By: Shelly Noyes, Partner, Delivery & Talent

Whether you're planning for your first MEDITECH Expanse implementation or it’s simply been a while, you recognize that planning and budgeting are critical to your project’s success. It can be challenging to think of everything. Often, organizations focus on licensing and infrastructure while underestimating or sometimes overlooking key components that drive long-term value and sustainability. These gaps can lead to funding shortfalls and sometimes timeline delays.

At Haffty Consulting, we’ve seen firsthand how early planning, and a comprehensive budget, can help avoid surprises and set your organization up for success. Below are a few commonly forgotten items that deserve a place in your planning process.  

Commonly Overlooked Budget Items in MEDITECH Expanse Planning

1. Internal Resource Backfill and Coverage

Your best operational leaders and subject matter experts will be essential to the success of your implementation, but they still have day jobs. Budgeting for temporary backfill or department coverage allows your core team to stay focused and engaged in project work without burning out or leaving gaps in day-to-day operations.

2. Workflow Redesign and Optimization Support

Expanse is more than a software implementation or upgrade, it’s an opportunity to rethink how care is delivered, documented, and billed. Project teams can get caught up in replicating existing workflows instead of designing for improvement. Allocating time and resources to the design process and engaging experienced consultants who understand both Expanse and real-world operations can drive meaningful change.

3. Training Development, Delivery and Support

While MEDITECH provides a framework and tools, many organizations need tailored roles-based training, materials, superuser programs, and go-live support that reflects their unique workflows and policies. This may include budgeting for:

• Time for trainers, end users, and super users
• Tools like a Learning Management System
• At-the-Elbow Support
• Post-live refreshers and optimization sessions

4. Interfaces, Devices, and Third-Party Systems

Expanse will integrate and touch many other systems and devices. Be sure to consider third-party systems (e.g. anesthesia, PACS) that will be maintained and interfaced, and what the associated fees will be. Fees may include integration (from one or more vendors), middleware, implementation or professional services to support these efforts.  Lab analyzers, imaging systems, Point of Care devices, revenue cycle vendors, and registries all require interface planning, testing, and in some cases, new licensing. Also consider hardware, devices and peripherals that will be required.

5. Project Management, Governance and Change Management

Strong project management and governance ensure decisions are made efficiently and transparently, while change management keeps your stakeholders informed and engaged. Consider costs for:

• Project management support
• Governance committee time
• Communications, events, and engagement materials

6. Temporary Productivity Impacts: Budget for the Dip to Recover Faster

Plan and budget for a temporary drop in productivity. It’s a natural part of the adoption curve as users adjust to new workflows, documentation requirements, and technology tools. The organizations that plan for this dip are the ones best positioned to rebound quickly and avoid operational or financial strain.

Yet this is one of the most under-budgeted areas in Expanse implementations.

Key considerations include:

• Reduced scheduling volumes for ambulatory clinics in the first 2–3 weeks post-go-live
• Fewer surgical cases or imaging appointments to allow for workflow stabilization in the first 1 – 2 days
• Additional staffing or overtime coverage to manage inpatient throughput and avoid bottlenecks

Planning ahead allows leaders to set realistic expectations and avoid cascading issues, from increased wait times and patient dissatisfaction to user frustration and burnout.

7. Ongoing Support & Optimization: Plan Beyond Go-LIVE

Go-live is just the beginning. To get the most out of your MEDITECH Expanse system, it can’t remain static. Clinical needs evolve. Regulatory requirements shift. Revenue cycle strategies mature. To truly be an organizational tool that assists in driving success, your EHR must be cared for, maintained, and continually improved.

Many organizations underbudget for post-implementation support, assuming internal teams will simply absorb optimization work. Sustaining momentum may require:

• Dedicated analysts or optimization roles
• Budget for periodic workflow and system reviews
• Access to MEDITECH experts or advisory resources
• Maintaining your governance and steering committee(s)
• A support model that includes prioritization, and feedback loops

Without a plan, and funding, for continuous improvement, your investment risks stagnation. Plan for ongoing updates and optimization from the start, ensuring they have the resources to adapt, innovate, and keep pace with change.

Final Thoughts

A well-thought-out budget isn’t just about avoiding overages; it’s about ensuring your project has the support and resources it needs to deliver real value and aligns with your organizational objectives. At Haffty Consulting, we believe great planning is the foundation for great outcomes.

If you’re in the early stages of planning a MEDITECH Expanse project, we’d love to connect with you. If you would benefit from a custom, complimentary work session tailored for your organization, we’ll share our collective experiences gathered from past projects and leave you with a Budgeting for Expanse toolkit, in the form of a comprehensive checklist of common line items for consideration. To sign up for a complimentary planning session, please email us at info@hafftyconsulting.com, or call 781-739-3175.

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