WellSpan Health

Epic Quarterly Update – Q2 2018

ISSUES NEEDING EXECUTIVE OVERSIGHT RECIPIENTS
Revenue Metrics – You are currently working with Epic revenue experts to Hal Baker CIO
investigate a 2% decrease in net revenue and determine an action plan. Geoff Nicholson VP, CMIO
Weekly calls have been set up with Rick Harley and will include other Mick Murphy CTO
WellSpan leaders on a biweekly basis. Liz Mueller has been coordinating the Robin Kimple Epic Project Director
Epic side. Jim Mays Epic Lead Project Manager
Tom McGann EVP of Clinical Practice
Rick Harley VP of Treasury
Kris O’Shea, System CNE
OUR ONGOING COLLABORATION
Strategic Planning Visit at Epic – On June 7, approximately 10 leaders from WellSpan came to Epic. The focus of the visit was
TeleHealth and Population Health.
Upgrade to 2018 – You are in the middle of an upgrade to Epic’s 2018 version, which will include new features and functionality for
your users. We have staffed an Upgrade Assistance team from Epic who has been working with your Project One team on these new
features. The build phase ends July 2 and then the testing and training phase will begin. Jim Mays is tracking milestones and
ensuring teams stay on track to meet deadlines.
Future Roll-Out Planning: You are planning on rolling out Epic as part of your collaborations with the Philhaven program and
Summit Health, and to your new location, Hanover. You continue to work with Epic as you make these preparations, and will have a
more detailed plan as these projects go through board approval.

WHAT’S INSIDE
PROJECTS AND INITIATIVES SYSTEM HEALTH
GETTING THE MOST OUT OF EPIC BUSINESS CONTINUITY
ROLLOUTS AND GO-LIVES END USER RESPONSE TIMES
REGULATORY AND QUALITY REPORTING CACHÉ SYSTEMS
EPIC ANALYTICS WINDOWS/CLIENT SYSTEMS
PATIENT ENGAGEMENT COGITO SYSTEMS
INTEROPERABILITY
HONOR ROLL GM GRANT PROGRAM
APP NOTES
STATUS KEY
Not Honor Roll
Satisfactory Watch Critical Complete In Progress Incomplete
Applicable Impact
 PROJECTS AND INITIATIVES
GETTING THE MOST OUT OF EPIC
ENHANCEMENT ADOPTION BY VERSION (NOVA) HONOR ROLL ENHANCEMENT ADOPTION STATUS

You are not currently meeting the Honor Roll Enhancement Adoption
requirement of 70% across all versions.

Secure Chat - You went live with Secure Chat on February 9, for all clinicians using Haiku and Canto on their
mobile devices.
RECENTLY
IMPLEMENTED Morphine Equivalent Daily Dose (MEDD) – Several teams, including Orders and Willow, worked together
ENHANCEMENTS to bring this Epic functionality live on May 15, which supports a WellSpan Blue Book Objective as well as an
Optimization request. This has been very well received in the first few weeks of being live.

Synoptic Cancer Staging – Map values from Beaker Anatomic Pathology synoptic staging forms to Beacon
pathologic staging forms to save clicks. This increases speed and reduces transcription errors when
documenting in the Cancer Staging activity. This feature also contributes to Gold Stars.
KEY
ENHANCEMENTS TO Extend a Hand to Patients Predicted to Be Less Engaged – The patient engagement risk score uses Epic’s
CONSIDER predictive analytics model to help you reach out to patients who are less likely to proactively engage with
their healthcare. This can help care managers know where to focus outreach efforts, and inform providers
and staff which patients will need extra reminders to check lab results or pick up medications.

GOLD STARS (NOVA)

You have not

completed an official
Gold Stars review.

28
Incomplete quick wins

This data is preliminary, pending an official Gold Stars review by your organization and the Epic
KEY UPDATES Gold Stars team.

Level Up in Gold Stars - Application Teams can work with their TS to build new features as part
ACTION ITEMS of the upgrade scope or verify that features are indeed on and available in Production.
ROLL-OUTS AND GO-LIVES
EXTENDING EPIC ENTERPRISE ROLLOUT YTD
You extend Epic through a Connect program to 6 affiliate practices across HOSPITALS CLINICS USERS
10 locations. One of these affiliate practices is an FQHC. There is 1 OB/Gyn
practice that is currently reviewing a contract and is interested in going live
with Epic this year. There are no official plans in place yet for this roll-out. 5 406* 20,853
Sueanne McKniff is your Connect coordinator and is working with other CC ROLLOUT YTD
prospective groups who are interested in Connect.
HOSPITALS CLINICS USERS
* Enterprise clinics include all ambulatory departments, including
Rehabilitation and Urgent Care, and do not include MSO departments
calculated separately. 0 10 122

VOLUME PROJECTIONS (for the 1,369,271 321,897 75,681

license year ending June 18, 2018) Ambulatory Visits Inpatient Days Tapestry Members
(2,500,000 Licensed Visits) (320,000 Licensed IP Days) (75,000 Licensed Members)
E-Prescribing of Controlled
IMPLEMENTATION PROJECT Philhaven Project Upgrade to 2018
Substances (EPCS)
GO-LIVE DATE Q2 2019 10/20/2018 8/5/2018

STATUS On Track On Track On Track

Future Modules – Your leadership and Project One team are currently investigating adding on
Epic’s Behavioral Health module and GI module, Lumens.
KEY UPDATES Summit Health – You recently signed an agreement with Summit Health, which has an MSO
program. Leadership from both organizations are still working out the details of the affiliation
and plan to roll out Epic.

Enterprise Catch-Up License – Your Project One leadership is currently working on an

Enterprise Catch-Up License Agreement. Finalize these decisions before 6/30/18 in order to
take advantage of the 30% discount.
ACTION ITEMS License Overages – At this time, you will need to increase your licensed Tapestry Member
volume to 100,000. In June, Epic will run full-year counts to determine whether or not you have
surpassed your licensed Inpatient volume. Geoff Nicholson is working with your Finance
committee to determine the payment plan.

REGULATORY AND QUALITY REPORTING

Eligible Hospital MU KEY UPDATES or AREAS TO IMPROVE

5/5
All 25 eCQMs were mapped as a part of the Epic Go-Live in 2017, and only Good Samaritan
Hospital reported the required 4 eCQMs out of Epic for the 2017 reporting year.

EH passing For the 2018 reporting year, Alicia Fry will work with operational leaders to discuss and
determine which measures will be the focus of testing and reporting for all WellSpan hospitals.
IQR Quality Measures While you are required to have data on these measures by the end of 2018, Epic recommends

25/4
selecting these measures by the end of June so you have two full quarters of data to work with.

eCQMs

Average MIPS Score KEY UPDATES or AREAS TO IMPROVE

91.2/100
Improvement Activity Field: As an MSSP ACO, WellSpan will qualify for full (15/15) IA points.
Currently, the IA field for our TINs in our Hyperspace Reports is showing 0. We are working to
 Average as of 5/2/18 for your update this to show on our Epic Reports. The full credit has been reflected in our Average MIPS
489 ECs Score.
Alternative Payment Models Thomas Hart’s TIN: The TIN for Thomas Hart is including many providers who do not practice
there. This is due to labs being resulted at York Hospital which shares a TIN with TH. Alexander
Garner, your Ambulatory TS, has identified resolution steps and is working with the MIPS team
to test and implement the fix.
MSSP
Next generation ACO Base ACI Measures: All TINs/Providers are currently failing on two Base Measures: Protect
CPC+ Patient Health Information and Patient Electronic Access. The first requires a PHI audit to ensure
our system is correctly protecting PHI and is required for RY 2018. The second requires an
interface to allow patients to transmit their medical record online in a timely manner and is
strongly recommended for RY 2018.

COGITO ANALYTICS
REQUEST PROCESS NOTES

Coordinated Intake Users request reports via a standard request form on Remedy with required discrete and free
Process text fields.

Reporting content is tracked in a Sharepoint repository which users have access to both directly
Report Repository
on Sharepoint and via a link on the Report Learning Home dashboard.

Priorities set by Operational leadership is regularly involved with both the Business Intelligence and Knowledge
Operations Management teams to prioritize projects.

CERTIFICATIONS AND OWNERS NOTES

Cogito Project Diane Ahearn and Candice Cole jointly fill the role of Cogito Project Manager.
Manager

Business Intelligence Each Business Intelligence Developer on the team is certified in at least one Clarity data model
Developers and proficient with Reporting Workbench and Radar.

RADAR CABOODLE REPORTING WORKBENCH

84% 3.1 sec 19.3%

Users with default Implementing the Used as a source for analytics
Avg queue wait time RW users viewing reports
dashboards CEO Web Dashboard

BENCHMARKING CUBES COGNITIVE COMPUTING SLICERDICER

10%
Meeting Honor Roll Using Cubes Using Cognitive Computing Key users with access to SlicerDicer

Custom Cubes - Pete Ivers presented WellSpan’s custom Cube development at XGM as a self-service
reporting solution. The Knowledge Management team has developed tools for referrals, diabetes, and several
other key reporting areas.
KEY UPDATES
SlicerDicer - Danny Brown, your Cogito TS, demonstrated SlicerDicer to a group of ED and Lab users in
anticipation of the new functionality available in Epic 2018. Both groups expressed interest in implementing
the data models as part of their upgrade.
 CEO Web Dashboard – Diane Ahearn will continue to work with Danny to publish dashboard to production by
August 2018 for further validation and customization.
ACTION ITEMS
SlicerDicer – Candice Cole will coordinate with application teams to determine build owners and subject
matter experts for the Beaker and ASAP data models by July 2018.

PATIENT ENGAGEMENT
MYCHART ACTIVATION FEATURE ADOPTION

31%
Instant Activation

(+1%) eCheck-In

Activation Goal: 35% Direct Scheduling

MYCHART KPIs
Icons determined by meeting our recommendations for getting the most out of MyChart.

RESULT RELEASE PAPERLESS BILLING ONLINE SCHEDULING MESSAGE RESPONSE TIME

98% 0.87% 6.1% 0.35 days

finalized tests released Paperless statements Appointments scheduled
average wait time
within 30 days sent online
($2.4 m collected)

Instant Activation – WellSpan is now live with Instant activation. With this feature, staff can quickly
activate patients on MyChart by sending an activation code in an email or a text.

Open Scheduling for Primary Care – With WellSpan’s primary care appointments now on open
KEY UPDATES scheduling, all patients regardless of MyChart active status can schedule a primary care appointment online
on WellSpan’s main site.

Virtual Lab Slip – WellSpan went live with the virtual lab slip in the Upcoming Orders section of MyChart,
which lets patients know about their upcoming labs and imaging.

Push Notifications – Holly Lobb, MyChart analyst, is working on the build and testing for MyChart push
notifications this quarter. With this feature, patients can receive push notification ticklers on their phones
about new information in MyChart.
ACTION ITEMS
Open Scheduling for Specialty Care – During this next quarter, Holly will expand open scheduling to
specialty care departments, which will give all patients the ability to schedule specialty care appointments
online.

INTEROPERABILITY
FEATURE ADOPTION SYSTEM BEST PRACTICES
Advanced Record Location On Target Platform
Streamlined authorized collection Set up training environments
Outside data reconciliation Enable full asynchronous document retrieve
Referrals Management Regularly review exception report
Sending Event Notifications Send and Load Provider Directory monthly
 Track Care Everywhere production certificates in System Pulse

HAPPY TOGETHER NON-EPIC CONNECTIONS RECORD EXCHANGE STATS

SENT/RECEIVED (2017)

9,375,480
Chart Review
Longitudinal Plan of Care
MyChart (2017)
Carequality Government connections SENT/RECEIVED (through
5/1/18)

1,687,201
(since 5/5/2017

CCD Repository – You are now sending CCDs to the CCD Repository again! This was originally used
KEY UPDATES
in between the go-lives, and now it is being used to send CCDs to local HIEs.

Sending Event Notifications – These notifications are helpful for the patient’s PCP to know if a
significant event occurs, such as an ED visit, inpatient discharge, etc., as they include details about the
event that triggered the transition of care. We recommend that David Janczyk continue reviewing this
feature and complete the build by 7/1.

Connection to Cloverleaf – We recommend that Marcy Lazzelle continue working with Ayana
Andalcio, your Care Everywhere TS, to build and test the non-Epic connection to Cloverleaf by 7/1.

Care Everywhere Referrals Management – Consider enabling the Care Everywhere Referrals
ACTION ITEMS Management feature. This will allow you to create and synchronize referrals between your
organization and other Epic organizations using Care Everywhere Referrals Management.

Care Everywhere Certificates in System Pulse – Consider adding the Care Everywhere Reverse
Proxy and Interconnect server certificates to System Pulse so that you can keep track of when those
certificate expire and prevent a Care Everywhere downtime due to expired certificates.

Government Connections – Consider joining the eHealth Exchange to connect to governments such
as the Social Security Administration (SSA) and the Veterans Affairs. Connecting to the SSA allows for
faster processing of disability claims and refunds from the SSA.

HONOR ROLL GOOD MAINTENANCE GRANT PROGRAM

CHECKLIST STATUS KEY UPDATES
You became eligible to begin an Honor Roll Checklist starting
OWNER N/A 5/5/18. A brief overview of the program was presented to
You don’t have an active Geoff Nicholson and Robin Kimple on 3/21/18.
checklist
EXPIRATION
N/A
DATE

UPGRADE & SPECIAL UPDATES

UPGRADES SU PACKAGES KEY UPDATES
Current Version: 2015 Frequency: Every 2 The last scheduled SU package for the 2015 version will be delivered 7/16/18 and
Upgrade Version: 2018 months installed in Production 9/16/18.
Last Upgrade Date: Last Install Date:
The last scheduled SU package for the 2018 upgrade version will be delivered
N/A 5/20/18
8/20/18 and will be installed in Production 10/20/18 with the upgrade.
Next Upgrade Date: Next Install Date:
10/20/18 7/15/18 As of 5/31/18, you have installed 97% of the released SUs that Epic requires or
recommends in Production.
APP NOTES
The Beacon team successfully worked through some challenges with the lack of cosign functionality
Beacon for treatment plans, and cleaned up a large number of orders that did not have the proper cosign.

The Beaker and Interfaces teams successfully implemented an Electronic Lab Results interface to the
Pennsylvania Department of Health for reportable laboratory results. This interface saves end users
approximately 40 hours of work a year by preventing users from entering reportable results manually
into the state’s database.
Lab users continue to struggle with revenue routing and ABN workflows. This is an opportunity for
Beaker Kristina and Wendy to work closely with the HIM, Claims, and Hospital Billing teams to address
outstanding concerns.
The Beaker team is currently in progress transitioning specimen label formats to be in line with Epic’s
recommended format. This project is anticipated to go live during the July maintenance window,
7/15/18.

The Professional Billing team continues to work through issues from the West Region go-live. While
there have been some successes, including decreasing AR days, there are still many areas that the PB
Professional Billing
team is working on with Claims and Hospital Billing to resolve. These teams are also working closely
with Epic experts to analyze WellSpan’s revenue concerns before the end of the fiscal year 6/30/18.
The Radiant team has kept ticket volumes stable and consistent, and is over 75% done with Upgrade
Radiant build. WellSpan has already been a reference for other Epic organizations who are wondering about
Radiant workflows and the mammography module.
Balancing Maintenance and Upgrade - A few teams are struggling with competing priorities,
between multiple large projects, optimization requests, and upgrade tasks. As you work on upgrade,
we want to make sure that you are finding the balance between ongoing maintenance and
optimization. We want to continue having conversations with you about this on an ongoing basis.
OVERALL SUPPORT Transitions – A number of your application teams have experienced a transition with their Epic
support in the last few months. We recognize that transitions can cause instability, and we always
strive to provide high quality support for your teams. Although we have no upcoming changes at this
time, Nicole Huang, your Epic Technical Coordinator, will work closely with Epic’s staffing team on any
future transitions to ensure an effective support strategy during the transition.

Q2 2017 Q3 2017 Q4 2017 Q1 2018

EVALUATION OF EPIC
Received Not Received Received Received – Thank you!
 SYSTEM HEALTH
BUSINESS CONTINUITY
UPTIME OUTAGE COUNT TOTAL OUTAGE TIME

99.988% 1 1 hour
12 MONTH STATISTICS CONSIDERING
ONLY UNPLANNED DOWNTIMES

ANNUAL BUSINESS CONTINUITY REVIEW SUMMARY

PREPARATION RECOVERY MITIGATION

Database Backups
Database Disaster

Continuity Access
Cogito Recovery
Vendor Support

Supports Read-
Database High

Client Backups
Client Disaster
Redundancy

Operational

Operational

Operational

Availability
Prevention

Recovery

Recovery
Planning

Business
Client

Only
TEST LAST PERFORMED NEXT DUE NEXT SCHEDULED

Disaster Recovery Activation/Test April 15, 2018 April 15, 2019 July 15, 2018
High Availability Failover Test January 26, 2017 January 26, 2018 Not Scheduled
Restore from Production Backup April 12, 2018 October 12, 2018 TBD
Restore from Disaster Recovery Backup January 26, 2017 July 26, 2017 Not Scheduled
KEY UPDATES Datacenter Flip - Production was successfully moved between datacenters on April 15, 2018.
ODB Backups - Thomas Scheevel, your server systems TS, will work with Annette Masenheimer, Burke Roberts,
and Kristie Bunn to schedule a restore test from DR Backup by June 15.

HA Failover Testing - Thomas will work with Chirag Shah and Kristie Bunn to schedule HA testing as part of a
datacenter flip by June 15.
ACTION ITEMS
Business Continuity Review – Ensure that you have documentation for business continuity best practices by
reviewing your Business Continuity review from October 2017 and making plans to update processes or
documentation by October 2018. Nicole Huang, your Epic Technical Coordinator, will work with Jeff Beaverson
and the technical team to coordinate.

END USER RESPONSE TIMES

HONOR ROLL RESPONSE TIME THRESHOLD

11/27/17 – 5/24/18
systempulse.epic.com
Response Times Following Patch Installation - Windows patches protecting against Variants 1 and 3 of the
KEY UPDATES
Spectre/Meltdown security vulnerabilities were installed in Production on 4/18/18. Since that date, average
 response times in Hyperspace have increased by approximately 120ms. An exception percentage of 1.3% is
required for Honor Roll.

Top opportunity to improve: Increase client server capacity to counter Spectre/Meltdown patches.
Provisioning - Provision more virtual machines for Hyperspace, following Epic’s recommendations.
ACTION ITEMS
Published Desktop Deployment - Work with Valerie Paulus, your Client Systems H&D TS, to investigate high
CPU utilization from published desktop deployment.

CACHÉ SYSTEMS
ESSENTIAL SYSTEM
CURRENT SYSTEM
CAPACITY PLANNING SETTINGS CACHÉ VERSION CACHÉ MIRRORING
PERFORMANCE
ASSESSMENT

System Health - The Production Caché database is in good shape, and is expected to accommodate the
KEY UPDATES
upcoming upgrade to Epic 2018.

WINDOWS & CLIENT SYSTEMS

CURRENT SYSTEM BUILD CHECKLIST RUN
CAPACITY PLANNING TARGET PLATFORM BEST PRACTICES
PERFORMANCE DATE

H&D – 2/7/2018
W&SS – 5/2/2017

System Performance – The exception percentage has averaged around 2.7% since late April after installing
Spectre/Meltdown patches and adding new XenApp hosts. The exception percentage is the number of
workflows taking over 5 seconds compared to the total number of workflows. An exception percentage of 1.3%
is required for Honor Roll.
KEY UPDATES Stability – The WellSpan Client Systems team and Epic resolved an integrated crash with Hyperspace and
Imprivata, improving stability for end users.

Projects – Secure Chat was implemented successfully in production on February 9, 2018.

The REL environment was upgraded to Epic 2018, including successfully testing the new EPS setup.

System Performance – Spectre/Meltdown patches were installed on 4/18/2018. Please work with Valerie
Paulus, your Client Systems H&D TS, to determine the performance impact.

Capacity Planning – New Gold 6152 hosts were added to your Citrix site on 4/24/2018. Please work with
ACTION ITEMS
Valerie to determine updated XenApp published desktop sizing.
Hyperspace Web: VM sizes have been increased to 4 vCPU x 10 GB RAM, and you have sufficient capacity for
the Epic 2018 upgrade.

COGITO SYSTEMS
CLARITY ETL CABOODLE ETL TARGET PLATFORM BEST PRACTICES CABOODLE VER.

Caboodle V16 – Andy Smith and Taru Garala recently completed upgrading Caboodle to version 16.3, the most
KEY UPDATES recent release of Caboodle.
 Target Platforms – Over the past several months, Andy and Taru updated the software platforms on several
reporting servers so they will stay on target through Epic 2018.
Epic 2018 Upgrade – Andy and Taru will continue to work through upgrades to Epic 2018 in non-production
ACTION ITEMS environments over the next several months, and make preparations for the production upgrade in October.

We recently released this new version of the Epic Quarterly Update report. Please send any feedback or questions about the new
template to Nicole Huang and EQUfeedback@epic.com.