Governance before go-live: How Children’s Mercy readied its analytics for Epic

Chloe Lim, Beckers Healthcare: 

Hello, everyone. This is Chloe Lim with Becker’s Health Care. Thank you so much for joining us for today’s webinar, Governance Before Go Live, How Children’s Mercy Readied Its Analytics for Epic. Before we begin, I’m going to walk us through a few quick housekeeping instructions. 

Today’s webinar will be a presentation and you can submit any questions you have throughout the webinar by typing them into the q and a box you see on your screen. Today’s session is being recorded and will be available after the event. You can use the same link used to log in to today’s webinar by accessing the same link and using that to see the recording. If at any time you have any issues with audio or visuals, just try refreshing your browser. You can also submit any technical questions you have into the q and a box. We are certainly here to help. 

With that, I am pleased to introduce today’s moderator, Glenn David, senior director of digital health at Nordic. Thank you so much for being here. And now I’ll turn the floor over to you to get us started on today’s conversation. 

Glenn David, Senior Director of Digital Health, Nordic: 

Thanks, Chloe, and welcome, everyone. And thank you for joining us for today’s webinar on building an analytics foundation ready for Epic. I’m Glenn David, senior director at Nordic, and I lead the data and analytics business for Nordic strategic advisory services. I served as the executive adviser for Epic Cogito for the Epic implementation at Children’s Mercy Hospital. 

As industry leaders know, many health care organizations preparing for Epic are also struggling with reporting complexities, inconsistent data, and unclear governance. 

Today, we’re going to explore how Children’s Mercy Hospital addressed those challenges and how it modernized its analytics environment and built a foundation for future growth, all in time for their successful epic go live, which happened last March twenty six. 

And this conversation is timely. In August, Children’s Mercy received a good install snap of approval from Epic. 

We have key leaders from Nordic and Children’s Mercy today. This discussion is part lessons learned, part candid thoughts and insights, and pop… And part tales from the trenches from the almost two years that our organizations have worked together. So let’s begin with introductions from our panel, starting with our friends from Children’s Mercy. 

Brett Generaux, Senior Director of Data Governance, Children’s Mercy: 

Yeah. Trenchless feels right. I’m Brett Generaux. I’m a senior director of data governance. I’ve been with Children’s Mercy for about five years. And on the EPYC project, I served as one of our few, cognitive project managers alongside Warren, and we also received help from Nordic. 

Awesome. 

Warren Teachout, Senior Director of Data Analytics, Children’s Mercy: 

Hi, everybody. I’m Warren Teachout. I’m the senior director of our data analytics team. I’ve been with Children’s Mercy for eighteen years now, And, my role was to lead the team of, data analysts, business intelligence developers, and Epic speak to make sure that we have the data available to our clinicians and leaders as needed. 

Mike Sayer, Senior Director of Data Science, Children’s Mercy: 

And my name is Mike Sayer. I’m the senior director of data science at Children’s Mercy. I’ve been at the hospital for twenty five years. My role in the application was, working with the registries in particular, the quality registries and also with the data science work that we needed to convert into Epic. 

Anthony Darling, Director, Digital Health, Nordic: 

Hey, everyone. I’m Anthony Darling. I’m a director here at Nordic within our data and analytics practice. 

I was part of the leadership team supporting Children’s Mercy as they prepare for their epic implementation. 

Glenn David, Senior Director of Digital Health, Nordic: 

Perfect. Right. I think let’s dive into it. 

So EHR transformations are an enterprise wide decision with different benefits across each department. As a background for everyone, can you tell us what made you at Data Intelligence excited about moving to Epic? 

Warren Teachout, Senior Director of Data Analytics, Children’s Mercy: 

Yeah. I’ll kick us off here. In our prior, EHR, when we started in two thousand eight, there were very few, if any, standard reports available. 

And one of the things that I was really excited about was the… Hearing about the foundation system or foundation standard of all of the dashboards and metrics and everything that Epic would have available. 

Also, our old system, there was very little formal training available, You know, with Epic, in order to get in there and develop anything, you had to go through training, get certified. Things were well documented. Very excited about that. Another thing, that Epic really positions us well is for self-service reporting, and there was very little of that available. 

The reporting tools were outside of the EHR. We had, things in business objects and Tableau and Power BI. 

And so clinicians and leaders would have to leave the HR in order to go look at the data. So I’m very excited to have one platform for them to access that. 

And then, really, we had seventeen years of technology that… With reports all across the enterprise, kind of felt like the wild wild west. We really were not able to reuse anything, and that could be for security reasons. So, like, if our endocrinology wanted a report and then gastro wanted something similar, we actually had to copy the report so that they couldn’t see each other’s data. And likewise, say we had a report, but someone wanted two more columns added, and it shouldn’t be that way for the other people who are using it. You had to create another copy. So it just proliferated, and it was crazy. 

So we looked at Epic like, you know, this was a way to clean out the garage and figure out what we wanted to put back in it. 

Brett Generaux, Senior Director of Data Governance, Children’s Mercy: 

Yeah. So, like, the cleaning the garage analogy does feel very right to me. Those made, like, seventeen thousand reports at the end of the day, and it is, like, stringing them all across the floor and, just kind of asking. It was really a good opportunity to ask our stakeholders that are actually using these reports. What are you doing with this thing? So, like, does this report actually bring you joy, or is this something that we can sunset? To what extent are we need… And then need to replicate this in that new environment? 

So I think we are… Feels very much still in the in the position that we’re starting to kinda still sort through those things and put them back in the closet or garage or whatever the right analogy is. But it is just that rare opportunity to be able to kinda dig into those things and figure out really what’s the ROI on this thing that we built for you. Because I think I think many of you have probably experienced the onslaught of people asking for a dashboard or, a report and just really not understanding the why behind why they actually need this thing. So, just kinda digging into, is this expensive curiosity that you have, or is this actually gonna be something that you’re incorporating into your day to day workflow and using on a regular basis and deriving, like, new insights that are really driving the organization forward? So just rare that you have that opportunity to kinda dig into that past work and think about the future. 

Glenn David, Senior Director of Digital Health, Nordic: 

Yeah. Brett, you said seventeen thousand? 

Brett Generaux, Senior Director of Data Governance, Children’s Mercy: 

I don’t know. Was it seventeen years? Seventeen… I don’t know. It’s it’s thousands, and it’s many years. But, yeah, that’s a lot. It was very luminous. 

Mike Sayer, Senior Director of Data Science, Children’s Mercy: 

I think what I’d add as well is that I really appreciated Epic’s governance around data capture itself. 

To give you an example, one of our data science models was using birth weight. And in our prior EMR, that was documented in five different ways, stored on different tables, and they did be massaged. And the amount of effort just to extract that data was substantial. And so while Epic is not perfect, it is certainly better than what we had. 

Yeah. 

Glenn David, Senior Director of Digital Health, Nordic: 

It’s a good insight. 

Brett Generaux, Senior Director of Data Governance, Children’s Mercy: 

I think the other thing I might add is… And I… Warren touched on this a little bit, but there’s a lot of optionality in our… In the BI tools that we’re using. So we were using business objects. We were using Power BI. We’re using Tableau. 

I don’t even… I can’t even begin to imagine how many things were derived in, like, Excel sheets floating wild in… Across the organization. So, this was really an awesome option… Opportunity to think about what are our single sources of truth. 

And this is also coupled really well with how we’re thinking about the enterprise data platform at Children’s Mercy. So it’s kind of an exercise. Part of our strategy is thinking about how do we consolidate those, all of the data that we’re producing across the organization. And instead of having multiple tools and systems that we’re using, instead focus that on more singular systems that we can put a lot more rigor with regard to quality controls and data governance. And Epic presents that opportunity as did our data platform, and just the way that those kind of coincide with each other was really exciting opportunity for us. 

Glenn David, Senior Director of Digital Health, Nordic: 

That’s great, Brett. I remember when we started our partnership partnership with Children’s Mercy, the data intelligence team under Bill Saltmarsh already articulated the what and the why for the need for transformation, and we were there to really validate it and execute on the how. 

Let’s talk more about the… That data platform strategy. 

What… Can you describe what was happening in the organization that led you to launch this initiative way ahead of your epic implementation? 

Brett Generaux, Senior Director of Data Governance, Children’s Mercy: 

Yeah. Definitely. From a data governance perspective… So I think I mentioned that I’ve been here for a little over five years now. So when I first started with data governance, our focus really was on how do we build that foundation or backbone for data governance and thinking about it from a people first. So the whole triad of people process and technology. We did approach governance work from a people side of the equation. And so I think we did a really good job of establishing that foundation for our data governance program and, with the idea that governance around the platform is really gonna be what leads us to longer term success. 

But what… 

Where we struggle, and I think every organization struggles a bit with data governance, is getting the individual stakeholders who are charging with that stewardship work to kinda understand the… 

What’s in it for them of it. So how do we activate you in doing good stewardship work when you have, like, a huge day job in front of you? So we’re, like, kinda side… 

We’re just kind of glomming on additional responsibilities on your overall work. So the… 

Really, I think the opportunity with Bandwidth and Nordic really helped us a lot is thinking about how do we use this epic transition to advance the work that we’re trying to do with stewardship and with our data literacy programs and… 

Which we call data fluency here. And it was really so thinking about how do we take advantage of this opportunity to, move forward that data governance work and make it make it more part of our process. So I think that’s really where you all helped us think through that. And so one example would be our data literacy program where you helped us develop some data literacy modules that we then used to, be those sort of prerequisite work that we made our users do to be able to get access rights or additional things that they needed to do. 

So in this case, we developed a data literacy module, which then became a prerequisite to give our users the ability to export out of Epic. So it just became this natural transition to take that foundational work we’ve done in data governance and really advance it through this Epic implementation. 

Anthony Darling, Director, Digital Health, Nordic: 

Yeah. Brett, I think you hit it on the head there. Right? 

Implementing Epic was more than just the EHR placement here. You weren’t just replacing Cerner, but it was an opportunity to really instill change or that catalyst really instill change across an organization, you know, to improve how data, reporting, governance, analytics were managed, really, you know, across the organization. 

I recall, you know, we were… When we first started getting involved in the project, you know, we conducted those two assessments. We had that data governance assessment, and then we had the reporting strategy assessment. And part of those assessments required, performing some interviews and surveys with a lot of key domains across the organization. 

And I remember that we found through those conversations that, you know, the challenges were weren’t necessarily technology related. It’s more kind of people oriented and how organizationally things are structured. Right? Teams define metrics differently. Data stewardship responsibilities kinda varied across, you know, the different domains. Some are, you know, more engaged, more, I guess, ready in… You know, to help populate a lot of the metric data that you needed. 

And then data quality process is very generally inconsistent, and reporting relied on multiple tools as, you know, you guys have mentioned previously. Right? You have objects or assets in Power BI and Tableau and Crystal Reports just really all over the place. And so it became clear, you know, after we had completed those assessments that addressing those issues before go live would make the transition a lot smoother, especially during the project period, and really help Children’s Mercy get more from Epic, you know, from the very beginning on day one when he went live. 

Yeah. 

Mike Sayer, Senior Director of Data Science, Children’s Mercy: 

Sorry. I guess I… What I would also add is that we had, some, models, data science models currently in production that were necessary at go live or near go live to go live. 

For example, we had a central line bloodstream infection model that’s predicting risk. It had a consumer base of thirty plus, vascular access technicians that use that in rounding. We wanted that to go live as soon as possible. And so what really helped us with this strategy and planning was to make sure that we had those required data elements on day one so that we could keep those models going. 

Glenn David, Senior Director of Digital Health, Nordic: 

Absolutely. 

Anthony Darling, Director, Digital Health, Nordic: 

No. Yeah. That’s a good point. Because I know when we were performing the assessment, really, as we started kinda getting into the trenches with the only epic implementation, We, you know, helped you and your team with, a lot of the mapping activity. Right? Just understanding that right now, you have all these data sources that are built on the legacy data, data systems. And then with Epic, we need a way to, you know, maintain that longitudinal reporting across your previous data models, your reporting, your dashboards. 

And so, you know, to help with that, we had embedded some, you know, BIDs as well as some engineers to, you know, work with you, work across organization to help determine how that data can be sourced from Epic so we could do that mapping up front so that on go live or at go live, you know, we had minimal disruption, you know, as we transition, as data started flowing in through Clarity and Kaboodle, to keep everything, at Children’s Mercy really depended on and learned to depend on, functional. 

Brett Generaux, Senior Director of Data Governance, Children’s Mercy: 

That longitudinal model piece, I mean, it’s still something we’re struggling with, but it is… Like, I don’t think I fully appreciated how difficult it would be to say that this thing in this old system represents this other thing in the new system. Like, to create that through line between those things is… Was just… It continues to be just insanely difficult.  

And so, yeah, as Mike was describing, like, these things that we’ve built for our users that they’ve come to rely upon, like, that seamless transition from what happened pre March one to what happened March one, was just a massive amount of work. And a lot of things still continue to surface as that still need some attention. We still need to figure that out. We still need to define those things and figure out how did you define that in our old EHR? 

How do you define it in epic? And there’s a lot still even… 

And not necessarily a single place you can go to and say, this is the expert we should listen to here. It did take kind of a village of talking with Nordic and talking with our epic experts and talking with our internal, our internal application teams and looking externally to our peers to say, how did you address this problem? So… 

But, yeah, definitely, continues to be something we’re working through, but I think we’re making progress every day. 

Glenn David, Senior Director of Digital Health, Nordic: 

No. I agree. Like, that longitudinal reporting, it’s the, it’s the granularity of the data in each of the different systems that… That’s… That makes it complex to map out across the systems. And, Brett, I just wanted to just acknowledge the… Like, what you said at the start, like, focusing on the people and the processes. Like, the epic implementation is a is a technology implementation. But, really, at least for us, the harder part is really the people and process components to… People and components. And then the strategy that Antonio mentioned, like, that was one of the main focus areas because you don’t want to put another technology solution to solve data governance as a whole. 

Brett Generaux, Senior Director of Data Governance, Children’s Mercy: 

Yep. Big surprise. People are complex. 

Glenn David, Senior Director of Digital Health, Nordic: 

Yeah. People are as complex. That’s right. Right. 

Well, let’s shift gears here. Let’s talk about future state vision. 

What did you envision as the outcome of the transformation? 

In other words, going into the epic implementation or preparing for it, what did success look like for you? 

Brett Generaux, Senior Director of Data Governance, Children’s Mercy: 

Yeah. I… 

Man, I feel like I’m hitting the people drum too hard, but I do think that that’s probably the thing I was thinking most about going into the transition. 

This was really about, understanding context for the information that we have. And so I think that’s looking at both what’s happening upstream of the analytical layer and then what’s happening with our end users, and then how do you kinda marry those two worlds together. So for… 

Like, as we approach the project, I think I was really welcoming the opportunity just to… 

For us all to kinda have these sessions where we’re talking through process and definitions work and some of the stuff that you just don’t have the opportunity to pause on in normal day to day work and really get to the heart of meaning of things. So so having those working sessions where we had our application teams building and then had our stakeholders in that same space to talk through what is it that’s important about this workflow, and what are you gonna want to see from an information and data standpoint further downstream, and how can we bring that all back together. So that’s really what I was most excited about is opportunities to connect with those internal partners in ways that you just don’t have that to pause and dig into those as every day. 

Warren Teachout, Senior Director of Data Analytics, Children’s Mercy: 

For me, from a data and analytics standpoint, first and foremost to me, I mean, success or what my vision was looked like at least fifty percent of the requests that we were getting would be able to be handled by self-service, and then that would lead my team to handle more complex requests and conduct and conduct data transformations on the back end that would then enable even more self-service. 

And while I didn’t expect my team members to be anywhere close to experts at go live, I knew that we would be successful if we knew the right questions to ask and we knew where to go to begin our investigation after our Nordic colleagues left. 

And one of the things that I was really excited about and and could envision was that for the first time, we would have data and analytics products available to all levels of the organization and accessible right from within Epic, you know, then our leaders would have the data and insights that they would need to take appropriate actions. 

And we would be successful when we saw our executives and leaders using those dashboards and metrics made for their roles. For example, like, if you’re managing the OR, then there’s a whole OR dashboard that is custom made for you to look at and see how you’re doing. So that that was really cool and had me excited. 

Glenn David, Senior Director of Digital Health, Nordic: 

And, Warren, you mentioned, like, at the start, you wanted at least fifty percent would be self-service. How is it faring right now in your journey a few months after go live? 

Warren Teachout, Senior Director of Data Analytics, Children’s Mercy: 

Yeah. I think it is about that. And it’s interesting because some of the requests that we get, we look at them, and we’re like, oh, this is self-service. There’s an opportunity for some additional training here for this end user. 

Glenn David, Senior Director of Digital Health, Nordic: 

Yeah. It’s perfect. 

Anthony Darling, Director, Digital Health, Nordic: 

From the Nordic perspective, it was never just about implementing Epic. Right? It wasn’t about, you know, creating reports and then patting ourselves on the back. We had a successful go live in leaving. You know, really, our goal, you know, especially after the handful of conversations that we had, you know, months, many months before the actual start of the epic implementation, was to help Children’s Mercy, you know, build out that governance and those processes and analytics capabilities to, you know, really help support the organization far beyond just the epic go live. 

You know, we understood that strong governance had to come first. We were very much aligned with, you know, this team and Bill’s vision for, you know, that that really structuring that strong governance with clear ownership and accountability. 

But just as important, we also wanna, you know, help, you know, warn you and your team, you know, build out those internal capabilities, you know, with the epic toolkit and strengthening those governance practices. 

So, you know, ultimately, the idea was to… Or the goal was to, you know, try to address all of these before go live so that Children’s Mercy, ACCO Live, and after would spend less time trying to fix issues that, you know, might pop up later. And we’ll spend more time focusing on optimization and innovation. 

Glenn David, Senior Director of Digital Health, Nordic: 

That’s good. Right. Let’s go into solutions that were proposed. 

This is a question for you, Antonio. So when Verdict first assessed the environment and we did the data governance and reporting strategy, what did you discover, and why did the team decide to focus on governance before technology? 

Anthony Darling, Director, Digital Health, Nordic: 

Yeah. Well, when we had completed the data governance and reporting strategy assessments, what we had found was a highly engaged organization that really have strong analytics talent in place and already a solid foundation. You know, you had data stewards already, set up. You had a governance committee, that was already, in place. 

But, you know, as we had completed those, various interviews across those different domains with, you know, those executives and leaders in each of those areas, We’ve heard some common challenges, throughout. Right? So as I mentioned previously, data stewardship wasn’t necessarily consistent across all the areas. Metrics were defined a little differently depending on who you asked and where that data was sourced. 

You know, many processes remain manual. 

And then there was, you know, limited adoption of deletion, your data catalog, and then a reporting landscape that, you know, was, supported by multiple tools, right, kind of, you know, increasing your overall technical debt. And so, you know, through that, one thing became clear, and it was just that technology alone wasn’t gonna solve these challenges. We really had to focus on, you know, Brett, like you said, you know, the people side of things first, And that would require changes to governance, you know, for your processes, and as well as some organizational alignment. Right? We all had to get kind of on the same level or playing field to… In order to ensure that we’re all moving along forward successfully. 

Okay. 

Glenn David, Senior Director of Digital Health, Nordic: 

And, Antonio, I’m not I’m not gonna harp on the people side anymore. I’m gonna harp on the process side of the equation. I actually thought, like, when we did the assessments, that you guys have good processes in place. It was a man… 

Matter of fine tuning them. So when Nordic was there, I think we looked at intake and prioritization, change control The reporting development life cycle, like, how are requirements documented, how are you validating it after development, how do you progress it across each of the different environments from testing all the way to production. And then on the data governance side, like, we look at five core things, which is data stewardship, data management, data quality, standardization, like what you said, like, a metric should be the same across wherever you are in the in the organization and other components of data governance. 

But outside that, I think there was also a strong focus and an understanding that upskilling isn’t going to be done overnight. Like, even if you had the best analyst go to Verona, get a hundred percent on their exit exams, it… 

Like, it… 

It’s… 

It will still take a few months, a few… 

Yeah. Definitely a few months for you to get the expertise that’s needed. So I think it’s that at the elbow support, the office hours that we wanted to provide to make sure that if there is something complex, you have you have support to to punt that over to. 

Right. I’ll flip the question. I think it’s the same solution theme, but for Children’s Mercy, what were the most important changes that you made to create a stronger foundation for analytics and Epic Readiness? 

Warren Teachout, Senior Director of Data Analytics, Children’s Mercy: 

Well, one of the things that you guys really helped us with was to bring in an experienced project manager that had worked with Epic before. 

So she… When we had risks or issues come up, she would know what application team or what Epic resource that we would need to reach out to. 

Having her was indispensable to the success of our project. 

Another thing, and you touched on this, Glenn, is that we had, office hours with the… So between the CMH business intelligence developers and the Nordic BIDs, we had that set on a calendar, and it was just open so people could come in and ask, general questions. 

And then in a similar fashion, we also had what we call joint application development sessions where a… Turns Mercy BID could come in and at the… Work with the Nordic BID to create an analytics metric or dashboard or whatever the artifact might be. 

And then two… And just talking with people, we really planned ahead of time how we were going to support our end users at go live. And the primary tool that we decided to use, again, calling it office hours, but this is just where end users would be able to sign up and get help. And so that was another thing that we implemented and hadn’t really done before. 

Brett Generaux, Senior Director of Data Governance, Children’s Mercy: 

I feel like those office hours are the only way we survived those… You’ve got five weeks because it was… Like, everything was coming out of the woodwork. And so… And it was the only way we could really sort, like, what’s really on fire versus, like, what is just, something we could solve with training or just unfamiliarity with the system. So, like, Warren’s team just did such a fantastic job embracing that, and it became just a tool in our arsenal just to address so many different problems that we’re surfacing across go live. Not that… I mean, I think our go live was very successful, but it’s just… You never know what you’re up against. But that was just a way that we could kinda triage and address problems in in real time and really get to the heart of the matter to resolve things much more quickly. 

Glenn David, Senior Director of Digital Health, Nordic: 

Yeah. No. I… I’d say we’re… We were also learning at the same time as you were because there were some new functionalities that Epic released around your go live, which is, like, the epic Launchpad, Sidekick for slicer dicer. So those were the things that, like, we were happy to opine and help explore with you guys. 

Right. So let’s shift to the outcomes of these solutions. 

Brett Generaux, Senior Director of Data Governance, Children’s Mercy: 

Mike, you’re on mute there for a second. 

Mike Sayer, Senior Director of Data Science, Children’s Mercy: 

Apologies. I think the other thing that that I would add here is we postponed several metrics that we didn’t need right at go live, but would need shortly after go live. 

You know, just prioritizing our work, but that that lift was heavy and intense pretty quickly after go live. And so we use the Nordic resources primarily to help us source or understand where to pull that data from. 

We also found that there were some build issues where, you know, we may have stored something as a smart data… Or a smart text field instead of a smart data element, and it caused issues downstream because those were not in the main caboodle tables that we could actually source from. So Yeah. They were very helpful in identifying here’s what the problem is and here’s what the solution is. 

Glenn David, Senior Director of Digital Health, Nordic: 

That’s perfect. 

Alright. 

So moving on to outcome. So we did all the preparation. We’ve laid out the foundation. In your perspective, how did this work improve your organization’s readiness? And, really, what benefits did you guys see as a result of this? 

Warren Teachout, Senior Director of Data Analytics, Children’s Mercy: 

Well, I think for one thing… I mean, the training is so fundamental to everything epic, and a lot of the training workflows included the Cogito analytics products. So it… Again, it didn’t make our end users experts by any means, but at least it gave them a foundation. It gave them a starting point. 

And, again, going back to those office hours that we established, just expanding on that a little bit, they could use those office hours for just about anything. I mean, so… And user could come and say, you know, I’m just wondering how I do x y z, you know, just a general thing, and we could be there to support them in that. Or we could… For a self-service thing, like, it were a slicer dicer session, we could actually watch them or guide them through the build of that. 

And so that has really helped us and helped end users to be experts with the data. 

Another thing that’s been really great is that the analytics catalog has helped us to prevent that duplicate of reporting that I talked about earlier and why we had so many thousands of reports. I mean, now we can see, okay. Hey. This report already exists. 

Just reuse it. And then another thing that was pretty cool is that about half of my team, for those two years that we were working with Nordic did become, certified business intelligence developers in Epic, while the other half continued to support the old system. And what was really cool is that around go live, they got the training and they got the certification, but we took those things that we were doing with Nordic and did those for the newer BIDs. So the BIDs that were children’s mercy that were slightly more experienced now conducted and held the office hours where the team that just got trained can come and ask questions or do those joint application development. 

So that was a that was a real great help. And it… And even though I wouldn’t say that any of us are experts yet by teaching, it helps make everyone be better developers because when you teach something, you learn it better. 

Glenn David, Senior Director of Digital Health, Nordic: 

Yeah. Yeah. And, Warren, just as an observation, when… 

This is something that we were talking at Nordic. Like, your adoption to slice or dice, and this is something maybe we can measure over with data in the future. But our observation was that you guys were… Had a higher utilization of slicer dicer. We’ve seen organizations do that many years have been in Epic and haven’t maximized the use of slicer dicer. So kudos to that. 

Warren Teachout, Senior Director of Data Analytics, Children’s Mercy: 

Yeah. Thank you. 

Brett Generaux, Senior Director of Data Governance, Children’s Mercy: 

Yeah. This is kinda anecdotal, I don’t know if you’d agree, Warren, but I’ve been hearing people talk about it. I feel like our organization has really developed a preference for slicer dicer, I think out of that self-service and a little bit of it is we’re kind of launching people in slicer dicer, and so they do get that familiarity with it. But I’ve just seen even as we’re developing new solutions for the organization and that we’ll sometimes get pushed back on things that are developed in other tools and reporting workbench. They’re like, can’t we get this in the slicer dicer? 

Glenn David, Senior Director of Digital Health, Nordic: 

I think it’s amazing. 

Like, that there’s an appetite for that self-service. 

Warren Teachout, Senior Director of Data Analytics, Children’s Mercy: 

Yeah. Absolutely. And just to expand on that a little bit, Brett, I mean, we, you know, when users ask us questions, we almost always say, see if you can find it on a dashboard first. 

You know, look at your metrics. Look at the dashboard first. See what you can drill down. And then if you can’t get it there, then go to slicer dicer. 

Then if you can’t get it there, then, like you said, then reporting workbench. So we do definitely have a hierarchy that we try to, or preference, I should say, that we try to steer people towards. 

Glenn David, Senior Director of Digital Health, Nordic: 

That’s perfect. That’s a good culture so that your backlog also doesn’t inflate unnecessarily. 

Brett Generaux, Senior Director of Data Governance, Children’s Mercy: 

It’s all about self preservation. I’ll throw in a couple comments just on the governance side. I think about, like, our early challenges with governance and thinking about stewardship, a lot of it has to do… Like, a lot of the challenges are governance as a thing feels… 

It’s… Well, it’s one that’s the most poorly named function in an organization. Data governance sounds so unfun, and everybody knows governance is the most fun thing in the world. But it’s the, it’s also just really abstract. So when we first started even developing our data domain structure and engaging data stewards, we had such really great engaged and energetic conversations with them. And I have come to call those data therapy sessions, really, because it was the opportunity for different departments to really air their grievances on challenges that they’re having with data and think ahead to how we might be able to resolve those. 

But we had a… 

It was a struggle then to convert that really great energy to… 

In thinking about art of the possible and how data can be improved in the organization to how… 

What is your role as a data steward in this process and taking responsibility and ownership for that. So that’s kind of that that sort of level in our process to advance data governance work. And I think this presented an opportunity for us to make that feel more tangible and less abstract because we could then say, the way you get your little blue ribbon check mark on the report or dashboard that you care about is that we’re going to wrap around an operational workflow where you approve it. And that’s what brings that… 

We’ll surface it for the organization as something that’s valuable. So I just think it makes the work of governance resonate with the organization a little bit more and just… 

They start to kinda realize that this is how we can advance that or show quality or I… 

How I can highlight the things that are most important to me and get those cataloged and inventoried for future use. 

Glenn David, Senior Director of Digital Health, Nordic: 

Absolutely. 

I think folks are realizing that they’re are not realizing that they’re already doing data governance even if they’re trying to avoid it just by, the mere exercise. Trying to get to the right data. And, Brett, I like your I like your term data therapist. I might steal that. I might change my title as data therapist. 

Brett Generaux, Senior Director of Data Governance, Children’s Mercy: 

People. You’ve seen the couch. 

Glenn David, Senior Director of Digital Health, Nordic: 

Good. Yeah. Awesome. And, Tony, do you have any final thoughts on the outcomes? 

Anthony Darling, Director, Digital Health, Nordic: 

Sorry about that. Got a little laggy there. Yeah. 

You know, Warren and Brett, you kinda saw a lot of the thoughts that I had as you were as you were talking through. I think one side… One thing on the data governance side was, you know, a lot the work that, we partnered with you on in in developing those, some of those data fluency kind of data personas, that, you know, has led to, using them as a way to provision, you know, greater access to reporting. We’re really putting structure around who receives what reporting, permissions, who has access to what data. 

Because I see that as a lot… Something that a lot of organizations kind of treat kind of after go live as part of their optimization, phase, and that’s something where a lot of time was spent, you know, during the project to really get that sorted out so that I go live. If someone needed something, there was a clear path on how they would get, you know, access to, you know, exporting data out of, you know, report workbench, for example.  

And, Warren, you really touched on the item that, you know, really set out to me that, you know, I was really big fan of was around the mentoring and partnering with Children’s Mercy BIDs, you know, being able to really offer a lot of the experience that Nordic has gained, you know, in this space for a long time and then, you know, being able to really help kind of brain dump or, you know, be a resource for your team, you know, as they’re learning, you know, Epic and Cogito and, you know, questions that they may have had during… 

You know, that came up during, you know, their classes. But more importantly, as they’re working through that foundation content that, you know, Epic, provides you, You know, as questions came up, you know, being available to help kinda rationalize, you know, not only, you know, what you need to do in the system, but kinda why Epic, you know, kind of designs it that way. 

Glenn David, Senior Director of Digital Health, Nordic: 

So let’s move on to the last topic, last question. 

And, like, Antonio and I, we’ve been doing epic implementations for, I think, over ten years now, and we’re still updating our methodologies as we learn from organizations from experience to experience. 

There are no perfect implementations, but as Epic has noted, you guys have had a really successful install, and we see that as well. 

Just looking back, what are the biggest lessons learned, and what advice would you give health care organizations preparing for Epic or a major analytics modernization effort? 

Mike Sayer, Senior Director of Data Science, Children’s Mercy: 

Yeah. I think I’ll start with there were lots of foundational reports that were promised. Oh, you’ll have that at go live. You’ll have that at go live. 

You’ll have that at go live. That when we went live, even with the best testing efforts or scripts, we were we were testing against inaccurate, entered by data analysts and not entered by people or clinical staff roles. And so we found that a lot of the standard reports either needed to be tweaked or modified or the prep business process needed to be better defined to support the report. And so I guess the word of caution there would be to keep asking the question and keep validating what will be there. 

The other thing that we found a little bit was that some of the reports or some of the the foundational metrics may not have been as robust as we previously thought. You couldn’t drill into them to the level that we thought that we might be able to or that, you know, we’re a pediatric hospital, and they were missing a critical data element specific to peds that is important in that measure. So just things to think about. Okay. 

Warren Teachout, Senior Director of Data Analytics, Children’s Mercy: 

Yeah. And adding on to that again, I talked about the office hours. I definitely have a plan in place for how you’re going to support your end users once you go live. 

Office hours has worked best for us, but, you know, there… There’s certainly other things out there as well. But, again, definitely have a plan in place for that. And then I think if I if I could just change one thing I can’t remember who it was, but they mentioned the application work group meetings. This is where, you know, the clinicians and leaders are coming together with the developers to create the workflows in Epic and everything that they would need. Make sure you have people there that know the data that their area needs. 

That… That’s gonna be critical to your success. And then another thing is, by all means, use the foundation standard metrics everywhere that you can even if the definitions are a little bit different than what they used to be in your old system. And, yeah, you might have to convince clinicians and leaders and others that it’s worth the the switch in context. 

And, you know, we didn’t we didn’t do that a hundred percent across the board, but it is just… It’ll save you a lot of time if you’re able to do that where you can. And then another thing that that I personally learned or I think that we, the data analytics analytics team, learned is that as you’re going through those foundation standard dashboards and you’re taking a first look at them, make sure to remove the adult content because, unfortunately, we went live with some dashboards that had metrics on them that only applied to adults. So if I could have a do over, that would be it too. And then the other thing, I was advised this myself and took it to heart, but I just plan for an onslaught of requests once you go live. You’ll be surprised how hungry your end users are for that data. 

Brett Generaux, Senior Director of Data Governance, Children’s Mercy: 

It’s a good sign. 

Glenn David, Senior Director of Digital Health, Nordic: 

Good problem to have. 

I will probably focus more on the advice than the lessons learned. So many lessons learned. And I feel like if we had it to do over again, we do a lot of things. We… But, you know, I… And I’m very anxious just to go through a whole other EHR implementation. That’s the most fun thing ever. But, no, I would say the thing that I… From an advice perspective, the thing I really focus on is the taking advantage of the infusion of energy that we had, that there’s… 

Like, our partnership with Nordic was fantastic. Having epic experts at our fingertips to opine on things and kind of debate an approach to a problem and just the just the opportunity to have these collaborative spaces where we’re kind of thinking about information and how we’re using information across the organization and how we can develop improved processes or take a more systemic, like, systematic approach to looking at how this thing in this world impacts something else or where there’s commonalities. And it’s just such a great opportunity to have all of these minds kind of thinking about the future and, and really thinking, like, how can we do better, and what do we want to do, and what is. 

And questioning, like, how we did things in the past. So, if we approached it this way, why did we do that? Is there any reason to continue to do that, or is there just a better path forward? So, I think that was the most exciting thing for me throughout the whole process was just having so many more opportunities for that collaboration, across partners like Nordic and Epic, but then also just our internal teams all focused on solving the problems that are really the most important for them in their spaces. 

Anthony Darling, Director, Digital Health, Nordic: 

Yeah. To piggyback on that a little bit, yeah, the one advice I’d probably give to those listening in is, you know, keep focused on what happens after go live. You know, use… As you said, Brett, you know, use the epic implementation as a catalyst to, you know, to implement change across the organization, not with the purpose of, you know, getting through the implementation and going live, but really, you know, setting yourself up for success after, you know, that go live date, you know, to strengthen your governance or to simplify reporting and minimize technical debt or reduce technical debt. 

You know, really start thinking about how data is managed across the organization because it’s much more than just… You know, we have a new HR, you know, but it… It’s really how do we, as an organization, grow and benefit from having, you know, that that big change agent during that, you know, period of time to really help standardize things moving forward. 

That’s perfect. 

Glenn David, Senior Director of Digital Health, Nordic: 

Alright. Well, thank you all for sharing your experiences. I think today’s discussion highlighted many lessons. 

I think I think what stuck with me is that, you know, epic implementations is a is a rare reset. It’s, like, an impetus for change for the organization. It’s a chance to impact data upstream, look at your workflows. As Brett said, like, work with different individuals across the entire organization and also impact downstream reporting and self-service reporting. 

And epic implementations may sound like a technology transformation, which it is, but bigger and more difficult components are in the people and process and how you manage that overall governance. 

By focusing on these, Children’s Mercy built a stronger foundation for analytics, decision making, and future innovation. With that, I’ll turn it back over to Chloe. Thank you. 

Chloe Lim, Beckers Healthcare: 

Yeah. Of course. And that is all the time we have for today. I wanna thank you all again for just such an excellent conversation, as well as Nordic for sponsoring today’s webinar. If you’ll be joining Becker’s Health IT and RCM Conference from September fourteenth to seventeenth, please stop by the Nordics booth at five three one four. 

Thank you all again for joining us today, and we hope you have a wonderful rest of your day.