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This document addresses the need for standardization of the Essentris system across all Military Health System (MHS) facilities and outlines a proposed SCR management process. The current lack of enterprise-level coordination, configuration management, and data sharing challenges are highlighted, along with recommendations for establishing a standardized Essentris baseline, normalizing data elements, and incorporating standardization into existing MHS processes. The proposed SCR management process focuses on notification, change identification, evaluation, and system change request prioritization. The document also suggests forming an Inpatient Standardization Work Group to drive Essentris standardization efforts and ensure effective sustainment at all MHS facilities.
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Essentris Collaboration Mtg Essentris SCR Management Information Brief, 11 Feb 2009 LTC Caterina Lasome, Chief, Inpatient Requirements Gregory Grant, Senior System Analyst Diane Struck, Senior System Analyst
Problem Statement • Essentris is not managed nor treated as an enterprise entity at the MHS level • Inpatient care historically treated as a local vs. enterprise process • Essentris very tailorable and supportive of local business practices • Enterprise-level standardization not previously an issue • Inability to seamlessly share data, eliminate redundancies, leverage economies of scale for procurement/deployment/training • Essentris is not universally implemented across MHS MTFs that provide inpatient services • Sustainment managed by both the MHS (DHIMS) and respective MTF • Roles and responsibilities for future planned deployments and ongoing support are not formally documented and agreed to by all affected parties • Configuration management managed by each MTF directly with vendor • Rapid, planned expansion for Essentris is underway without an adequate resourcing, sustainment, and configuration management plan to support the effort • The MHS and each Service are independently developing deployment plans to additional sites
Proposed Essentris Standardization Plan • Establish a standardized Essentris baseline at all MHS MTFs • Normalize the Essentris data elements • Standardize data elements of select Essentris notes (H&P, Op Report, Consultation, Discharge Plan) • Develop and implement an MHS configuration management process • Leverage and consolidate DoD interactions via a formal MHS policy • Incorporate Essentris standardization into existing MHS EHR activities, structure, and processes
Proposed SCR Management Process Part 1 Part 2 Part 3 Part 4
Proposed SCR Management Process – part 1 Who notifies the submitter here? Or– a DBI change is being requested.
Proposed SCR Management Process – part 2 Has the been identified, or is it left to the Services to decide?
Evaluate requests for additions and changes to the MHS Essentris baseline database elements. Maintain and recommend changes to a specific list of standard notes that will be provided to each site at the time of Essentris deployment so that the site does not have to “re-invent the wheel”. Gather and maintain a description of lessons learned from previous and ongoing Essentris deployments. Standardize database elements on four Essentris clinical note types: History and Physical, Discharge Summary, Operative Reports, and Consultations. Identify policy needs and draft policy recommendations that will be needed to support both Service and MHS business processes as a consolidated MHS sustainment project. Identify resource requirements for the continued sustainment of the MHS Essentris baseline at all sites Review, approve and prioritize Essentris system change requests. Proposed Inpatient Standardization Work Group Objectives
Recommendations (in priority order) • CPSC to charter an Inpatient Standardization Work Group (ISWG) to address Essentris standardization issues across the enterprise • CPSC to establish MHS policy on use of Essentris • Fully resource the MHS-led project management team to implement and support sustainment of Essentris at currently deployed sites as well as future planned site deployments This will still be the EHRAB for the Navy.
