Introduction to the Epic EHR Implementation
Providence, Rhode Island-based Care New England Health System successfully launched its Epic electronic health record (EHR) system on October 4, marking a significant milestone in the organization’s digital transformation journey. What distinguishes this implementation from typical healthcare IT projects is the health system’s strategic decision to leverage an outsourced IT workforce during this critical transition period.
The Epic EHR platform represents one of healthcare’s most comprehensive and complex technology systems, requiring extensive planning, resources, and expertise to implement successfully. Care New England’s approach to this challenge demonstrates how healthcare organizations can effectively manage large-scale IT transformations through strategic partnerships and strong internal oversight.
The Outsourcing Partnership Strategy
Transferring IT Operations to Kyndryl
In 2023, Care New England made a strategic decision to transfer nearly 160 information technology employees to Kyndryl, an IBM spinoff specializing in IT infrastructure services. This outsourcing arrangement positioned Kyndryl’s team to play a central role in supporting the Epic implementation, representing the vendor’s first Epic project undertaken for a healthcare client.
According to Chief Information Officer Tomas Gregorio, the partnership created a unique dynamic that blended external expertise with internal knowledge. “It felt more like it was my team, but I was working with an outsourcer,” Mr. Gregorio explained. This collaborative approach became essential as the project progressed and challenges emerged.
Navigating the Experience Gap
The outsourcing partnership presented a significant challenge: Kyndryl lacked prior experience with Epic implementations. This knowledge gap required Care New England’s internal management team to maintain deeper involvement throughout the project, providing continuous oversight, guidance, and additional resources to ensure success.
“Epic has a playbook you follow, and they had never followed it before,” Mr. Gregorio noted. To address this limitation, Kyndryl had to hire consultants and experienced professionals who understood Epic’s implementation methodology. The vendor relied heavily on Care New England’s leadership to navigate the complexities of the Epic ecosystem.
Overcoming Implementation Challenges
Building Expertise Through Collaboration
Despite the initial experience gap, Kyndryl demonstrated strong adaptability and commitment to learning. The vendor assembled a team that included Epic-experienced consultants and worked closely with Care New England’s management to understand best practices and implementation requirements.
“They did a good job adapting and working with me and my team to get through the journey. It was tough, but we got through it and were incredibly successful,” Mr. Gregorio said. This collaborative approach transformed what could have been a major obstacle into a partnership success story.
Managing Complex Technical Requirements
Epic implementations require meticulous attention to detail across multiple areas: system configuration, data migration, workflow design, testing protocols, and user training. Care New England and Kyndryl worked together to ensure each component received proper attention and validation before go-live.
Achieving Exceptional Go-Live Results
Rapid System Stabilization
The success of Care New England’s Epic implementation became evident quickly after launch. The health system stabilized its Epic environment significantly faster than typical organizations of comparable size, demonstrating the effectiveness of their preparation and partnership approach.
The implementation team successfully resolved 82 percent of the 10,000 support tickets generated during the post-go-live period. This impressive resolution rate indicates strong technical preparation and responsive support infrastructure, both critical factors in minimizing disruption to clinical operations.
Strong User Adoption Metrics
Beyond technical performance, Care New England achieved strong user adoption across its clinical and administrative staff. High adoption rates are crucial for EHR success, as they directly impact workflow efficiency, data quality, and return on investment. The health system’s focus on training, support, and change management contributed to this positive outcome.
Financial Performance and User Adoption
Achieving Budget-Neutral Implementation
Perhaps most remarkably, Care New England closed the implementation month in a positive financial position. This outcome is particularly significant given that only approximately one percent of Epic implementations nationwide achieve budget-neutral status. Care New England came very close to this rare benchmark, demonstrating exceptional project management and financial planning.
Revenue Cycle Management Success
Mr. Gregorio identified a common pitfall that affects many Epic implementations: revenue cycle disruption. “One of the biggest problems Epic implementations have is that when you go live, things don’t always get built properly. Work queues get backed up, you don’t have the right plan to work those queues, and you may not have tested well enough,” he explained.
When these issues occur, healthcare organizations struggle to generate bills promptly, resulting in significant revenue losses during the critical early weeks post-implementation. Care New England avoided this trap through careful planning and execution of a well-coordinated transition strategy from their previous system, maintaining necessary revenue levels while fully transitioning to Epic.
Leadership’s Role in Success
Strategic Oversight and Management
Mr. Gregorio credits Kyndryl’s willingness to accept guidance and adapt to Epic’s requirements as critical to the implementation’s success. However, he emphasizes that effective outsourcing requires strong internal leadership and oversight.
“You need a strong group of leaders who can manage the outsourcer. I built an executive team that helps provide strategic guidance and direction, and then we monitor closely,” Mr. Gregorio stated. This executive team provided the strategic framework and accountability necessary to keep the project on track despite challenges.
Contract Management and Quality Assurance
The CIO emphasizes that successful outsourcing partnerships depend on having the right people monitoring contract terms and work quality. “That’s the most important part of this outsourcing model: having the right people watching the contract terms and the work being done,” he noted.
Key Takeaways for Healthcare Organizations
Care New England’s experience offers valuable lessons for healthcare organizations considering Epic implementations or IT outsourcing partnerships:
Strategic planning and financial management can enable budget-neutral implementations even during complex system transitions.
Vendor adaptability matters as much as initial expertise when selecting outsourcing partners.
Strong internal leadership and oversight remain essential even when leveraging external resources.
Collaborative partnerships that combine external capabilities with internal knowledge produce superior outcomes.
Revenue cycle protection through careful transition planning prevents common post-implementation financial challenges.
The health system’s successful Epic EHR implementation demonstrates that with proper planning, strong leadership, and collaborative partnerships, healthcare organizations can achieve exceptional results even when facing significant challenges.
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