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Anne Hyland: Building, rebuilding, and optimizing Epic training environments

The training environment is the end user’s first exposure to an organization’s Epic EHR and the workflows designed for it. If the experience is not a good one, adoption and efficiency will suffer. Your return on investment is at stake, not to mention the quality of your documentation, and ultimately, your patients’ care.

The three greatest challenges Epic customers face for a master training environment (MST) build

Allocated time, preparedness, and inexperience. By design, the timeframe for this build is generally sandwiched in a small window between completion of the first round of testing and the start of pilot training. Starting earlier means the environment is lacking validated build. Starting later means that your Principal Trainers (PTs) have nowhere to conduct pilot training, and you can’t confirm curriculum and environments will meet expectations with key stakeholders.

Sadly, this already tight timeframe is further compromised by shifting testing dates, compounding the need to do a thorough job with training build and testing.

Worse yet, if it's a rebuild, it is squeezed in on top of keeping the lights on for ongoing training efforts.

Having a thorough training project plan, solid communications with the build team, and a seat at the table for project leadership can all help to manage to the timeline and mitigate issues that arise due to shifting timelines.

PTs are also challenged by working to complete the curriculum right up to the start of MST build, which hampers their ability to effectively prepare. Pre-copy (MST build prep) tasks are done in the slivers of time between last-minute meetings with SMEs and analysts, or are simply left incomplete due to prioritization of curriculum. Helping PTs to escalate curriculum concerns and explain the needs of the training environment build will help to coordinate some of this activity.

Perhaps the biggest challenge I see regularly is that the MST build event is unlike anything the training team has been a part of before. It is unfamiliar, involves a LOT of complex, moving parts, and is their first time working with the tools and processes unique to this niche. There is no dress rehearsal, little to no opportunity for practice, and the training team truly doesn’t know what they don’t know. Even in a rebuild situation, I’ve generally seen that at least some, if not most, of the trainers are new to MST build, and those that aren’t haven’t done one in a couple of years.

Often, post-live training teams are structured such that one PT owns the build for multiple apps, adding time and strain to an already difficult task. Additionally, Epic is always working to improve their Training Wheels curriculum and MST build materials and tools, which means there is never a shortage of “new stuff to learn.” This is great, but can leave even experienced MST dogs to learn a lot of new tricks in the aforementioned limited window of time.

Designing a rebuild project plan, being up to date on Epic’s training tools, and establishing strong communication paths for the effort can all go a long way towards smoothing the path to great training environments and training execution.

How to better address the challenges

MST build is its own mini project, and we know that it is difficult and time consuming. Tight organization, communication, and preparedness will go a long way in helping you meet the deadlines and successfully executing the build. Bluetree has tools and processes for planning to make sure you stay on track, complete the build, and manage lesson testing. We often see teams underestimate the time needed for a rebuild with the idea that a rebuild will somehow go faster and/or be easier than an initial build.

The reality is that a rebuild is every bit as time and effort-intensive as an initial build, and has its own set of complicating factors that can make it more so. Competing priorities, trainer attrition, loss of cookbook/poor documentation, length of time since last build, first-time builders, changes in tools and processes…these all increase the complexity of a rebuild.

The necessary stakeholders and contributors for a successful MST build

Communication and collaboration are the hallmarks of a successful MST build. Ensuring that your training and technical team—the Epic technical folks—and various project leadership members are all on the same page and ready to support the effort will save a lot of confusion and headaches. Key stakeholders and actors in this effort include, but are not limited to, the Training Manager, Principal Trainers, Operational Data Base Administrators (ODBA), Server Systems, Epic TC and TS, the Interfaces team, Data Courier Admins, Epic Client System Admins, Project Directors, application leads, and analysts.

Additionally, there are a few point person roles that are extremely beneficial for the PTs to identify and fulfill:

  • Training Environment Lead (overall point person for all things Data Courier, Refresh, and Access
  • Historical Build User Specialist
  • Scotty Lead
  • Mitosis Guru
  • Facility Structure Lead (IP and Ambulatory)
  • Learning Home Dashboard Lead

These roles allow for specialization and should be owned by a single person. This lead can then support the PTs in these efforts and allow them to focus on their own application’s curriculum and environment needs. The MST build effort really is its own project – a lot of moving parts, a lot of stakeholders, and a tight time frame.

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