Thank you to everyone who contributed time, expertise, and energy over the past year. The progress made to date would not be possible without you all. We have progressed from an idea to pre-implementation of a statewide EHR known as HCMACS. Despite unknowns with budget, HCMACS will move into the new year with a strong foundation and collective focus to continue advancing our statewide EHR.  

Major highlights of 2025 include:

• Development of the HCMACS Enterprise EHR Roadmap
• Launch of our multi-agency project management office (PMO)
• Purchase of enterprise Epic licenses
• Release and evaluation of the System Integrator Request for Proposal (RFP)
• Consolidation of over 40 legacy third-party applications
• Centers for Medicare and Medicaid (CMS) IAPD update approval
• Completion of Epic Overview of Implementation for key program leaders
• Gates 3 and 4 funding approvals

The State of Washington was also recognized at Epic User Group Meeting (UGM) as the first state to advance an enterprise EHR across multi-state agencies and community providers. We look forward to tackling so much more with you in the coming year.  

With any large-scale innovative project long-term, sustainable funding is necessary to implement and maintain the transformative effort. HCMACS Program recognizes this fact and acknowledges the difficult budget decisions to be made this coming year. Program leadership and partner agencies are actively engaging with the Office of Financial Management (OFM) to better understand the intent behind the released budget recommendations and how they are expected to shape program governance and execution going forward. The Governor’s proposed fiscal year 2026 supplemental budget further supports continued development of a statewide electronic health record. The budget also proposes a new partnership with the University of Washington (UW) to maximize existing state resources and strengthen coordination with the Department of Corrections (DOC) and Department of Social and Health Services (DSHS). 

While there is still uncertainty to work through, it is important to emphasize what remains unchanged. The Governor’s budget continues to recognize the value of a statewide, enterprise approach to electronic health records, and funding is provided to advance this work for DOC, DSHS, and UW. Statutory language also reinforces expectations for agile delivery, strong cross-agency collaboration, and progress toward shared go-live targets. 

In light of these developments, HCMACS Program Executive Steering Committee has decided to postpone and reschedule the Epic Overview of Implementation sessions that were scheduled for January 6–7. This pause is intended to ensure that the right participants are learning together at the right time, with clarity on roles and expectations. Importantly, this decision was made to protect the program from rework and avoid unnecessary delays later, not because of a loss of commitment or direction.  

HCMACS PMO is determining how to best proceed with established workgroups and work efforts while budget and direction are being determined. Some workgroups may scale back or pause while others may adjust focus to work through implementation scenarios. HCMACS will continue foundational efforts that benefit all participating agencies in the near and longer term. 

The HCMACS Program has navigated complex environments before, and the current moment reflects the realities of operating in a constrained and evolving budget landscape. With continued collaboration, open communication, and thoughtful decision-making, the program remains well positioned to move forward in a way that preserves progress, minimizes disruption, and keeps the vision of a statewide EHR intact. 

As we enter the new year, the work ahead will continue to require patience, collaboration, and adaptability. While there are open questions to resolve, there is also clear and ongoing support for a statewide EHR solution and a shared commitment to moving this work forward responsibly.  

Respectfully,

Carrie Yasemin Paykoc
HCMACS Executive Program Director 

The HCMACS Program Management Office is evaluating the frequency of workgroups, advisory councils, and workstreams in alignment with the released Governor’s budget. This ensures individuals and teams work on the most impactful readiness tasks while budgets and scope are finalized through the legislative session which is set to conclude March 12, 2026. 

As a result, HCMACS PMO will continue essential workgroups such as Technology and Data, Budget, and Communications workgroups and delay the launch of advisory councils until the budget for FY27 is finalized. 

Additionally, the PMO continues to strengthen core program management capabilities, including updates to the Program Management Plan (PMP) and transitioning program schedules into Jira to improve transparency, coordination, and execution across teams. 

The team is also advancing key pre-implementation work defined in the HCMACS Program Schedule, including: 

• Understanding and documenting the process for user role changes 
• Identifying data sources required for end-user provisioning 
• Beginning identification of super user coordinators and planning the ramp-up of the super user program 
• Completing data collection workbooks needed to support the first governance workgroups 

Additional priority topics include: 

• Persona planning
• Enterprise Master Patient Index (EMPI)
• Printing Workflows
• Mobile device Planning
• End-Use Access Strategy 
• Data Extracts
• Epic Reporting and Analytics 

As 2025 drew to a close, the DSHS EHR newsletter and monthly EHR Project Team Update meeting highlighted the impressive strides made by the project team and workgroups and offered a glimpse into what’s ahead for 2026. Over the course of 2025, the project team engaged with Epic and successfully established a governance structure and enhanced project management through tools like Jira and Confluence, while recruiting essential staff and submitting decision packages for future fiscal years. Meanwhile, the Clinical Project Team made notable progress by reviewing a vast number of pre-readiness Orion Building Blocks questions and Epic foundation workflows, analyzing policies for Wave 1 facilities, and completing SBARs in diverse areas to ensure standardization and a seamless EHR integration. The team's diligent efforts focused on identifying mandatory EHR requirements for crucial programs, underscoring their dedication to a smooth transition and enhanced service delivery. 

The Revenue Cycle Project Team identified opportunities for standardization in provider queries and billing practices, practitioner coding, and developing business requirements to align with state and federal regulations. On the technical front, the Technical Manager's assessment of Epic Foundation Hardware provided insights into current hardware states at Wave 1 facilities, aiding in estimating technology budgets and readiness evaluations. Additionally, the SI preparation involved a thorough evaluation of third-party systems, data, and infrastructure to ensure comprehensive readiness in alignment with the HCMACS Roadmap. As DSHS moves into 2026, the overarching theme for the project team and workgroups is one of readiness. Governance, project management and agile activities will continue to mature as the team grows and aligns with HCMACS. We look forward to the onboarding of the SI, increased engagement with Epic, the kick-off of councils and workgroups, and building the EHR system. 

HCA Project with support and leadership from HCMACS Program continues to make progress on readiness activities. This includes refinement of a Connect business plan for the EHR as a service component, communications and outreach plans for behavioral health and tribal health providers, and relaunch of HCA project steering committee with a revised charter and revised membership. 

The HCA Project steering committee is set to meet January 20th to discuss how best to proceed in alignment with the released Governor’s budget while scope and budgets are being finalized through the legislative session.