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An Epic Overhaul: UMass CFO Reveals How The System Made The Switch

Analysis  |  By Marie DeFreitas  
   December 19, 2024

Switching to Epic not only improved operations, but also team synergy.

So much of healthcare requires collaboration, and executives today are realizing that old strategies, and systems, aren't going to cut it.

UMass Memorial Health (UMMH) installed the Epic EHR platform in 2017.

Now the organization has achieved Epic's Gold Stars Level 10 recognition for its use of the platform. The recognition is awarded to users who enhance team workflow and efficiency while delivering the highest quality care. UMMH is the only hospital or health system in Massachusetts to have achieved the milestone in 2023 and is categorized in the top four percent of all Epic organizations

Before the integration, UMMH – the largest not-for-profit health system in central Massachusetts -- was working off of five different revenue cycle teams, which caused confusion and inefficiency to the system's daily operations, as well as staff dissatisfaction.

"The clinical system was not integrated across the entire system, so we effectively had to work in silos because we couldn't really move information across," said UMass Memorial Health CFO Sergio Melgar.

Before the unanimous vote to integrate Epic, Melgar said UMass trudged forward with poor operational connections and a high price tag to do just about anything. Switching IT systems allowed UMMH to come together and find a new staff synergy across the organization.

"One of the first keys to the success is that we were actually able to integrate people under different systems, but under a common leadership," said Melgar. "Once that happened, then decisions could be made across the system in a much faster way."

The switch also prompted more transparency across the organization, paving the way for smoother operations where each staff member was working from the same data and the same system.

"So a lot of these bad habits that have been formed by the individual silos, now, could basically begin to be eliminated," said Melgar.

Melgar said UMMH didn't customize its Epic system too much, which helped speed up the integration and expansion process.

"We modified it a little bit from what was recommended and did have a little bit more of a finance element in the front than what others might have done, and I think it's helped us tremendously," he said.

The format in which Epic is structured also helped UMMH to get a better grip of its flow of data by moving more items to the front end of the system. 

"In a lot of the legacy revenue systems, in particular, the work is back-ended," he said. "Some of those are moved to the front, and the reason they're moved to the front is that if you can get them done correctly at the front, the flow of information is more complete."

The journey to get where the health system is today was long, grueling, and tough on staff. It required intense training for every staff member and somber meetings with board members. It also required a loan of $125 million, and a total of $700 million invested over 10 years.

CFOs should keep in mind that while an IT system switch may be exactly what a health system needs, the road to get there can be long, riddled with potholes and speed bumps. For a switch like this, CFOs must acknowledge the fiscal realities that go hand-in-hand with a long-term strategy for system transformation.

"I think [it] has helped our quality tremendously, because for one, I think our information is much more readily available," Melgar said. "It's much more uniform. We have much more common practices and we're able to implement things across the system much quicker."

"It's not perfect," he said "but it's definitely getting better."

Stay tuned for a deeper dive into this story including what sacrifices it took to switch systems, what it took to bring UMMH's staff to excel with Epic's system, the cost savings, and how Meglar honed in on his financial strategy for a successful overhaul.

Marie DeFreitas is the CFO editor for HealthLeaders.


KEY TAKEAWAYS

UMass Memorial Health integrated Epic in 2017, now the system has received gold star status from the company.

The switch ultimately improved operational efficiency as well as staff synergy.

CFOs can note the impact a new system can have, but must also acknowledge the long term journey towards improvement.


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