected in April 2012.

* Some procedure areas/clinics (RadOnc, hyperbaric), lab-draw stations, and others will go-live with the hospitals)

CareConnect Lite – which replicates much of the functionality of cView – will serve as a bridge to the full clinical suite in ambulatory clinics. The module will resolve the technical problem that required CareConnect to revise its original rollout schedule, support clinical care provision in all locations throughout the rollout period, and familiarize everyone with CareConnect at the outset.

Considerable benefits expected of new approach

After working on the development for the last nine months, the CareConnect team now has a greater appreciation now of the complexity, rigidity, and fragility of our current legacy environment than was understood when we developed CareConnect’s original phased-deployment plan.  This made the necessity to transition to CareConnect all at once clear.

Bringing all hospitals up on CareConnect at one time has significant benefits, including easing the transition for physicians, eliminating the disruption of multiple go-lives, and reducing the training required for nurses and physicians.

The new timeline allows for the significant testing and substantial preparation that will be needed with this “big-bang” rollout approach. The ability to keep enthusiasm high with a single, large go-live – rather than gearing up for multiple go-lives spread out over a longer period – will help counter the scale of the one-time disruption.

“Even this approach has significant challenges,” said Michael Steinberg, MD, chairman of CareConnect's Executive Oversight Board. “We’ll need robust super-user, credentialed-trainer, and end-user training programs to support the simultaneous go-lives. And continuation of strong management focus and commitment is essential.”

Technical feasibility, clinical impact, cost influenced decision

Once the decision was made to delay CareConnect’s original schedule (see this story for an explanation of the decision), the team began looking for alternatives. The team needed to devise a way to offer similar functionality of the cView, ClinDoc, and PCiMs systems so providers who had not transitioned to the full clinical suite would be able to patient information reliably. CareConnect Lite solves this problem and permmited new assumptions to be considered in developing a new rollout plan. The scope of the sites, locations, and Epic Systems' modules included, however, remains unchanged.

The CareConnect team analyzed more than 30 factors in evaluating the two options, such as the impact on patient care operations and revenue management, timeline, training, Meaningful Use adoption, overall costs, and technical feasibility.

The major considerations were:

• Feasibility of CareConnect Lite to fully replace cView, ClinDoc, and PCiMS as an interim solution
• Logistical requirements of testing, training, and go-live requirements
• Risk of significant and/or lengthy impacts to billing or accounts receivable cash flows
• Patient care disruptions, risks, and need for interim workflows
• Risk and degree of organizational disruption during the go-live
• Implications for achieving the initial go-live and the overall project timeline
• Incremental project cost increases

The EOB placed the greatest weight to the risks involved in three factors in reaching its decision: technical complexity and uncertainty of building CareConnect Lite in the sequenced option (not a technical issue for the simultaneous go-live); disruption to clinical care and interim workflows in a sequenced option; and go-live magnitude in the simultaneous option, which was assessed to be a challenging, but manageable risk.

The clinical applications will be implemented in our clinics in a compressed rollout that extends the completion date just five months from the original.

CareConnect Lite serves as a bridge to full implementation

Two weeks ago, the EOB approved development of a tool – called CareConnect Lite – that will serve as a bridge to the full clinical suite of applications in CareConnect. Physicians and staff members who haven't started using the clincal applications in their ambulatory clinics will be able to use CareConnect Lite to:

• View results/charts
• Write notes (for MDs who use CDS or cView now for notes, others will continue with current workflows)
• View patient lists/rounding lists
• Access InBasket (to sign dictation/verbal orders,  cosign resident notes)
• View clinic schedule
• View OR schedule
• View and edit allergies
• View and edit outpatient care team list
• Link to P4P

 Based on the same Epic architecture as CareConnect, CareConnect Lite has the same user interface, which will make the transition to the full clinical suite seamless. Users will receive classroom training on this tool – which will also serve as an orientation to components of CareConnect, so training time is not wasted.

Moving forward

Even though the first go-live is a year away, the CareConnect team will proceed with the same commitment toward completing the system build according to the original schedule. The team will work closely with operational staff, managers, and leadership to increase attention on testing, user-validation, and readiness.

We expect to have a new ambulatory rollout schedule available within four weeks, and details of training requirements and dates, as well as information about recruitment and training of super users and credentialed training within the next eight weeks.

Please contact us at CareConnect@mednet.ucla.edu with your questions or concerns. You may also direct questions or comments to us – anonymously, if you’d like – through the Contact Us function on our website.