Lessons learned from an Epic go live – Patient Financial Services Perspective March 18, 2016

About Lahey Health Lahey Health includes Lahey Hospital & Medical Center - a teaching hospital of Tufts University School of Medicine - and Lahey Clinic physician group with practices in Burlington, Peabody and other locations throughout northeastern Massachusetts and southern New Hampshire; Beverly Hospital; Addison Gilbert Hospital; Winchester Hospital; Lahey Health Senior Care and Lahey Health Behavioral Services as well as more than 30 primary care physician practices and multiple outpatient and satellite specialty care facilities.

Important Dates May 1, 2012 - Northeast Health System and Lahey Clinic Foundation complete affiliation agreement and officially establish Lahey Health System. June 1, 2013 - Epic project launch. March 1, 2014 - VP of Revenue Cycle moves to San Francisco. July 8, 2014 - Lahey Health and Winchester Hospital announce that the affiliation is official. October 1, 2014 - ICD 10 is scheduled to go live….. April 1, 2015 Marsha Raim, Director of PFS at Northeast Health retired. June 15, 2015 VP of Revenue Cycle Operations joins Lahey Health.

Patient Financial Services prior to Epic Business office in Burlington – supporting hospital and physician group practices billing using Meditech and GE Centricity. Business office in Beverly – supporting hospital billing using Meditech (more up to date version than Burlington was using). Business office in Beverly (different location) supporting physician group practices utilizing multiple versions on IDX. Business office in Beverly (different location) supporting Home Health billing. Patients were receiving multiple statements and calling multiple business offices.

Single Billing Office Decision made to implement Epic’s Single Billing Office solution. All physician, hospital and home health services, regardless of where the service was rendered, would appear on a single statement. Patients would call one Customer Service department. In January of 2015 all colleagues with the exception of those supporting Home Health moved to Burlington as part of our overall Single Billing Office strategy ……and then……

Single Billing Office cont’d Planned to have the Beverly colleagues assist with the Burlington Meditech A/R while the Burlington colleagues were training on Epic. Lost a significant number of colleagues in the physical move from Beverly to Burlington, and were unable to move anyone off of the Beverly A/R. With only weeks left to launch we focused on getting as much cash in from the legacy A/R to strengthen our position in the event of a cash drop due to Epic and getting the team ready for go live.

Ride the Epic Wave PFS had a beach themed party a week prior to Wave 1 go live - complete with flip flops, beach towels, frisbees, beach balls, photo ops, pizza, etc… Goal was to celebrate the work that had already been accomplished and welcome the work ahead of us. PFS was one of the few departments that would participate heavily in multiple “waves” so we were able continue the theme with Wave 2.

Epic Go Lives Wave 1 Big Bang Go-Live on March 28, 2015 included - Lahey Hospital & Medical Center Lahey Medical Center, Peabody Lahey community group practices that were using Allscripts Wave 2 Big Bang Go-Live on August 1, 2015 included - Beverly Hospital Addison-Gilbert Hospital BayRidge Hospital

Definition of Big Bang Every Epic module that you’ve purchased is implemented at the same time.

Lessons Learned Lesson What we learned Do not treat the Epic implementation like a project Did not dedicate enough full time/permanent resources from the onset. Lahey partnered with Encore to assist with the implementation. Learn how the system works Difficult to participate in design and make decisions regarding how certain modules will be used without fully understanding the integration of the system. Very different from what we were used to.

Lessons Learned Lesson What we learned Workflow Workflow was validated at a much too high level, and was validated for Wave 1 and Wave 2 at the same time. Six months post go live we are still struggling with some of the complex workflows. Communication Overwhelmed with communication. Surf’s Up!

Lessons Learned Lesson What we learned Testing You cannot test enough. Parallel Revenue Cycle Testing. Training You cannot train enough. ATE – At the elbow support. Appoint a bright credentialed trainer.

Lessons Learned Lesson What we learned Legacy A/R Burlington outsourced the remaining A/R at 90 days post go live – too late. Beverly outsourced the day we went live with Epic – too soon. Resources Have resources dedicated to legacy and day to day and other resources dedicated to Epic. Resources are needed to manage the outsourcing.

Lessons Learned Lesson What we learned Go Live If possible go live on the first day of a calendar month. Burlington went live on 3/28 and had to convert Outpatient Recurring accounts into Epic in order to generate a single claim. Financial reporting for the month was more challenging since data had to be pulled from two systems. Post Go Live Epic dashboards provide a very user friendly way to quickly see and analyze various KPI’s. Optimization.

Some things we did really well Foundation Single CDM Credentialed Trainer ARCR – Access Revenue Cycle Readiness SBO – reduced mailing costs, less phone calls MyChart Daily dashboard and bi-weekly graph package calls

Most Important Lesson HAVE FUN!