NextGen 5.8/KBM 8.3.3 Upgrade Tips, Tricks and Lessons Learned Adam Cox, EHR Implementation Coordinator Ginger Grass, Manager NextGen EHR Implementation

About us… We are a group of 80+ Providers in eight specialties and their staff. We are part of the IASIS Healthcare group that has hospitals and clinics across the nation. The Eastern Division of our group was a beta client for 8.3.3 as part of the Drive to Live program. We worked closely with NextGen to successfully test and implement the 5.8/8.3 versions in September 2013.

What we did that really helped! Tips and Tricks What we did that really helped!

5.8 Upgrade We split the two upgrades and held them five weeks apart. Because the 5.8 upgrade had fewer effects on the user interface, we held several webinar trainings and allowed users to attend at their preferred time. We didn’t turn on several features until after the KBM Upgrade: Patient toolbar Immunization Module

KBM 8.3.3 Upgrade Our team performed a gap analysis. Allowed us to see all customizations. Allowed us to see the last time and how frequently each customization was used. We reviewed customizations with our clinics and decided which items to include in the new version. We had weekly “Train the Trainer” webinars before the Eastern Division upgrade where each staff member presented a portion of the new template sets. These were recorded for later reference as needed.

Gap Analysis Tool

Super User Program We established a Super User program about a year before we upgraded. There is at least one Super User per clinic. Super Users receive additional training monthly on how to troubleshoot problems and open tickets. Super Users are the primary point of contact for their location. Super Users are paid a monthly bonus. We incentivize our Super Users with a quarterly reward for the best ticket.

S.T.A.R. Super User Ticketing Achievement Reward

Super User Training We scheduled a five hour training four weeks before the upgrade with all of our Super Users. We began the training with a demonstration of the new templates. We then broke our Super Users into groups by specialty and asked them to come up with an ideal workflow and map it out. This allowed them to learn from each other. Several of the Super Users were able to point out areas where we were missing orders, etc. before we upgraded. We had LOTS of candy at this meeting!

Provider and Staff Training We trained providers and staff over a three week period prior to the upgrade. We scheduled trainings onsite at clinics. We trained each provider individually. We trained the staff members as a group. We utilized Super Users as facilitators during the training. We asked every person that attended training to sign off a checklist.

Hands On Room This was held the week leading up to Go Live. We had a room available and manned by a trainer where providers and staff could drop in and practice. The Hands On Room rotated locations. Training materials, laptops and scanners were available. Missed trainings were completed in the Hands On Room. This also allowed users to ask questions on items that were not specific to the upgrade.

Go Live We flew in five additional resources for Go Live support. Each person supported between 2-5 locations. We had a call-in support line for Super Users, Practice Administrators and onsite help. We kept a copy of the previous version (7.9.2) on a Demo server to refer back to for questions regarding changes. The decision to cut back schedules was left up to the individual locations. The Go Live support team had daily conferences to discuss issues. Have these somewhere fun with good food and alcohol!

What would have made our upgrade even more brilliant… Lessons Learned What would have made our upgrade even more brilliant…

Training Our users would have benefited from more written cheat sheets that explained new features. Super User coaching on how to best triage problems and handle questions on the day of Go Live. Ongoing scenario-based training with the Super Users leading up to Go Live.

Testing YOU CANNOT DO TOO MUCH TESTING! Super User testing of the new version. Have users with different system access test workflows. Make sure to test all specialties and all visit types (configuration matters!)

Go Live COMPLETE ALL ENCOUNTER NOTES BEFORE UPGRADE We found that notes spanning the upgrade had so many issues we ended up hand typing on the documents. We told our providers it would cause problems, but we should have said, “…it will make your life a nightmare if you don’t do this!!” Factor in provider vacations and days off. Increasingly frequent reminders of upgrade down time and chart completion deadlines leading up to Go Live.

Go Live If possible, make sure Super Users are not performing clinical duties on the day of Go Live. (Good luck with this one!) We had an issue with tasking that was related to two users having the same user ID. Might be a good idea to check for this pre-upgrade. Identify “problem providers” (you know who you are) and make sure they have extra help. Supervising physician signoff process changed.

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Contact Information acox@iasishealthcare.com ggrass@iasishealthcare.com