Epic Refuel Projects: The Healthcare IT Talent That Makes Realignment Work

Epic holds 43.7% of the U.S. acute care hospital EHR market, according to 2025 KLAS Research data. A growing share of that installed base isn't chasing a first implementation anymore. Many long-tenured Epic customers built their systems years ago around workflows, customizations, and Epic versions that no longer reflect what the platform can do today. The project showing up on more roadmaps this year has a name inside Epic circles: Refuel.

Refuel projects realign an existing Epic build back to Epic's current Foundation model. They run shorter and narrower than a full reimplementation, but they still depend on the right mix of certified analysts, informaticists, and project leadership to go well. Here is what a Refuel actually involves, and the talent it takes to get one right.

What Is an Epic Refuel?

An Epic Refuel is a scoped effort to bring an aging or heavily customized Epic environment back in line with Epic's Foundation system. It is not a rebuild from scratch. Most Refuel projects run three to nine months, depending on how far the environment has drifted and how many modules are in scope.

A Refuel typically is not: a full reimplementation, a chance to add new features to workflows that already work fine, or a training refresh done on its own.

A Refuel typically is: a targeted realignment of build decisions that have aged out, a way to restore upgradeability and access to new Epic functionality, and a project measured in months rather than the years a reimplementation takes.

Why Refuel Is Showing Up on More Roadmaps Right Now

Reid Health in Richmond, Indiana is a useful example of what's driving the trend. The health system was three versions behind on Epic, workflows had gone stale, and personalization was minimal. Through an internal initiative it called Epic Refuel, the team standardized order sets, rebuilt performance tracking, and folded generative AI documentation tools into the build. Within six months, Reid Health moved from Epic's Gold Star Level 2 to Level 10, its highest rating, and cut downtime for system upgrades from more than an hour to eleven minutes. The health system is now on a regular quarterly upgrade cycle, according to Becker's Hospital Review.

Results like that are why CIOs are prioritizing Refuel work now instead of deferring it. Health systems that implemented Epic a decade or more ago are hitting a point where the gap between their build and Epic's current Foundation has become expensive to maintain. Mergers and acquisitions add pressure too. Bringing a newly acquired hospital onto an already-customized Epic environment multiplies the maintenance burden, which is pushing more organizations to use a Refuel to reset the foundation before adding new facilities.

Signs an Organization Is a Refuel Candidate

• The Epic environment is several versions behind current release

• Upgrade cycles take longer each year instead of getting more routine

• Clinicians routinely work around inefficient steps that Epic's current build no longer requires

• The internal Epic team spends more time keeping the system running than improving it

• New Epic modules are difficult or slow to turn on

• Third-party integrations exist to cover gaps that Epic's native functionality can now fill

The Talent Behind a Successful Refuel

Refuel staffing looks different from staffing a net-new Epic implementation. There's no legacy-to-Epic data conversion, and go-live is usually staged module by module instead of one large cutover. But the judgment required is, if anything, more specialized, because every decision involves comparing what exists today against what Epic's current Foundation recommends.

Executive Sponsor

The executive sponsor treats build debt the way clinical leaders treat a care backlog: as something with a real, measurable cost if it goes unaddressed. That framing matters because Refuel decisions get made across IT and clinical leadership together, not inside IT alone.

Program Manager

Sequencing a Refuel is harder than sequencing a new build, because the system is already live. The program manager has to plan realignment work around daily operations, other Epic upgrades already on the calendar, and in some cases an acquisition bringing a new hospital onto the same instance mid-project.

Realignment Analysts (Epic Certified, Module-Specific)

Refuel work commonly touches ClinDoc, Cupid, Ambulatory, Radiant, Willow, Beaker, and the Hyperspace Reporting Workbench. A Refuel analyst needs something a net-new build analyst doesn't: fluency in why the existing customization was built the way it was, so they can tell the difference between a workaround worth preserving and one worth retiring.

Clinical Informaticists

Clinical informaticists decide which customizations clinicians actually rely on and which ones are legacy habits nobody remembers the reason for anymore. Getting that call wrong in either direction either strips out something clinicians need or preserves the exact complexity the Refuel was supposed to remove.

Reporting and Analytics Specialists

Refuel work frequently includes cleaning up a reporting library that has accumulated years of one-off requests, rebuilding dashboards, and working through the backlog of Workbench requests that piled up while the team was focused on maintenance instead of improvement.

Trainers and Super Users

Training for a Refuel is lighter than a full go-live, but it isn't optional. Workflows change module by module, and end users need to know what moved and why before each realigned piece goes live.

At-the-Elbow Support

Support during a Refuel comes in shorter, targeted bursts tied to each module's release, rather than one all-hands command center built around a single cutover date.

Staff Augmentation Is How Most Refuel Projects Get Staffed

A nonprofit hospital system with 13 acute care hospitals and more than 300 primary, urgent, pediatric, and specialty care locations recently ran a Refuel using augmented staff: ClinDoc, Cupid, Hyperspace Reporting, and Ambulatory analysts, plus a Cupid/Radiant clinical informaticist and an Ambulatory clinical informaticist. Over the course of the project, that team helped the health system onboard two new hospital acquisitions onto Epic, convert to Epic's Hyperdrive, clean up its reporting library, and mentor internal staff who were newer to Epic.

That project illustrates why staff augmentation is the default staffing model for Refuel work. Internal Epic teams are already running daily operations, Refuel projects are time-bound by design, and the module expertise a Refuel needs doesn't have to sit on permanent headcount once the realignment is complete.

Questions to Answer Before Starting a Refuel

• Which parts of the build have drifted furthest from Epic's Foundation, and what is that drift actually costing in maintenance hours or blocked functionality?

• Which customizations are clinician-protected, and which are legacy workarounds nobody would rebuild today?

• Where are the module-specific gaps on the internal team, and which of those gaps call for augmented staff versus permanent hires?

• How does the Refuel sequence against other Epic upgrades, module rollouts, or facility onboarding already on the calendar?

• Who has final say when a department wants to keep a customization that blocks realignment?

  
  

How Healthcare IT Recruitment Supports Refuel Work

Refuel projects need analysts who have done realignment work before, not generalists with Epic experience on a resume. A recruitment partner with Refuel-specific placements can point to candidates who have handled the harder part of the job: telling a clinically necessary customization apart from an outdated one, on a timeline measured in months, not years.

For organizations staffing a Refuel, that specificity cuts the interview burden internally and reduces the odds of a mismatched hire mid-project.

Refuel Is Already Happening. The Question Is Whether the Team Is Ready.

More Epic customers are choosing to realign their environment with Foundation this year than in years past, and the projects that go well share one thing: a team built for the specific work of realignment, not a team assembled the way a first implementation would be staffed.

If your organization is evaluating a Refuel, or already has one on the calendar, HERS Advisors can help identify the module-specific talent gaps and build the right mix of permanent and project-based staff to close them. Contact us today to start the conversation.

Frequently Asked Questions

What is the difference between an Epic Refuel and a regular Epic upgrade?

A standard Epic upgrade applies new functionality to an existing build. A Refuel goes further: it realigns the build itself back to Epic's current Foundation model first, which is often what makes future upgrades faster and less disruptive.

How long does an Epic Refuel take?

Most Refuel projects run three to nine months, depending on how many modules are in scope and how far the environment has drifted from Foundation.

Does a Refuel disrupt clinical workflows?

It can, if it's poorly sequenced. Well-run Refuel projects stage realignment module by module and lean on clinical informaticists to validate changes against real workflows before anything goes live.

Which roles should a health system hire first for a Refuel?

Start with the program manager, since sequencing realignment work around a live system is the hardest planning problem in a Refuel. From there, prioritize certified analysts for the modules furthest from Foundation, typically ClinDoc, Willow, and Cupid.

How is staffing a Refuel different from staffing a new Epic implementation?

A Refuel doesn't need data conversion specialists or a single go-live command center. It needs analysts who understand both the existing customized build and Epic's current Foundation content, so they can judge what to keep and what to retire.

About HERS Advisors

HERS Advisors

(Honest. Ethical. Responsible. Solutions.) is a women-owned, mission-driven recruitment and consulting firm specializing in the proactive sourcing and full-cycle placement of skilled professionals in the Legal, Compliance, Healthcare IT (HIT), and Information Technology (IT/IS) sectors.