It takes much more than tapping an "Update App" button to upgrade what is arguably a health system's central nervous system.
This past year, the UCSF Health Informatics team, clinical systems, and Epic experts upgraded APeX, UCSF's customized version of Epic. This electronic health record (EHR) powers UCSF Health's clinics and hospitals and encompasses patient notes, medication orders, lab results, billing, scheduling, and communications — nearly every aspect of patient-centric care.
This Go-Live event — an overnight event where teams of people work to revamp this software — occurs after months of tireless preparation. Preparation ranges from studying EHR upgrade documentation to rehearsing upgrades on test systems, and making sure any upgrades do not negatively impact patient care.
This preparation culminates into the actual Go-Live upgrade, which takes place over the course of several hours. During a safe time period at night — when patient care activity is at its minimum — teams work ferverishly through checklists and computer scripts, like pilots and airline ground crew would before a flight.
Over the next 48 to 72 hours, my colleagues and I will be live-blogging the events of the Apex (Epic) EHR go-live. We’ll try to present an engaging front-line description of what goes in to an EHR launch at a major academic hospital.
Russ Cucina, MD MS
Vice President of Informatics
Chief Health Information Officer, UCSF Health
Once a Go-Live is complete, the users can launch the newly-upgraded system to start the patient care. Thousands of users, in fact.
"Before flipping the switch and releasing a live system into the wild, you build and rebuild, meet and discuss, plan and prepare, train and cajole," writes Aaron Neinstein, MD, who helped orchestrate UCSF's first Epic Go-Live in 2012. "You think you have a good idea of how your end users will interact with the system. Then you go live. And thousands of people start using the system."
These users include pharmacists, physicians, nurses, therapists, accountants, managers, administrators — even our uniformed officers surveying a monitor of patients in the emergency department.
This journey is chronicled on Cucina's Epic Go-Live Blog. There, you can learn what it takes to run a Go-Live. Similar Go-Live events occur at hospitals and clinics around the nation.