Day zero of a hospital go live

We are SET! Dozens of fresh red shirts, ready to be donned. We have invaded the local hotels and will be set for go live in the morning.

Furthermore, lots of pens and papers to sketch out issues, problem solve. And of course lots of tissues for the tears … of empathy. Yes, we anticipate being sad for everyone for whom we will have ‘moved their cheese‘ in the process of replacing their previous medical record system with UCHealth’s system EHR. For this, we anticipate saying ‘sorry’ all week long.

Meantime, behind the scenes, feverish activity in the Cutover room. In front of these dozen computers, hospital and IT teammates are gathering data on the handful of patients who we anticipate will stay overnight in the hospital and thus will need to have their data moved by hand (some copy and paste) from one EHR to another so that the docs will ‘hit the ground running’ in the morning. This means all the demographic information, their med list, their IVs, their diagnoses, any treatment plans for nurses, their active treatment orders and any pending labs or tests.

The cutover moment will be 2am when the old system is retired and the new one is live. We have databases to convert, interfaces to move, we have to unhook the transcription system and move it, we have to unhook the speech recognition system and move it. We have to add hundreds of new physicians to the database and grant them the correct security access. There are tons of mini settings to get right: hospital admit privileges? Ability to dictate? License to use Dragon speech? Ability to badge into the OB suite? Privileges to do EPCS? (E-prescribe controlled substances?) did we capture their digital signature? Did they come to training and get certified to use the EHR? Are they a surgeon and need access to the OR schedule? Do we have them set up in the right clinic? Do they have the right ER tools if they work in the ER? Months of planning come down to tonight and tomorrow.

And this is just the stuff that a CMIO cares about.

The CIO’s team also handles: Cloud storage, network traffic, downtime plans, Outlook integration, single sign on, employee badge management, coordinating meals for about 100 workers, hotel accommodations, network interfaces, wireless access points, brand new WOWs (workstations on wheels) retiring the old EHR and old habits and workflows, etc. Whew.

CMIO’s take? It is an exciting time. Stay tuned! We’ll be live blogging all weekend and into next week. We’ll try hard to bring you the pitter-patter excitement of a Go Live. One of my colleagues compares it to ‘replacing an aircraft engine in mid flight.’ He’s not wrong.

Author: CT Lin

CMIO, UCHealth (Colorado); Professor, University of Colorado School of Medicine

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