How Surety Systems Stabilized a Client’s Epic Ambulatory Environment
The Client
One of our regional healthcare clients operating across primary and urgent care settings recently went live on Epic. Like many organizations in the weeks and months following go-live, they were managing a growing backlog of support tickets, incomplete build in key clinical workflows, and the friction of a new system finding its footing.
Complicating the picture, this client operated as a Community Connect partner on a shared Epic instance with its host organization. This meant two different operational models running on largely the same build, requiring every fix to account for how it would affect both sides.
They needed a team who could step in and start closing gaps immediately. Just as importantly, they needed a support system who’d take the time to actually understand two organizations sharing one system, rather than treating every ticket as its own fix.
The Challenge
Post-live stabilization is rarely just about clearing a ticket queue. This engagement surfaced three distinct problem areas:
- A ProcDoc build environment that had outgrown itself: Preference lists had become too large for providers to navigate efficiently, slowing down documentation for in-house procedures like X-rays, ultrasounds, and barometry workflows.
- Order and charge routing issues impacting overall revenue: In-house imaging orders weren’t flowing correctly through the system, and charges weren’t always dropping to the right place. This reflected direct financial consequences for the client’s internal team.
- Structural complexity from a shared Epic instance: Because the client and its host organization used the same Epic build in different ways, they regularly encountered issues with a near-duplicate build: same logic, one small variation, with no established process for tracking what changed and why.
These issues required a dedicated team to diagnose root causes, prioritize a shifting workload, and know when to hand work off cleanly to the client’s internal employees.
Our Approach
Understand Before You Build
Before making a change to their system, our team took the time to learn how the client’s ProcDoc build had grown over time. In this phase, we identified which preference lists had moved past the point of usefulness, which orders no longer served a purpose, and where forms could be consolidated instead of rebuilt from scratch.
That groundwork set up the technical framework for a connected Epic landscape and built trust early with a team that had already been through a lot of change. The assessment became the foundation for everything that followed, and was later handed off as a roadmap for continued improvement.
Roll Up Your Sleeves
With priorities identified, our team worked within the client’s ticketing environment to:
- Rebuild and streamline ProcDoc preference lists, removing extraneous orders and renaming others so providers could find what they needed faster
- Correct charge-linking rules for in-house imaging orders so charges were routed and dropped correctly
- Resolve smaller-scale barometry workflow issues for medical assistants, including new workflow configuration across the Epic landscape
- Stand up a value-based care reporting program that helped the internal team build out tracking and optimization of referrals to their connected insurance provider, create new reports, and establish recurring Cogito-based monthly report-outs
- Extend core reporting work into a follow-on evaluation process for flagging urgent mental health follow-up cases to providers
Throughout the project, our goal was never just to close tickets. It was to make sure the people on the other end of each ticket felt heard and taken care of, even when the fix took longer than a quicker patch alternative.
Leave It Better Than You Found It
Rather than simply packing up and shipping out when the engagement ended, our team set the stage for a broader ProcDoc overhaul and transitioned that work and supporting documentation to their internal analysis team.
This handoff embodied what real partnership means: making sure the people who inherit the work can succeed without you in the room.
The Impact
- A more navigable ProcDoc environment: Providers were spending less time hunting through cluttered lists and more time actually documenting and personalizing patient care.
- Corrected charge routing for in-house imaging: A behind-the-scenes fix, but one that gave the client’s billing team real peace of mind that in-house X-rays and ultrasounds were being accounted for correctly.
- A new value-based care reporting foundation: This fix gave the client a repeatable process that their team could keep running long after the engagement ended. Better reporting allowed for more visibility into insurance referral patterns and supported a stronger bottom line increase.
- Continuity beyond the engagement: By transitioning ProcDoc improvement work directly to an internal analyst rather than leaving it incomplete, the team avoided leaving loose ends for anyone else to tie down.
The Relationship
Onboarding is never simple, but this client went out of their way to get our team the equipment, access, and support needed to hit the ground running, even when that meant working outside their standard process. Early wins on the imaging and reporting front helped build trust quickly, and that momentum carried the engagement past its original three-month scope.
“The client team was terrific to work with from the start. Even with everything they had going on post-go-live, their managers were fully supportive and did everything they could to make things easier on our end. Being able to show them results early on made a real difference in how the relationship grew from there.” — Surety Systems Consultant
That kind of mutual trust is also what made it possible to be candid where it counted. Managing one Epic build across two organizations with different operational needs created a few areas of friction with duplicated system build, reactive data migration, and no standing process for what should trigger change requests.
Rather than simply working around it, our team raised it directly, recommending the two organizations establish a clearer, published process for flagging and handling system changes.
Why It Matters
This engagement reflects what Surety Systems delivers on every project: unbiased guidance, hands-on execution that owns the outcome, and a handoff that leaves clients stronger than we found them. That’s the standard we hold ourselves to, whether we’re three weeks into an engagement or three months past the original scope.
Facing a post-live Epic stabilization challenge of your own? Let’s talk.
