NextGen 5.8/KBM 8.3.3 Upgrade

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

2. 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.

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

4. 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

5. 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 clinicsand 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.

6. Gap Analysis Tool

7. 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.

8. S.T.A.R.Super UserTicketingAchievementReward

9. 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!

10. 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.

12. 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.

13. 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!

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

15. 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.

16. 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!)

17. 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.

18. 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.

19. Questions? Answers free. Good answers $5 each.

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