In this blog post, we discuss budget considerations that should be front of mind when planning your next Epic upgrade.
Staying current with Epic releases is important, and the reasons for upgrading are many: take advantage of the latest functionality, ensure compliance with Meaningful Use requirements, remain in Good Maintenance standing, and leverage the latest technical platforms. The big takeaway is that preparing and executing a cyclical upgrade schedule is critical to maximizing your organization’s investment in an Electronic Health Record.
While a fair amount of the costs associated with an Epic upgrade fall within the realm of Information Technology (IT) responsibility, there are indeed additional cost elements within the organization outside of IT that contribute to an upgrade of Epic. HCI suggests starting with a communication plan to key stakeholders within the organization that includes: What do the upgrade(s) entail?, When will the upgrade(s) occur?, Why the upgrades are necessary?, and How the organization will be effected?. Through this dialogue, cost contributors such as temporary Epic staff augmentation and overtime expense from the business in order to participate in activities such as integrated testing, manual registrations, increased staffing during downtimes, etc. will reveal themselves.
Within IT, cost variables that are commonly associated with an Epic Upgrade include Infrastructure, Software and Hardware, Labor, Training, Testing, and Cutover.
1) Infrastructure, Software, and Hardware
Epic works with clients to ensure deployed infrastructure meet or exceed the necessary requirements for its most current releases. However, you will need to understand and account for impacts to its overall enterprise architecture in order to identify technical constraints such as compatibility challenges, training on new technology, impacts of upgrading operating systems, database engines, storage area networks, etc.
Storage considerations need to account for at least a year long, temporary, Epic environment dedicated to testing for the upgrade; and therefore may require investment in additional disks and/or drive shelves. HCI strongly suggests that if a comparison has not yet been performed, to consider completing as soon as possible, for the potential costs of hardware refreshes, software licensing, and potential infrastructure upgrades can be substantial that require ample lead time for procurement. Lastly, upgrade investments are not limited to solely the production infrastructure. Disaster recovery implications also need to be considered and may also have a significant budgetary impact.
The effort required for planning, testing, and executing a successful upgrade is considerable. The greater the number of interfaces to ancillary systems the higher the degree of complexity of testing becomes, which in turn equates to additional hours dedicated to the upgrade activity. You will need to quickly assess the capacity available with current staff to absorb the activities associated with an upgrade while also being able to maintain support and already allocated hours to projects. The PMO will need to assess the impact of leveraging internal resources for support of the upgrade. If there are resources constraint that prohibits additional capacity from being realized or possibly causing a delay with other projects, then the costs of temporary labor in the form of Epic staff augmentation may prove to be necessary and thus contribute to the overall budget.
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