Demo Overview: Day in the Life of a Hospital Physician

1. Ms. Mary McPherson Inpatient Care Team Nurses, etc Dr Rob VerhoffPathologist Dr Don FunkInfectious Disease Expert Dr CoxPhysician Dr Claus HansenChief Pathologist Reviewing Inpatients with Care Team Connect with Experts for Support Manage Inpatient Care Activities Rounding on Inpatients Demo Overview: Day in the Life of a Hospital Physician Prof. MasonExternal Expert

2. Reviewing Inpatients with Care Team Manage Inpatient Care Activities Connect with Experts for Support Rounding on Inpatients Demo Overview: Day in the Life of a Hospital Physician WSS and SPS Portal, Integration with LOB apps WSSTemplateActivity Tracking SharepointDocument Library Office MobileCommunicator WWF SPD Audio and Video Conferencing Presence Outlook E12UM Enterprise Search Groove KnowledgeNetworks IRM Livemeeting

3. Innovative Collaborative Healthcare Technologies • Enterprise Search • Clinical Portal (aggregation of LOB applications) • Collaborative Workspaces (synchronous and asynch) • Secure Communications (Instant & email messaging) • Blogs and Wikis • Presence • Audio and Video Conference • Workflow (agendas, templates and alerts) • DRM

4. CSF (Critical Success Factors) Addressed • Cost Containment through Increased Clinician Productivity • Reduction in Medical Errors (Increased Patient Safety) through better collaboration and communications • Meeting HIPAA and other Regulatory requirements through more complete documentation of all processes and DRM • Improved business and clinical decision support through better analytical data

5. Reviewing Inpatients with Care Team Manage Inpatient Care Activities Connect with Experts for Support Rounding on Inpatients Day in the Life of a Physician

6. Reviewing Inpatients with Care Team Rounding on Inpatients Manage Inpatient Care Activities Connect with Experts for Support Driving To Work • Dr Robbins receives current patient Information on Mobile Device • Active Patient List • Pathology results • Email • Dr Robbins notices a pathology result on one of his patients (Mr. McPherson) that is inconsistent with previous findings. • Notice Pathologist is online and begins a IM with him from his Windows Mobile Phone.

7. Reviewing Inpatients with Care Team Rounding on Inpatients Manage Inpatient Care Activities Connect with Experts for Support Patient Bedside with Tablet PC • Switch to the Tablet PC at Hospital and goes to Mr McPherson (patient) bed. • 360 view of patient, Mr McPherson, in Contoso Clinical Portal, includling a list of patient’s his care team with presence. • Opens Pathology result as he did on Mobile. Now he gets a picture of the culture and a visual indicator e.g. drug sensitivity • Restarts his IM from patient bedside with Pathologist. • Pathology resident adds his chief to the IM

8. Reviewing Inpatients with Care Team Manage Inpatient Care Activities Connect with Experts for Support Rounding on Inpatients Patient Review Meeting (also Grand Rounds) • Care team meets in a conference room to review patients, Initiates a Livemeeting • Open Portal and click to Mr McPherson, show his EMR • Next they see a list of history findings and highlight certain ones. • Review his pathology results (infection with drug sensitivities). • Dr. Robbins explains his concerns. • Together the care team develop an agenda or plan for the patient.

9. Reviewing Inpatients with Care Team Connect with Experts for Support Manage Inpatient Care Activities Rounding on Inpatients Enterprise Search, Blogs and Wikis • Dr Robbins does Enterprise search pulling up documents, policies, articles, news items and people. He also finds records of all similar cases. • Reviews hospital and government policy for this infection (osteomyelitis).. • Dr Robbins searches for Osteomyelitis on the internet and get a blog at the hospital community discussion forum on contol of hospital based infections hosted by Prof Bryan. In that blog he finds a discussion forum on the frequency of occurrence of Osteomyelitis. He sees entries from local nurses pointing out complications in the last 5 years, • Dr Robbins finds a technique that some innovative hospitals are using based on a combination of water purification together with a new antibiotic. This seems to be a highly effective procedure that the hospital can purchase and implement at a relatively low cost. • Dr Robbins also find good comments about how to manage his patient and especially a local rehab facility that specializes in the management of Osteomyelitis.

10. Reviewing Inpatients with Care Team Connect with Experts for Support Manage Inpatient Care Activities Rounding on Inpatients People Search in MOSS • Dr Robbins uses People Search to find a colleague 1 or 2 degrees removed from him who knows Prof Bryan. He finds that Dr Johnson (Infectious disease expert in his hospital) is in his network and Prof Bryan. Using presence he sees she is online and available and starts an IM session with her. Discuss the infection and possible drugs to use for the treatment. • He asks Dr Johnson to introduce him to the external expert; Prof Bryan, so that he can discuss the new technique further. She agrees.

11. Manage Inpatient Care Activities Reviewing Inpatients with Care Team Connect with Experts for Support Rounding on Inpatients Set up Patient Plan to manage new condition (Infection): Outlook, Sharepoint, 3rd party • Plans immediately documented and shared • SharePoint and shared workspaces for notes allows all to see prognosis • IM Nurse with tasks • Unified view of time and tasks. These tasks are from Project Server, workflows, Outlook, SharePoint • Outlook also makes it easy to convert a meeting to a task with a specified due date – see it show up in task list • Outlook also lets us view a team calendar in overlay mode. Now this is a SharePoint calendar from a team site you’ll see in a moment, and I have it opened in Outlook here.

12. Manage Inpatient Care Activities Reviewing Inpatients with Care Team Connect with Experts for Support Rounding on Inpatients Document Management • Dr. Robbins enters his SOAP notesand adds all the supporting documents that are being used as the basis for his treatment. Document library contains all the key Osteomyelitis documents. These are actually based on Content Types. You see when I click New, I get a drop down of different document types – a Word document, a spreadsheet, etc. • Define not only the document templates but also things like whether a special workflow is associated with that document type, or whether it has an expiration policy or a barcode requirement, and most obviously, what metadata is associated with the document type. You see that here in these columns, and it’s really powerful in making content more searchable and much more usable, as well as for driving workflows,

13. Manage Inpatient Care Activities Reviewing Inpatients with Care Team Connect with Experts for Support Rounding on Inpatients Rights Management • Documents are IRM protected to meet HIPAA requirements. • The IRM policies are applied automatically, mapped to the permissions on that document library, thereby allowing the salespersons to focus on their expertise on just creating the response and not worrying about how/when to apply the policies. • You can see here in this document that it is protected with the Osteomyelitis Confidential template. • No risk of it leaking to unauthorized users, inside or outside the hospital system. • Note that the Office clients are RMS-enabled, allowing the policies to be enforced through these clients.

14. Manage Inpatient Care Activities Reviewing Inpatients with Care Team Connect with Experts for Support Rounding on Inpatients Access outside the Hospital • Now Dr Robbins is headed back to his office offsite and he wants to take the documents with him to read from at home tonight. He can easily take the library offline into Outlook. • Dr Robbins makes a decision to work with Professor Bryan as the infectious disease expert.. • He launches a Groove workspace from the “Groove McPherson Osteomyelitis Template.gsa file in Sharepoint.  Dr Robbins checks out the docs from the main library and puts them in another library, and syncs to that library for collaborating with Professor Bryan. • Dr Robbins synchronizes with SharePoint to automatically populate the space with the documents that he needs to share with the expert • We’ve already sent Professor Bryan the invitation to join the workspace, so let’s go see his view. He sees the same content, automatically synced, and he can add documents by dragging them in. • When we switch back to Dr Robbin’s desktop, we see how Groove automatically receives the added file • Finally, when Dr Robbins wants to sync back to SharePoint, he can click the Preview button to see what’s different. In this case, one doc is changed

15. Manage Inpatient Care Activities Reviewing Inpatients with Care Team Connect with Experts for Support Rounding on Inpatients Tracking Processes • Let’s go to the SharePoint site that hosts the McPherson Osteomyelitis Documents library we’ve been looking at • Contoso Hospital wanted to have a more formal process for tracking patient care, so they actually used the Project Tracking template to build this Care Management site. • This site template is one the 40 new WSS v3 SharePoint application templates.  While standard workspaces in Windows SharePoint Services are easy to implement, organizations seeking a more customized deployment can get started quickly with application templates for addressing specific business processes or sets of tasks.

16. Manage Inpatient Care Activities Reviewing Inpatients with Care Team Connect with Experts for Support Rounding on Inpatients Workflow based on WWF • In this example, the Status field drives our workflow. • Let me open SharePoint Designer. Now I’ll open the workflows folder and open the existing workflow, which opens in a wizard. Now, this workflow literally took 10 minutes to build. Let me show you what it does. • When I built this workflow, I specified the McPherson Osteomyelitis Documents library that we’ve been looking at, and SharePoint Designer automatically retrieved all the properties and column headings for that library so that when I go to create my workflow logic (click Next), I can literally just pick a field (like Content Type) from this drop down and then pick a value (like “Cost Breakdown”). • In this case, we simply want a nurse on the care team (this could be a dynamic value in the file as well) to get an email whenever any document that arrives in the library is based on certain criteria. This can all be dynamic, and the contents of the email can be dynamic as well, like providing a link to the document in the library. • If we switch back over to the spreadsheet document, you’ll see how we actually use the InfoPath-based information panel to set that metadata value. • And when I save the document back to the library, the workflow executes, and in 10 seconds or so I get an email.

17. Built on the Connected Healthcare Framework(CHF)

18. Connect with Experts for Support Reviewing Inpatients with Care Team Rounding on Inpatients Manage Inpatient Care Activities • Library: Less Structured set of files ( i.e word, JPEG) within WSSwhose document name populate the rows of a list • Lists: Structured Data within WSSColumns: Metadata such as: ContentType, Author, etcRows: info or values about a specidifc document (name=ContosoCostBreak.xls) • Conditions: Events (IFs) that trigger actions from WWF (Windows Workflow Foundation) • i.e ContentType=CostBreakdown • Action: Coordinated IT or human task i.e Send email, Approve proposal, Invoke a .Net Service • Workflow • The production of a desired outcome through a structured flow of people and IT Actions orchestrated by Events triggered by status change on Lists.