How Content360 Solutions Helped Achieve HIMSS Stage 7

1. How Content360 Solutions Helped Achieve HIMSS Stage 7 Jason Bickford HIMS Applications Director

2. “We exist to make a difference in people’s lives through excellent patient care” • 7 states / 23 Hospitals • 4,330+ Beds • 35,000+ employees • 9,000 employed physicians • 55 bed simulation medical center

3. HIMSS Analytics • Developed EMR Adoption Model in 2005. • Stage 7 represents an advanced patient record environment. • 121 stage 7 US Hospitals. • Final evaluation of Stage 7 status is conducted via an on-site visit

4. HIMSS Analytics – Stage 7 NO PAPER CHARTS: The hospital no longer uses paper charts to deliver and manage patient care and has a mixture of discrete data, document images, and medical images within its EMR environment. ANALYTICS: Data warehousing is being used to analyze patterns of clinical data to improve quality of care and patient safety and care delivery efficiency. DATA SHARING: Clinical information can be readily shared via standardized electronic transactions (i.e. CCD) with all entities that are authorized to treat the patient, or a health information exchange (i.e., other non-associated hospitals, ambulatory clinics, sub-acute environments, employers, payers and patients in a data sharing environment). DATA COTINUITY: The hospital demonstrates summary data continuity for all hospital services (e.g. inpatient, outpatient, ED, and with any owned or managed ambulatory clinics).

5. Why HIMSS believes Stage 7 Organizations are Successful • An enterprise that uses data to drive improved outcomes related to: • Process, Financial, Clinical, Quality & Safety • A paperless, or near paperless, organization  • All clinically relevant data is in the EMR • An enterprise fully committed to continuous process improvement through collaboration • Strong IT leadership and executive champions • Clinician/end-user champions • An organization that has embraced their technology supplier as a partner

6. The Goal • Requirements for Stage 7 on paper documents • Clinically Relevant Documentation:  24 hours of creation of the document to be scanned into the EMR, for any medications, we expect those to be entered into the MAR before a patient is moved to the next unit of care. • Non-clinically relevant documentation: 72 hours after discharge is acceptable.

7. The Process • HIMSS Analytics surveyors conducted an on-site review of Banner’s EMR technologies at Banner Good Samaritan Medical Center located in Phoenix. • Suggested HIMSS Analytics Stage 7 Review Agenda: • Determine if coding staff requires paper for any paper/scanned documents that they must review. • Evaluate all documents being scanned to ensure they are being scanned in a timely fashion (critical information should be scanned ASAP, less critical information within 72 hours) and that no required electronic documentation is still on paper. • Evaluate dictation/transcription procedures for turn-around times relative to patient care impacts • Determine if floor space has been recovered from the removal of paper charts

8. The Test

9. The Solution: Content360 Document Imaging • Batch Capture: Complete capture within 24 hours • Frequent small batch scanning using Kofax • 2005 Beginnings at Banner Estrella • Distributed point of service scanning for near real-time capture • 2007-2011: Phased model approach: PFS, LABS, & Clinical/CPOE • Hourly scanning and twice daily HIMS rounding • Single Document Capture: Real-time Capture • Direct scanning into Cerner applications • Real-time capture within the workflow: Horizon Labs, Drivers License, Insurance Cards, and ROI Authorization.

10. Content360 Reports Management at Banner • COLD feeds • Phillips EKG PDF • AGFA Echocardiogram PDF • ProVation Endoscopy PDF

11. Content360 Forms Management at Banner Conent360 eForms Previous Forms Storage

12. Content360 Patient eSignature at Banner PFS eSignature

13. Content360 Benefits • Content360 solutions provide sophisticated document capture, storage • and retrieval — connecting users with relevant documentation within their daily • workflows. • Patient care and organizational performance are optimized by easy access to complete and usable electronic records. • Patients can sign electronic documents with a handwritten signature on a signature pad or tablet. • HIM staff can scan large volumes of paper in batches, flag and automatically route images for physician signature, and send coders home with remote access to images. • Physicians can electronically sign document images in the same application they sign transcribed documents and electronic orders.

14. HIMSS Stage 7 – Lessons Learned • Cultural Change • Strong leadership and communication • Training and ongoing support of both staff and leadership are essential • Perception and Diminish Individual Autonomy • Evidence based best practices • Work Flow Redesign • Rapid-cycle work redesign • Decision making includes participation of all stakeholders and functional area experts

15. Continued Partnership • Banner/Kofax/Cerner Content360 visioning session – March 2013 • Cerner/Banner Health Strategic Roadmap Session – August 2013 How Banner defines innovation: "Innovation at Banner is defined as the rapid identification and deployment of strategies leveraging Banner’s operating model and the science of care delivery to ensure an extraordinary patient experience, which is safe, efficient and effective."

16. QUESTIONS?

17. Visit the Enterprise Document Management pod within the Imaging Zone.