Download - EMR Best Practices Radiant Webinar

Epic Radiant Go-Live

greythorn.com | [email protected] | +1 (312) 853 6100

@GreythornNA | EMR Staffing and Best Practices

Tips, Tricks, and Lessons Learned

Presented by: Angi Cessna, RDMS, RT(R)

Introduction

� Angi Cessna, Epic certified since beginning of

2007

� Involved in over 20 implementations

� Large 300+ bed facilities

� Critical Access Hospitals



� Critical Access Hospitals

� Ambulatory HOD radiant departments

� Ambulatory only radiant departments

What you can take away from today’s talk

� Better understanding of the approaches to taking Epic

Radiant software

� Big Bang and After-the-Fact

� You will understand if this process will it be easy or

difficult?



� Share lessons learned from different implementations

� Enhancements – Can we do this easily?

� Importance of staying engaged with other teams

� Surprises you may want to avoid

Why Radiant?

� Rules-based scheduling

� Documentation

� Results communication

� Chart/film tracking

� Detailed statistical reporting



� Detailed statistical reporting

� Unified system that is fully integrated with Epic clinical

systems

Could it be that simple?



Big Bang – 1st Approach

Learning a new

system

Streamlined care



Big Bang Go Live

(all Epic products together)

system together

Adding Radiant later – 2nd Approach

1• Other products are now live

2• Implement Radiant after the fact



2

3• Is this good or bad?

Adding Radiant later – contd.

Cons

� Difficult adjustment

� Training

� Testing

Pros

� Easier Go-Lives

� Familiarity

� One system

� Reduced cost



� Reduced cost

Enhance – 3rd Approach

Transportation Workflows

Minimal Functionality –

Initial Install

Enhancement



Workflow is RIS-centric

More Robust Scheduling

Enhancement

Some Recommendations

� Try to keep on a concise schedule:

� Use standard reports and work lists

� Use experienced analysts/builders

� You can keep costs down

� Users ownership in optimization process



� Users ownership in optimization process

� Integrated Rads vs. non-integrated Rads – support is

important

� Where can you help – support schedulers?

Heartburn



Some things to look out for

� 3rd party billing files if needed

� PACS driven vs RIS driven

� Interfaced results across time zones

� Security changes to existing users

� Radiologists’ support



� Radiologists’ support

Keep Engaged with Special Teams

� Team that manage shared Masterfiles

� Security

� Change Control

� User records (SERs and EMPs)

� ICD-10 Team



� ICD-10 Team

� Meaningful Use Team

� Data Courier Team

Wow!

� DICOM – (lack of) testing concerns

� Where is the test box? TST or PRD only?

� Users security – inadvertent changes at go-live

� Results – coming from Epic RIS, vs. outside radiology

systems



systems

� Interfaces - test in appropriate environments

What do we do now?



Planning for the future

Enhancement Optimization Upgrade



Questions?



For moving data, we use Data Courier. Do you

think it’s best to have all members of team move

data, or just a set of users within the team?

� A subset of users is best, so they can be experts in the

manipulation of data, keeping up on any Data Courier

changes that comes with upgrades, etc.



changes that comes with upgrades, etc.

For supporting a go-live, do you like to use

analysts as hands-on Floor Support, or do you

prefer to use Superusers?

� Analysts are best utilized in the command center. Floor

support should be superusers so they can build that

report with the regular users, which will mean a better



long-term support and success

Have you ever ‘let’ non-Radiologists read in Epic,

like Cardiologists, or mid-levels that read stress

exams, etc? How did you manage support of

these reading docs?

� Yes, they just need Radiant reading security. They need

appropriate training, either reading from a Reading

Worklist or via the InBasket. You can train any support



Worklist or via the InBasket. You can train any support

staff, usually their preference, to be able to support

them, but I usually see it’s their staff, not Rad staff.

Do you import new EAPS and SERs (procedure

master file and provider master files) or manually

build them? Which is best?

� I recommend importing the data. It’s easier to document

the changes with the import spreadsheet used. It’s less

easy to make build mistakes too. You can even have



easy to make build mistakes too. You can even have

multiple teams enter data on a central import

spreadsheet, then have a daily import time, so all date

can go in at once, and not at various times of day.

Do you recommend a one-to-one Visit Type-to-

Procedure build?

� Yes I do. This way, you can specify where the exam is

scheduled, specific day and time restrictions, as well as

specific patient and scheduler instructions.



How long should we staff our command center?

� For a Big Bang, anywhere from 2-3 weeks may be

needed, using 24 hr shifts the for at least the first week.

� For adding Radiant after-the-fact, usually a 1-2 week

mini command center is needed, maybe only staffed 6a-

7p, with on-call availability. You will also need adequate



7p, with on-call availability. You will also need adequate

Super-user Floor Support after hours.

Disclaimer

� This presentation is intended to give you a general

overview of Radiant implementation processes as

experienced by Greythorn contracted employees.

� For a more tailored and confidential discussion on how

this will affect your business or your own career, please



this will affect your business or your own career, please

get in touch with us.

� Greythorn will not be reliable for any damages of any

kind arising out of or relating to the use of this

information.