New ideas and strategies for

a new kind of healthcare

A large healthcare provider needed a full EHR implementation
to merge four physician practices into one and position it for
an efficient and effective future.
Consulting
Healthcare

April 2014

Clients challenge
When a major healthcare payer with close to three million customers made the decision
to acquire four physician practices and merge them into a single organization of more
than 400 primary care physicians in close to 40 locations, it knew it was facing
tremendous organizational and technological challenges. The new physician practice
would need a fully integrated electronic health record (EHR) and practice management
(PM) system, and it would need to implement quickly enough to meet urgent Stage 2
Meaningful Use and ICD-10 federal regulatory deadlines.
The company was eager to complete the transformational project in order to achieve
better patient outcomes, get higher levels of member satisfaction and growth, and take a
leadership role in driving healthcare improvements throughout its community. The idea
of a health plan building a provider network and converging the payer and provider
markets is a relatively new concept. Navigating these uncharted waters would be an
adventure.

PwCs Advisory solution

PwC was initially engaged with the healthcare payer to develop the business strategy for
the acquisition and integration of the four legacy medical groups and conduct the IT due
diligence for the acquisition transaction. Through our due diligence work, we were able to
conduct an extensive IT assessment and help develop a strategy that would allow them to
achieve their business goals, including the ability to effectively respond to changes in
healthcare reform. Once the acquisition was completed, and based on the quality of our
previous work, PwC was again engaged to conduct the vendor selection of a single, fully
integrated EHR and PM system.
We quickly assembled a team led by a partner with experience in EHR and revenue cycle
implementations and a director with a clinical systems background. The first task was to
design an integration plan for the four physician groups and their disparate legacy
systems (there were three vendors and five different solutions in the mix).

We began with vendor selection, working collaboratively with the company to develop a
list of functional requirements, a vendor request for quotation (RFQ), a vendor selection
process (including vendor and market analysis and coordinating and summarizing the
vendor demonstrations), and a five-year total cost of ownership (TCO) model for the EHR
and practice management systems to help aid the decision. Within 12 weeks, the company
had reviewed their options and selected Epic.
Next, we moved into pre-implementation planning, working with the medical practice
and Epic to establish a project plan and resource plan that included the design, build,
testing, training, rollout and transition to operations. We helped determine and measure
baseline key performance indicators (KPIs), identify potential risks and barriers that
could occur, and define specific mitigation strategies for the potential risks. Other
significant elements of this phase included the education of the companys leadership
team on leading practices for EHR/PM implementations, establishing a Program
Management Office (PMO) and related project management tools, and developing a
change management plan focusing on physician engagement and adoption strategies.
From there, PwC assisted as primary implementation leader, helping with the day-to-day
project management of the systems, and dedicated program resources in other important
project roles such as project managers, team leaders, architects, training lead, testing
lead, reporting lead, technical integration lead and interface lead to round out. And after
a rapid five-month development cycle, we helped configure an Epic solution that could
stand up quickly with minimal customization.

Impact on clients business

As the system begins to function, company leaders will be able to measure the established
key performance indicators to evaluate its success monthly, weekly, and even daily.
Operational metrics such as wait times for patient scheduling are in place, as are financial
metrics and quality metrics based on industry standards as well.
The leadership of the healthcare provider and its newly integrated primary care practice
know they are breaking new ground and are counting on the foundation we helped them
establish to provide an exceptional patient experience and create a financially strong
company that can compete effectively as the healthcare industry continues to reform.

For more information, please visit

www.pwc.com/us/consulting

Or contact
Charles Anastos
Principal
(617) 894-8916
charles.anastos@us.pwc.com

Donna Schmidt
Director
(843) 222-6827
donna.y.schmidt@us.pwc.com

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