Healthcare analytics projects can present significant challenges, particularly when addressing complex regulatory requirements that appear disconnected from actual patient care. However, the opportunity to work on initiatives that create meaningful impact, where you can directly observe improvements in clinical care delivery, makes the complexity worthwhile.
This was precisely the situation during a recent comprehensive Epic optimization project. What began as a compliance challenge evolved into something substantially more significant: a transformation of how an organization approaches data analysis, regulatory requirements, workflow optimization, and patient care.
The Challenge: When Excellent Care Cannot Be Demonstrated
The initial assessment of this organization’s Epic system revealed they were delivering excellent clinical work. The challenge was in proving it. They had a multi-year remedial plan with extensive requirements, and the legal language was complex even for professionals who regularly work with such documentation. However, within that detailed language were very specific requirements: follow up within 24 hours, document specific types of care, track particular metrics consistently.
The challenge was not the requirements themselves but rather that their Epic system was configured in a way that made compliance tracking nearly impossible. Documentation was predominantly free text. When attempting to extract data for reporting, the process required essentially manual chart reviews. Even when clinical care was being delivered appropriately, there was no systematic way to demonstrate compliance to auditors.
Key Challenges Addressed:
- 20+ compliance measures across mental health and medical care
- Free-text documentation preventing systematic data extraction
- Two different auditors with distinct reporting expectations
- Absence of baseline data to demonstrate current performance or improvements
The most significant frustration was recognizing that excellent care was being delivered while lacking the capability to demonstrate it systematically.
The Cactus Methodology: Integrated Epic Excellence
What distinguished this project was our collaborative approach that integrated Epic build expertise with analytics specialization from the project’s inception. Rather than the typical model where analytics professionals are engaged after the build phase is complete, we employ a true partnership methodology throughout the entire process.
Our team identified data elements required for reporting while simultaneously determining optimal methods for incorporating those requirements into Epic workflows. Beyond data collection, our focus remained on ensuring Epic tools enhanced clinical workflows rather than creating additional burdens.
We invested significant time in design sessions with clinical users, carefully listening to their workflows and understanding their operational challenges. While analytics professionals naturally want comprehensive data capture with numerous discrete fields, we maintain realistic expectations about user requirements. Our goal was finding the optimal balance between capturing necessary data and maintaining efficient, user-friendly workflows.
Cactus’s Collaborative Approach:
- Integrated Epic build and analytics expertise from project initiation
- Joint design sessions with clinical users throughout all project phases
- Continuous feedback loops during development and implementation
- Ongoing refinement based on actual usage patterns
The key was establishing trust with clinical teams. We ensured clinical staff understood that compliance reports were not intended to criticize performance or impose penalties. Rather than functioning as quality enforcement, our approach focused on demonstrating what could and could not be reported based on how the tools were being utilized.
Implementation: Achieving Immediate Results
Once our Epic builds were implemented, immediate impact was observable. Instead of conducting manual chart reviews to locate follow-up notes, the organization had discrete note types that enabled precise tracking of required elements. Return-to-facility notes, yearly H&P notes, suicide precaution follow-ups became trackable through normal clinical workflows.
However, our implementation approach extended beyond technology. Our team conducted detailed reporting for several weeks following any go-live, ensuring users were utilizing the tools correctly. When we observed that users were not engaging with particular fields, or when they were using features in ways that suggested confusion, we would identify these issues so teams could address them promptly.
Our Implementation Success Factors:
- Real-time monitoring during Epic go-lives
- Daily reports to users showing usage patterns
- Rapid adjustments when workflows were not intuitive
- Building user trust through transparent communication
The most rewarding aspect was observing how quickly clinical teams embraced the new workflows once they realized the tools were designed to support rather than burden their work.
Real Clinical Impact: Meaningful Outcomes
Track 1 Mental Health: From Weeks to Hours
One of the most significant successes involved Track 1 mental health patients, who are patients in active crisis requiring psychiatrist consultation within 24 hours and monitoring every eight hours until stabilized. Prior to Cactus’s Epic optimization, patients might remain on Track 1 status for extended periods, and tracking was conducted manually through chart reviews.
The issue was not inadequate clinical care but rather the inability to access real-time data to understand patient status. Once we built discrete tracking workflows with appropriate reporting capabilities, the organization observed Track 1 patients being moved to lower care levels within 24 hours or less. Our project successfully redefined Track 1 classification, transitioning from a general severity indicator to a designation requiring immediate action.
Track 1 Results:
- Crisis episodes resolved in under 24 hours instead of weeks
- Clear visibility into care levels and patient progression
- Significantly improved compliance above baseline
The Oral Surgery Discovery
One of the most powerful aspects of our Epic data solutions is discovering previously unknown problems. An auditor identified one patient with an extended wait time for oral surgery, and medical leadership wanted to determine whether this was an isolated case or a systemic issue.
When we generated Epic reports, the data revealed this was affecting a significant number of patients. With this information, leadership was able to justify expanding their oral surgeon network to include providers willing to work within their payment model. Patients now receive oral surgery care more rapidly, and the organization can monitor the impact directly through their dashboards.
Systemic Problem Resolution:
- Single audit finding revealed widespread issue
- Epic data demonstrated the monthly impact
- Leadership used data to expand provider network
- Methodology applied to all referral types
Addressing dental pain systematically rather than case by case represented a meaningful improvement in patient care quality.
Daily Visibility into Hospital Transfers
Another significant improvement was tracking patients who require external hospital care. Previously, there was limited insight into hospitalization volumes, reasons for transfer, or hospital stay outcomes. Medical leadership was making decisions based on incomplete information.
We built Epic workflows to capture every transfer, including reason, length of stay, services received, and follow-up care upon return. Leadership now has daily visibility instead of retrospective analysis. When issues require peer review attention or training protocol adjustments, they can respond in real time rather than identifying problems months later.
Hospital Transfer Tracking:
- Automated capture of every patient transfer
- Real-time visibility for clinical leadership
- Immediate data availability for auditor inquiries
- Proactive identification of care gaps
Technical Innovation: Optimizing Epic Functionality
Our Epic build approach was particularly effective in translating complex legal requirements from the remedial plan into workflows that were clinically logical. For example, suicide precaution follow-up requirements became automated Epic reminders and tracking, ensuring clinicians could not overlook them during demanding shifts.
One of the most significant technical challenges was accommodating two distinct auditor approaches within the same Epic system. The mental health auditor preferred aggregate data, wanting to review percentages and trends with follow-up questions about numerical changes. However, the medical auditor did not want percentage data, preferring patient lists for independent chart reviews.
Our Technical Solutions:
- Discrete note types replacing free-text documentation
- Automated Epic reminders for critical follow-ups
- Flexible reporting serving different auditor preferences
- Seamless integration across Epic modules
We engineered Epic solutions that could serve both approaches simultaneously, representing excellent problem-solving capabilities that demonstrate our technical depth.
Lessons Learned: Balancing Data Requirements with User Experience
Reflecting on the project, one of our most important lessons was learning to balance analytics requirements with user experience realities. Initially, our tendency was to create comprehensive forms because analytics teams naturally want complete data capture. However, we made adjustments when users indicated the complexity was excessive.
It is important to recognize that remedial plans sometimes include requirements that do not translate effectively to clinical workflows. Users might be asked to document specific elements that are not meaningful to nurses or doctors working with actual patients because they were written from a legal rather than clinical perspective.
Key Lessons from Our Approach:
- Start with patient-level data to build credibility
- Always explain the rationale behind workflow changes
- Maintain flexibility and readiness to adapt based on actual usage
- Focus on measures that genuinely drive clinical improvement
The most successful aspect of our approach was maintaining close connections with both the build team and end users throughout the entire process. Our methodology included participating in design sessions, listening to user feedback, and adjusting Epic solutions based on lessons learned.
Beyond Compliance: Building a Data-Driven Culture
What has been particularly exciting to observe is how this project transformed the organization’s relationship with data. They evolved from being compliance-focused to improvement-focused. Epic became a strategic asset for understanding operations and improving patient care, not merely a documentation requirement.
The foundation we established is now enabling new projects, such as behavioral health executive dashboards. The organization is analyzing client services, claims processing, and claim turnaround times, all made possible by robust Epic workflows and reliable data infrastructure.
Cultural Transformation Results:
- Shift from compliance-focused to improvement-focused approach
- Epic data enabling proactive clinical management
- Organizational confidence in data-driven decisions
- Foundation for future strategic initiatives
The methodology we developed is being applied to other departments and compliance areas, and the organization is positioned for new opportunities such as reimbursement programs that require documented service volumes.
The Cactus Advantage: Sustainable Partnership
What distinguishes Cactus Healthcare Resources is our long-term partnership approach. Rather than simply building solutions and departing, we invest in the ongoing success of our clients. Over the course of extended engagements, our relationships evolve beyond typical consultant-client arrangements. We become trusted advisors who understand client operations thoroughly and can help navigate whatever challenges emerge.
This project demonstrates what is possible when Epic build expertise and analytics expertise work together from the start, with consultants who understand healthcare operations and can translate complex requirements into practical solutions that genuinely improve patient care.
Whether organizations are addressing regulatory compliance challenges, seeking to optimize Epic workflows, or wanting to build enhanced analytics capabilities, the key is finding partners who can work collaboratively with internal teams to create solutions that are clinically sensible and deliver lasting value.
The Cactus Healthcare Resources Difference:
- Integrated Epic build and analytics expertise
- Long-term partnership approach focused on sustainable results
- Deep healthcare operations understanding
- Proven methodology for transforming compliance into clinical excellence
Sarah Hale
Sarah Hale is a Senior Analytics Consultant at Cactus Healthcare Resources specializing in Epic optimization and healthcare data solutions.