Improving technology landscape with Epic EHR for patient care and revenue cycle

Client background 

The client is a not-for-profit, safety-net, acute-care community hospital with approximately 400 beds. As a vital healthcare provider, the hospital offers a comprehensive range of services, including pediatric, adolescent, and adult primary care, and specialized medical services. The hospital is deeply committed to serving its community, often caring for underserved populations. 

The business challenge 

Recognizing the need to enhance its operational efficiency and service delivery, the organization sought to modernize its technology landscape, particularly in the areas of patient care and revenue cycle management. This modernization effort was driven by the hospital's mission to improve patient outcomes and streamline processes in a rapidly evolving healthcare environment. 

Since 2008, the healthcare organization had been operating with a fragmented technology landscape, utilizing separate systems for various critical functions. These included McKesson Star Financial for revenue management, Altera Sunrise Clinical Manager for inpatient care, eClinicalWorks for outpatient care, and SIS for surgical management. The lack of integration between these systems led to the creation of countless manual workarounds which significantly hampered efficiency and resulted in low overall satisfaction with the organization’s technology infrastructure. 

Faced with these challenges, the organization embarked on a mission to modernize its operations. They set an ambitious timeline of just 10 months to implement a new electronic health record (EHR) system, all while concurrently managing an enterprise resource planning (ERP) system implementation. Recognizing the need for a unified approach to patient care and revenue cycle management, the organization developed guiding principles focused on leveraging advanced technology to enable a more efficient and modernized healthcare environment. 

Strategy and solution 

To address these challenges, the organization engaged Baker Tilly to oversee the implementation of Epic, a comprehensive EHR system that would consolidate patient care and revenue cycle processes into a single, integrated platform. Baker Tilly’s role was critical in navigating the aggressive timeline, limited staff resources, and the complexity of running the Epic implementation in tandem with the ERP project. 

Prior to signing the Epic contract, Baker Tilly served as a critical liaison between the client and Epic, ensuring that all vendor recommendations were validated before proceeding. This approach was crucial in mitigating the risks associated with the client’s limited familiarity with the complexities of Epic’s system. Baker Tilly's early involvement was instrumental in preparing the client for a smooth and informed transition. 

The Epic implementation commenced in January 2023, with a successful go-live in October 2023. The client launched a comprehensive suite of Epic modules, including Inpatient (ASAP, ClinDoc, Orders, Willow), Outpatient (Ambulatory, Bones, Kaleidoscope), Cupid, Radiant, Beaker, Cadence, Prelude, Cheers, and MyChart. Baker Tilly played a pivotal role in this process, handling critical aspects such as data migration from eClinicalWorks and Altera to Epic and completing the interface build with InterSystems. The firm also managed integrated testing, charge testing, and parallel revenue cycle testing. 

Baker Tilly also led and supported the implementation of Oracle ERP for supply chain and finance, ensuring a smooth integration with Epic.  

Throughout the project, Baker Tilly demonstrated flexibility by adjusting team size up or down to meet the shifting project demands. Baker Tilly took on full responsibility for program management, consultant oversight, and the management of the build, testing, and go-live support. This comprehensive approach ensured that every phase of the project was meticulously managed and aligned with the client’s goals. 

To maintain transparency and ensure seamless communication, Baker Tilly facilitated weekly calls with Epic analysts, provided detailed weekly status reports, conducted financial reconciliation meetings as needed, and offered 24/7 support via a dedicated team. Frequent project update meetings with both Epic and the client’s leadership teams ensured that all stakeholders were aligned and informed throughout the project. 

Following the successful go-live, Baker Tilly worked closely with the client to transition into the optimization phase, scaling down the team as required.  

Baker Tilly’s strategic approach and thorough execution led to the successful implementation of both Epic and Oracle systems, enabling the client to transition from multiple disparate backend systems and manual processes to a single, integrated platform for clinical and financial data. This transition has resulted in standardized processes for patient data, with information now easily and readily retrievable. 

Additionally, Baker Tilly continues to partner with the organization, ensuring that resources are available for future optimization efforts and the implementation of additional Epic modules.