An Epic Update for IS/Epic Quarterly Staff Meeting April 1, 2011

1. An Epic Update for IS/Epic Quarterly Staff Meeting April 1, 2011

2. Our system vision Together, as people of Providence, we will answer the call of every person we serve: “Know me, care for me,ease my way.” One ministry committed to excellence

3. The goal We want … • Safer, more reliable care • A connected, compassionate experience for patients • Consistent workflows for caregivers • Streamlined administrative processes • Consistent, seamless, compassionate care

4. What is Epic? An integrated suite of health care software that supports all the functions related to patient care, including: • Registration and scheduling • Ambulatory and acute clinical systems • Ancillary systems for lab, pharmacy, radiology • Billing and financial information • Patient portals for medical record access

5. The power of Epic • All Epic applications leverage the same central database • Creates a single medical record for each patient across all care settings • Connects patient information between our clinics and hospitals

6. An integrated software system Epic and Non-Epic Users Everywhere • Personal health records and portals • Clinical • Ambulatory • Inpatient • Departmental, specialty and ancillary services • Health information management • Access • Revenue • Reporting and analytics • Enterprise systems Patients On-the-go Providence Hospitals Patients At Home Community Physicians Physicians On-the-go Providence Medical Group

7. We are doing this together This is a Providence wide implementation, involving all four of our regions: • Allowing us to share information across Providence in new ways • Spread knowledge faster for the benefit of our patients • Speak the same language and use common metrics To improve health outcomes and the patient experience

8. What this means • We must have Providence wide agreement on administrative and clinical standards and workflows • We will need input from people across Providence, both clinicians and business operations experts We will implement best practices

9. Guiding principles • We will center our work on the patient to ensure positive quality outcomes and a compassionate patient experience. • We will work together as one ministry committed to excellence as we engage in this Mission-critical systemwide effort. • We will value simplicity as we strive for “good” and not “perfect.”

10. Guiding principles • We will reduce unnecessary clinical and administrative variation. • We will ensure that decisions affecting clinical care will be made by clinicians. • We will set realistic schedules and will resource this initiative appropriately. • We will make project decisions respecting both excellence and stewardship.

11. Epic phases Phase 3: Localized build, testing and end-user training Phase 4: Go live, support and stabilization Phase 5: Rollout Phase 0-1: Foundation, planning and team training Phase 2: Collaborative build, validation and adoption GO LIVE Integrated testing conducted Super users, managers, and end users trained Go live readiness assessed Go live planning and dress rehearsal completed Help desk resources and support procedures prepared Post live review and user proficiency assessed Transition to long-term support model initiated Preparation for rollout underway Ongoing measurement of benefits realization conducted Rollout planning, engagement and training Networks and hardware prepared Additional build and testing conducted Dress rehearsals completed Go live support, transition to support and optimization with each site provided Guiding principles and scope defined Current workflows and needs discussed Model system adapted Project team formed; roles and accountability defined Project team certified Interfaces designed Integrated validation sessions conducted Additional design and build completed Workflows approved Master filed data gathered and loaded Training plan and materials created Super users and training staff identified

12. Building Epic together Three key tasks: • Clinical content development • Collaborative workflow validation and build process • Third-party vendor and scope discernments

13. Providence model system

14. Roles Champions and Readiness Owners • Physician • Other clinical • Non-clinical Subject matter experts • Physician • Other clinical • Access and revenue Informatics Super users and trainers

15. Oregon Region Champions • 37 Physicians in 24 specialties • Nursing • Med/Surg, ED, Surgical Services, Critical Care, L&D,/PP, Newborn, Pediatrics, Behavioral Health, Informatics • Other disciplines: • Lab, Rehab, Pharmacy, Respiratory Therapy, Nutrition Services, Diagnostic Imaging, Spiritual Care, Care/Case Management • Readiness Owners • Access/Scheduling • Revenue Cycle

16. Clinical guidance

17. Clinical Advisory Council CAT Teams Work Groups Collaborative Build Safe Medication Formulary Workgroup Interdisciplinary Content Review Workgroup 32 specialty Clinical Advancement Teams Review Teams Physician Content Review Workgroup Review Teams Clinical Decision Support Workgroup Review Teams Clinical ROI Workgroup

18. CAT Teams

19. A “mountain” of experts Translates clinical input from many subject matter experts Clinical Advancement Teams This is where the real work is: How will we engage the rest of the organization? We will use existing structures and relationships, only creating new ones where necessary. We will “cast a wide net” for feedback. Regional and Ministry Review

20. Resource Councils Casting a wide net • CAT Team • Local Clinicians • Service LineGroups

21. Oregon participants by CAT

22. Clinical guidance

23. Collaborative build goals • Incorporate the best clinical, revenue and operational practices • Reduce unnecessary variation in patient care across system • Increase ability to leverage reporting and outcomes across Providence • Minimize long-term maintenance and costs

24. Collaborative build schedule

25. Workflow Demo

26. Decision Points

27. Voting Green: This looks good. Yellow: The workflow has a few issues but I could live with this. It could work. Red: I can’t move forward with this.

28. Sequencing = Go live Physician ARRA Hospital ARRA ICD10 Systemwide Project planning, staffing, governance Clinical content Build Alaska 1st clinic 1st hospital California 1st clinic Oregon 1st PMG clinic Local build, testing and training PSVMC PPMC and PMH PWFMC, PNMC, PSH PHRMH PMMC Wash./Mont. 1st clinic 1st hospital