In healthcare IT, few words spark as much anxiety as “update.” Even experienced informatics leaders feel it – that split-second tension, like settling into the starting blocks and wondering if this race will go the distance.
At NMC Health, that feeling was grounded in experience. Our 2017 move from 5.67 to 6.15/Web Ambulatory felt less like a smooth race and more like a series of false starts – stalled momentum, frustrated end users, and a long grind to regain stability. It took over a year before we found our stride. Naturally, no one was eager to step back onto the track.
But by 2025, postponing wasn’t an option. It was time to line up again – this time for MEDITECH Expanse 2.2.
And this time? We didn’t just finish – we executed.
So, what changed? What turned a difficult race into a strong, controlled run?
1. The Warm-Up: Preparing Before the Gun
No athlete shows up on race day without preparation, and we approached this update the same way.
Before committing to a timeline with MEDITECH, we brought in a consulting partner to conduct a comprehensive Expanse Readiness Assessment. Over three days, department leaders and super-users broke down workflows – identifying strengths, gaps, and opportunities.
This wasn’t just planning; it was conditioning. The consultants incorporated workflow realities, technical infrastructure, third-party integrations, staffing, and training into a grounded, actionable project plan. By the time we stepped onto the track, we weren’t guessing – we were prepared.
2. The Training: Repetition Builds Performance
Success in track and field comes from disciplined training – and we applied that same rigor to testing.
We didn’t rely on a single pass. We built endurance and precision through repetition:
- First round: 23 structured scripts, approximately 1,800 tasks completed by core teams.
- Second round: 28 real-world scenarios, more than 3,500 tasks, with super-users and trainers engaged.
- Final phase: A full parallel run simulating live conditions.
This approach strengthened both the system and the team. It exposed issues earlier, brought in fresh perspectives, and gave trainers meaningful hands-on experience before go-live. By race day, this wasn’t new territory – it was a course we had already run.
3. The Race Execution: Right People in the Right Lanes
In 2017, we tried to run every leg of the race with the same group. Analysts were splitting time between at-the-elbow support and command center responsibilities – resulting in fatigue, delays, and missed handoffs.
This time, we ran a coordinated relay.
We invested in contract support to provide dedicated at-the-elbow assistance, while also ensuring nursing super-users were scheduled without patient assignments to support their teams. That allowed our analysts to stay focused in a fully staffed 24/7 command center – monitoring, troubleshooting, and resolving issues in real time.
The results were clear:
- Over 75% of issues were resolved immediately or within one hour.
- Minimal backlog.
- Limited negative feedback – and even positive feedback from providers.
That’s what it looks like when every runner stays in their lane and every handoff is clean.
Crossing the Finish Line
If you couldn’t tell, one of my favorite spectator sports is track and field, and I can tell you that no race is perfect. There are always opportunities to refine technique, improve pacing, and strengthen coordination. But compared to our previous experience, this was a completely different performance.
We didn’t just get through the update – we executed with control, preparation, and teamwork.
In healthcare IT, updates will always require effort. But with the right preparation and structure, they don’t have to feel like a struggle to finish – they can feel like a race well run.
Kelly Lippold, RN, MSN
Director of Health Informatics