Inside Duke Medicine

Wave 2 Preparations Set the Stage for Oct. 10 Go-Live

William J. Fulkerson Jr., M.D. (center), executive vice president of Duke University Health System, participates in a Maestro Care training class.

Providers and staff at 32 clinic sites have been working toward the next major Duke Maestro Care milestone – Wave 2 go-live on Oct. 10.

While they are able to build on the experiences from July’s Wave 1 go-live, providers and staff in Wave 2 are also pioneers because they include the first Duke ambulatory specialty clinics to go-live with the system.

The specialties with clinics going live include, Cardiology; Dermatology; Endocrinology; Infectious Disease; Gastroenterology; Gynecology; Pulmonary, Allergy and Critical Care Medicine; Rheumatology and Immunology; and Urogynecology.

To prepare for a successful go-live, individual Wave 2 clinics conducted workflow realignments, as build teams created specialty-specific content for documentation and order sets.

Duke Urogynecology at Patterson Place in Durham started implementing workflow changes in July, and has scheduled time each day for the entire office to practice in the Duke Maestro Care playground.

"Wave 1 folks gave us some great information, including telling us to make sure get in and use the playground,” said Adriane Donohue, RN, BSN, nurse manager at Duke Urogynecology and a super user. “We’ve schedule that for an hour every morning, nurses are in the Duke Maestro Care playground, following scenarios for new patients and returning patients."

Training for Wave 2 providers, nurses, ancillary staff and administrative staff began in late August and will continue through the October 10 go-live date.

With workflow and operational details being ironed out and training underway, the next steps for readiness will continue on schedule, as technical dress rehearsals have already started and operational dress rehearsals begin on Sept. 17. Technical dress rehearsals are designed to test all hardware and printers, while the operational dress rehearsals provide all users with access to the system to test workflows.

In Their Own Words

Manesh Patel, M.D.
John Bush Simpson Assistant Professor in Cardiology

“I think Maestro Care is going to help us do a better job for patients and, ultimately, make our lives easier. For me, right now, I have to open a lot of physician notes to get the full picture of a patient. I’m looking forward to having all the metrics of cardiovascular care in one place and in one system. But, we are all going through a transition. So, I’m taking the time between training and go-live to become as comfortable as possible with Maestro Care, and to start to learn how to personalize it to the way I want it.” 

Amy Broach, M.D., MS
Division of Minimally Invasive Gynecologic Surgery

“I have the experience of transitioning from paper chart to Epic at my previous health system. As our clinics prepare to go live in just a few weeks, I have reassured my partners and staff that the arduous task ahead of us is well worth the effort. The key to a successful transition is preparation. Practicing in the playground and attending personalization clinics are paramount to making the first few weeks as efficient as possible.” 

Michael Blazing, M.D.,
Associate professor of medicine and Maestro Care super user

“Learning Maestro Care presents challenges that need to be conquered to get to the benefits. To me, it’s like traveling to another country – until you learn the language, you’re not going to be as efficient. Training and practicing help us learn the new language. So, ultimately, the new system should decrease the workload, but it will increase the workload until it becomes facile. With training and practice, we’ll get there.” 

Matthew Fitzsimmons
Clinical operations supervisor at Triangle Heart Associates

“We were already using a pretty robust EHR, so what we needed to do was adjust our workflows to the way Maestro Care works. Among the team, the big thing we have been stressing is training – going to the training and then getting the practice in the playground. For providers, we are working with them on personalization.” 

Angela Canady-Blaylock, RN
ACN III at Duke Gastroenterology of Raleigh

“We're using our clinic downtimes to prepare for go-live. We are meeting regularly with our super users, asking about critical issues so that we can make things as easy as possible for the transition. And, we are sending groups off to training, so we all really feel the Maestro Care energy ramping up.”