Whether it’s a massive enterprise-wide EHR transition or the smaller affair of sunsetting a departmental system, the devil of making such projects work is not only in the details, it’s in the people. By that, we mean figuring out who moves, who stays, and how to execute the transition without having a corrupt end product is paramount. But fear not, there are established best practices for navigating every leg of this journey. In this webinar, you’ll hear from one executive who’s made this type of EHR transition odyssey so your trip can be that much smoother.

1. http://healthsystemcio.com/presentation/legacy-support-webinar.pdf
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EHR Transitions:
Legacy Support and Staff Augmentation
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2. http://healthsystemcio.com/presentation/legacy-support-webinar.pdf
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Housekeeping
• Webinar Moderated by Anthony Guerra, editor-in-chief, healthsystemCIO.com
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• Deck @ http://healthsystemcio.com/presentation/legacy-support-webinar.pdf

3. http://healthsystemcio.com/presentation/legacy-support-webinar.pdf
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Agenda
• 30 minutes: Chad Brisendine, VP/CIO, St.
Luke's University Health Network
• 10 minutes: Erin Sain, COO, Galen
Healthcare Solutions
• 10 minutes: Q&A

4. A Complimentary Webinar & TweetChat from healthsystemCIO.com
EHR Transitions:
Legacy Support and Staff Augmentation

5. Presenter Introduction
SLUHN Overview
EMR Replacement & Transition
Resourcing Assessment & Planning
Legacy Application Support Project Details
Next Steps – Data Migration & Archival
Questions
Today’s Agenda

6. Today’s
Presenter
EHR Transitions: Legacy Support and Staff Augmentation
A Complimentary Webinar & TweetChat from healthsystemCIO.com
Chad Brisendine
Vice President & CIO
Mr. Brisendine became St. Luke’s University Health
Network’s CIO in 2009. In 2013, he received Lehigh
Valley’s “40 under 40” award. Under Mr. Brisendine’s
guidance, St. Luke’s aligned the health system’s
delivery infrastructure with new applications. He also
oversaw the EMR adoption and implementation of
the health system and achieved HIMSS’ EMR
Adoption Model Stage 6 recognition. Prior to joining
St. Luke’s, Mr. Brisendine was with CHRISTUS
Health in Irving, Texas, as the corporate director for
new technology and delivery. He also served as
regional CIO for CHRISTUS Health

7. St. Luke’s University Health Network
Expenses Per Adjusted Discharge
Temple $8,852
Hahnemann $8,488
Jefferson $8,439
Reading $8,215
LVHN $7,516
Hershey $7,413
Geisinger $7,392
HUP $6,947
UPMC Presbyterian $6,901
St. Luke’s $5,003

8. Replacement Drivers

9. Replacement Drivers
Top Features of EHR Replacement
Patient tracking
Regulatory compliance
Tablet/mobile integration
Lab integration Customizable templates
E-prescribing
Robust reporting
Appointment reminders

10. The Decision – Epic Implementation
Needed better integration to
facilitate streamlined process
Ease of information access
and care delivery
Standardization of system
Voice of client  product
development
Extensive, 12 month
system selection
process
Evaluated 5 vendors and landed on Epic

11. Tackling Transition

12. Legacy Application Support Objectives
Staff Buy-In
No one feels left out
Predictability & Flexibility
in staffing model – ramp up/down
Platform Experts
Stability
Anticipated change in current System – Upgrades,
Acquisition, Additional functionality deployed

13. Legacy Application Support Outsourcing
Benefits
Reduce Costs

14. Legacy Application Support Outsourcing
Benefits
Obtain flexibility in staffing Manage change

15. Legacy Application Support Outsourcing
Benefits
Support AreasImprove Service

16. Legacy Application Support Outsourcing Assessment

17. Legacy Application Support Outsourcing
Critical Success Factors
Critical Success Factor Commitments/Solution
Collaborative Governance Model
Executive Sponsorship by Senior Management
Dedicated Project Management
Defined objectives, renewed by organizational manager on periodic basis
Knowledge Transfer
Availability of organization’s SMEs and IT staff
Close interaction with staff to cover all components for system in scope
Equivalent skill level between resources
Pre-Requisites Met On Time
System access, required licenses in place
Follow timeline for deliverables
Change Management
Prioritize and approve changes
Develop a structure for dealing with change
Service Agreement
Establish protocols for the various tools and system being managed, with associated
response times for their mission critical applications

18. Legacy Application Support Outsourcing
Critical Success Factors

19. Project Metrics & Measurement
Hospitals must demonstrate quality through reports and dashboards for external
benchmarking and internal quality improvements
Effective partnership governance includes:
Reporting Dashboards Service metrics reporting

20. Galen Roles:
• Program Management & Physician
Onboarding
• Legacy Application Support, Build &
Upgrades
• Technical Support – Reporting & Integration
• Data Migration
• Transition from Allscripts Touchworks & GE
Centricity to Epic
⁃ Schedule Epic go-live: January 2018
⁃ Source Systems:
⁃ Allscripts Touchworks 15.1 (since 2012)
⁃ GE Centricity Group Management 4.3
⁃ Ancillary Systems Supported: Phreesia, Wand,
ePreOp, Intellidose, Midmark, TouchChart, CQS,
Prenatal.
Key Metrics
Immunizations2.4MM
Allergies860K
Medications8MM
Problems12.2MM
960
Active Providers
3MM
Active Patients
St. Luke’s University Health Network

21. Legacy Application Support

22. Support Project Phases
Engagement Kick-off Ramp up and onboarding Monitor & Maintenance
Galen Full Operations
Support
Begin Archival & Sunset
procedures
Knowledge Transfer Transition of support
responsibilities
Full or partial ownership Full support ownership with
SLA metric tracking, issue
remediation running
Full Support ownership with
SLA metric tracking, issue
remediation running
Best Practice Education Tools, workflow, SOP
education
SLA metrics and monitoring
in place
Onboarding new providers –
user build and elbow/elbow
support.
Over 15 months,
onboard 100-150 physicians
Monitoring and scheduling
of selected projects
Tools and Services Knowledge Transfer with
staff
Ticketing system ownership Transition and archival of
selected clinical and non-
clinical applications
Resource alignment SLA metrics and tracking Training plan in place Ongoing training needs
Resource scheduling ServiceNow training Resource schedule in place 15.2 TW Upgrade – Project
Management, Testing,
Training, feature adoption
ad related buils (c. Go Live
Feb 2017)
Credentialing Continued mentoring and
shadowing
- Adoption of Afterhours
support
- Hotfix evaluation, testing
and related build (c. Go Live
Sept 2017)

23. Scope of Responsibilities
Legacy Application Support
Downstream
Applications
Patching
New Build
Upstream
Applications
Customizations
Interfaces
New
Implementations
Upgrades
Remote
Connections

24. Performance Tracking & Evaluation
Regularly Scheduled Status Reporting
Quarterly Management Meetings
Communication Best Practices

25. Project Scorecard
Category SLA
Un-responded communications
– End of each shift
0
Open incidents beyond 10 days <0.5
Open incidents beyond 5 days <1%
Customer SLA Compliance
Steady state SLA of 95%
month on month basis
Re-activations <1% on
monthly basis
Open incidents <3 per
application
Escalations
A downward trend in the
escalations to BSWH FTEs –
Baseline will be established
Test/Development – Baseline
will be established
SLA Target Compliance
Incident
Priority
Response
Resolution/
Closure
Response Resolution
P1 1 hour 4 hours 95% 100%
P2 4 hours 24 hours 95% >98%
P3 48 hours 72 hours 95% >98%
P4/P5 48 hours 96 hours 95% >98%

26. 99% closed
to date
Project Scorecard
Ticket Volume by Team April 2016 to March 2017
Team Allscripts Allscripts IDX Interface Totals
Total 14166 265 8264 3362 26057
Total Open 117 8 34 1 160
Total Closed 14049 257 8139 3361 25806
% Closed 99% 97% 98% 100% 99%
144+ Net new
providers
9 New sites 26,000+
tickets
fielded

27. Chad’s Key Insight
Message to audience
Assess data & resourcing
needs before starting project
NeedWant

28. Access to source clinical data
Accuracy, validity, and cleanliness of clinical data
Cost effectiveness of approach (business vs. clinical
decision)
Data Governance & Stewardship: Abstraction, Migration, Archival
Considerations

29. EHR Transition

30. Galen Healthcare Solutions

31. Vendor Expertise, Services & Solutions

32. Data Migration

33. Operation Support

34. Confidential © 2017 Galen Healthcare Solutions 34
Archival legally required
– Preservation required for between 6 years and forever.
Requirements vary by state, payor, patient
demographics, and a variety of other factors.
Expensive to maintain
– The cost of servers, infrastructure, and software
licenses can be prohibitively costly.
Risk increases with time
– The longer a legacy system must be maintained, the
greater the risk involved. Knowledge atrophies, as do
platforms.
Legal and Clinical Continuity
– Data often critical to legal scenarios, as well to
clinicians whose patient data is incomplete or
unavailable in the go-forward EMR.
Legacy Systems

35. Our Philosophy

36. Questions?

37. MUCH MORE THAN
I.T.
GALENHEALTHCARE.COM

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Thank You!
• Please take a moment to answer our post-event survey.
• Continuing Education
• CHIME CHCIO Credits – Attending our Webinars = 1 CEU
• Certificate of attendance: See final slide
• You will receive an email when our archive recording has been posted to our YouTube channel
• To have us produce a Webinar on the topic of your choice, please contact Nancy Wilcox
nwilcox@healthsystemCIO.com
• Go to www.healthsystemCIO.com/webinars to view our upcoming schedule.
• Thanks to our panel:
• Chad Brisendine
• Erin Sain
• Thanks to our sponsor: Galen Healthcare Solutions
• Thanks to YOU!

40. http://healthsystemcio.com/presentation/legacy-support-webinar.pdf
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Certificate of Attendance
This bearer of this certificate has attended the
healthsystemCIO.com-Produced Web Seminar, entitled, “EHR
Transitions: Legacy Support and Staff Augmentation” on
6/14/17
Contacts:
Anthony Guerra, Editor-in-Chief, healthsystemCIO.com
Nancy Wilcox, Director of Sales and Marketing, healthsystemCIO.com