NextGen Upgrades: A CMIO Perspective Executive 200 Amanda Heidemann MD Senior Director, Clinical Transformation
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NextGen Upgrades: A CMIO PerspectiveExecutive 200
Amanda Heidemann MD
Senior Director, Clinical Transformation
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SAFE HARBOR PROVISIONS FOR FORWARD-LOOKING STATEMENTS:
This presentation may contain forward-looking statements within the meaning of the federal securities laws. Statements regarding future events,
developments, the Company's future performance, as well as management's expectations, beliefs, intentions, plans, estimates or projections
relating to the future (including, without limitation, statements concerning revenue and net income), are forward-looking statements within the
meaning of these laws and involve a number of risks and uncertainties. Management believes that these forward looking statements are
reasonable and are based on reasonable assumptions and forecasts, however, undue reliance should not be placed on such statements that
speak only as of the date hereof. Moreover, these forward-looking statements are subject to a number of risks and uncertainties, some of which
are outlined below. As a result, actual results may vary materially from those anticipated by the forward-looking statements. Among the
important factors that could cause actual results to differ materially from those indicated by such forward-looking statements are: the volume
and timing of systems sales and installations; length of sales cycles and the installation process; the possibility that products will not achieve or
sustain market acceptance; seasonal patterns of sales and customer buying behavior; impact of incentive payments under The American
Recovery and Reinvestment Act on sales and the ability of the Company to meet continued certification requirements; the development by
competitors of new or superior technologies; the timing, cost and success or failure of new product and service introductions, development and
product upgrade releases; undetected errors or bugs in software; product liability; impact of internal and external privacy and security breaches;
changing economic, political or regulatory influences in the health-care industry and changes to the regulatory framework applicable to our
business; changes in product-pricing policies; availability of third-party products and components; competitive pressures including product
offerings, pricing and promotional activities; the Company's ability or inability to attract and retain qualified personnel; uncertainties concerning
threatened, pending and new litigation against the Company including related professional services fees; uncertainties concerning the amount
and timing of professional fees incurred by the Company generally; changes of accounting estimates and assumptions used to prepare the prior
periods' financial statements; general economic conditions; and the risk factors detailed from time to time in the Company’s periodic reports and
registration statements filed with the Securities and Exchange Commission.
CME DisclosureLearning Objectives - After completing this activity, attendees should be able to:
-Understand why a solid upgrade plan is critical to your organization’s ongoing success
-Understand the steps needed for an efficient and effective deployment of new releases,
service packs, and hotfixes
-Understand how clinical leaders can play a role in the upgrade process
The planners and presenters of this activity have no relevant financial relationships to disclose. No commercial support
was received for this activity.
NextGen Healthcare designates this live activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians
should only claim credit commensurate with the extent of their participation in the activity.
To receive CME credit you need to: 1) Attend the entire session; and 2) Complete and submit the session evaluation
that will be emailed to you, within two weeks of the email date.
NextGen Healthcare is accredited by the Accreditation Council for Continuing Medical Education to provide continuing
medical education for physicians.
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Objectives
• Understand why a solid upgrade plan is critical to your organization’s ongoing success
• Understand the steps needed for an efficient and effective deployment of new
releases, service packs, and hotfixes
• Understand how clinical leaders can play a role in the upgrade process
Why do we need a solid upgrade
plan?
Why Upgrade?
Change is the only constant
Implement new features and fixes
Standardize Content
Let NextGen manage the burden of regulatory change
How can a solid upgrade plan help?
Reduce time needed to evaluate/implement new releases
– Stay current
– Deliver new features faster
Reduce upgrade fatigue
– Identify whether current issues are addressed
– Assessment of benefits and risks
– Determine whether an upgrade should be taken or skipped
Reduce the possibility of error or malfunction
How can a solid upgrade plan help?
Manage timelines
– Determine whether an upgrade is feasible
– Ensure the team is on-track
– Allow for issues
Plan for the unexpected
– Every role should have a backup
– Cross training is essential
Plan your work and work your plan
How should we as an organization
approach an upgrade?
Strong project planning is a must
Assess timeline
Assess competing priorities
– ICD-10 is a great example
Assess resource issues
– Availability of key players
– Skill sets
– Body count
Systematic review of features and functions
Goals:
Be able to understand all new features and functions
Be able to explain why they may or not be better than current state
How does a new feature or change apply to your organization?
Systematic review - process
Changes vs. additions
Structured review with appropriate resources
– Clinical
– Technical
– Operations
Systematic review - process
Recommended process
– Review release notes and shipment reports
– Compare inventory of open tickets to NG documentation
– Take advantage of complimentary training
– Request additional training as needed
Once these steps are done you can determine whether the upgrade/update should move
forward
Upgrade Statement of Purpose
Explains why you’re undertaking this effort
Identifies core features or improvements to support the cause
– MU, new specialty content,
– Defect fixes
– Performance improvements
Aid leadership buy-in
Upgrade Statement of Purpose
Will remind you why you’re doing this if/when the going gets tough
Justification for expense/resources
Setting Up Your Environments
Version Upgrades
– Clean copy of PROD to BUILD or DEMO environment
– Compare to PROD
– KBM Upgrades
– Clean copy of PROD to BUILD or DEMO environment
– Apply “New Install” version of KBM
• Clean install without any residual custom templates or other customization
– Compare to PROD
Structured Gap Analysis Methodology
Understand your current state
Understand what tools are available
It takes a village…
Understand Current State WorkflowHow do the users actually operate in the system?
Are there any parts of the system they’re not using?
Divide and conquer
– By specialty, module, etc.
Assess the Core first
– Avoid rework – many specialties share templates and workflows
Don’t forget documents
– Can be a time-consuming “gotchya”
NextGen Tools
KBM Database Survey Utility (system template)
– Identifies template usage as part of workflow
• Sorts from most to least used
– Identifies potential custom templates that may be overwritten
– Identifies document usage
• Sorts from most to least used
NextGen Tools
KBM Template Compare Utility (system template)
– Compares template elements across databases (within the same server)
KBM Document Compare Utility (system template)
– Compares document elements across databases (within the same server)
Sometimes Tools Aren’t Enough
Visual inspection of functionality
Applications, modules, and templates
What’s new?
What’s changed?
Only you know what your “normal” workflow looks like!
Sometimes Tools Aren’t Enough
Are there any issues?
Assess usage of current functionality – use data if possible
– Are customizations actually being used?
Assess usage of current work-arounds
Test-drive new features and functions
Decision Making – Who Decides?
Project Governance
Application Governance
Rapid Decision Making process
Documentation – your best friend for the future
Decision Making
Should we take a new feature at all?
If so, should we implement it with the upgrade or some time in the future?
If configuration is needed, how will it be set up?
Decision Making
Who is responsible for training it?
Who is responsible for maintaining it?
What happens if it doesn’t work the way we hoped?
Testing
Testing actual office processes is essential
– Include all critical workflows and business paths
Be careful about “turn-by-turn” driving directions
Users often follow their own paths
Testing
Test the actual upgrade process
Track processing and run times in TEST to create your upgrade weekend timeline
Regression testing
Integrated testing
Training/Testing Events
Benefits:
– Allows you to test-drive training materials and methodology
– Gets users out of their environment so they can focus
– Must be scheduled well-enough in advance
– Allows for rapid trouble-shooting of issues
– Allows for rapid re-testing
– Completes User Validation Testing requirements
– Allows User Sign-Off and Acceptance
Should be a milestone event
End User Training
Will we train in person?
What techniques or technologies will we use?
– WebEx? YouTube? E-Learning?
Will we train by job role?
Will we train as a care team?
Will training be mandatory?
Go-Live Prep
Pre-upgrade notifications and status calls
Testing milestone
Training milestone
Pre-upgrade preparations
– Cutover Plan
– Batches (EPM, ICS/DM)
– Tasks (Worklog, EHR)
– Office schedules
– Downtime preparation
Back-out planning
What role should the clinical team
play?
Model Clinical Application Governance
Determine level of configuration
– Enterprise
– Practice
– Specialty
– Physician
Determine whether customizations will be allowed
Model Clinical Application Governance
Determine whether an upgrade/update will proceed
– Review of initial findings (release notes, shipment reports, etc.)
Formal review of Gap Analysis
– Will customizations be retired?
• Keep custom templates vs. customize new templates
– Use previous decision records as a guide
• Build records or tickets
– KBM usage assessment
• Data is often different from recollections
– Will new features be taken? If so, how/when?
Implementing New Features
Are they configurable by practice, specialty, or provider?
Should we consider a pilot?
Should we implement gradually?
Or should we just do it “big bang” style?
Go-Live Management
Step Number One
Follow the Cutover Plan!
Follow the Cutover Plan!
Follow the Cutover Plan!
Follow the Cutover Plan!
Upgrade Night/Weekend
Downtime process
The Main Event
Post-upgrade tasks
Regression Testing
Returning users to the system
Post-Live Support
Staffing
Ticketing processes
Troubleshooting
Communication
Post-Live Support
Issue resolution and reporting
– Technical
– Operational/Training
– Application
Post-Live Support
An army fights on its stomach….
Reward the team for their hard work
Make it fun!
Post-Live Support
Week One
– Pre-scheduled status calls
– Bridge lines
– Practice visits
Post-Live Support
Stabilization
– Circle-backs – 30 day, 60 day
Optimization
– Circle-backs – 60 day, 90 day
Implementation of postponed features
– No sooner than 60 days
Summary
• A solid upgrade plan is critical to your organization’s ongoing success.
• There steps needed for an efficient and effective deployment of new
releases, service packs, and hotfixes aren’t difficult, but they must be done.
• Clinical leaders can play a significant role in the upgrade process.
Session Survey
Please take a moment to complete a brief survey regarding this session.
1. Open your ONE UGM Mobile App (please note: you must have already logged in and
accepted the “Terms of Use” to access this feature)
2. Click the Navigation Button at the top left of the screen
3. Select “Sessions”
4. Search for and select this session
5. From the sessions details screen, select “Rate this Session”
6. Remember to hit “Submit” once you have answered the questions
Any Questions?
Thank You
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