Need for a Builder Program
Rationale
Connect Care implementations require clinical input for successful design, adoption, testing and implementation of clinical content. Much of this can be provided by subject matter experts. However, many design decisions are best made when clinical experience is paired with a deep understanding of the the Clinical Information System (CIS) database and interface. Testing is more effective when done by persons aware of the limitations, and potential risks associated with, particular workflows and toolkits. When stakeholder communities generate customization and personalization requests, again, the key to efficient design choices is deep understanding of both technical and clinical considerations.
Routing all change requests through technology teams can contribute to delays and end-user frustration. Bottlenecks occur at multiple levels: need characterization, risk-assessment, prioritization, solution design, building, testing, producing, documentation and evaluation. Moreover, analysts may not fully appreciate the organizational context for change requests and so produce solutions that do not fully address end-user needs.
To date, a number of tech-savvy clinicians have grown familiar with Epic applications and have become Epic-trained PBs. They have gained experience working with AHS IT and CIS Project teams and have proven how builders can enhance the work of technical experts while promoting optimal CIS use by their clinical colleagues. Their clinical credentials build trust among colleagues, while their technical fluency makes them useful to the IT team.
Based on the shared experience of other large and complex Epic clients, it is unlikely that AHS IT resources will be sufficient to address the growing volume of Connect Care stakeholder requests. Properly trained and certified builders, who are clinicians first and Connect Care experts second, could significantly amplify the productivity of established analysts.
Benefits
Epic recommends supporting capable clinicians as IT extenders. Spreading CIS customization, adaptation and personalization work among a pool of trained practitioners not only reduces the workload for IT team members, but also facilitates other types of change:
As trusted colleagues with a deep understanding of how the CIS works, Builders can manage user expectations, sometimes re-directing change requests away from new build.
By tracking when existing content needs to be updated to fit current best practice, builders can give IT team developers specific instructions, or even make changes in pre-production environments while following accepted change management processes.
As clinical stakeholders, Builders are motivated to allocate time to the most pragmatic, acceptable and impactful design for of common workflows.
IT analysts can be freed to focus on more complex build and can provide faster response times for work beyond the capabilities of Builders.
Builders can network with like-trained colleagues at other client organizations and speed access to innovative ways to solve CIS design challenges.
Builders can help train and support superusers, powerusers and trainers, while also serving during design and testing as facilitators of subject matter expert reviews.
Change requests are more likely to produce desired results when Builders educate and support their peers.
In sum, Builders can improve communication between the IT team and CIS user-groups, contribute to pragmatic design, and advocate for meaningful use of the CIS.