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One Size Fits All? Enterprise vs. Best of Breed Systems

One Size Fits All? Enterprise vs. Best of Breed Systems. Chief Medical Information Officer Caritas Christi Health Care System Attending Emergency Physician St. Elizabeth’s Medical Center, Boston Co-chair, Emergency Care Special Interest Group Health Level 7

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One Size Fits All? Enterprise vs. Best of Breed Systems

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  1. One Size Fits All?Enterprise vs. Best of Breed Systems Chief Medical Information Officer Caritas Christi Health Care System Attending Emergency Physician St. Elizabeth’s Medical Center, Boston Co-chair, Emergency Care Special Interest Group Health Level 7 Co-chair, Emergency Care Special Interest Group Health Level 7 Todd Rothenhaus, MD FACEP

  2. EDIS Evaluation and Selection }

  3. Hospital Vendor Strategies Single vendor strategy Core vendor strategy Best of Suite Best of Cluster Best of Breed 165 systems  less than 100

  4. Vendor Selection • Selection process is a collaborative process • ED is better at determining: • How system will integrate with workflow • Impact on efficiency and flow • Potential Revenue increase • IT is better at determining: • Vendor health • System design and maintainability • Long term costs • Neither is perfect at predicting ROI • Consider consultancy to help with selection • Listen to each other

  5. ROI and TCO • Clinical documentation  charge capture • Patient throughput and LWOBS • Be wary of huge claims • Initial Capital expense • Implementation costs • Local expertise • Consultancy

  6. The ED’s Place in the HIS Queue CPOE Clinical Applications Nursing Doc eMAR Order Entry (Clerical) Document Management Scanning EMR (Results Reporting) Core Applications Radiology Information System Pathology Pharmacy Lab Billing/ Accounts Receivable Scheduling Registration/ Admissions General Finance Materials Management

  7. “It won’t be integrated” • Common myth • Self fulfilling prophecy • “Lack of integration” = duplicate data entry • Amount of critical legacy data in HIS • Pharmacy • Order Entry

  8. The Three “I”s • Integration – “desirable state of affairs where information flows between systems” • Interfaces – “a mechanism to achieve integration” • Interoperability – “the ability of a systems exchange data”

  9. Integration HIS System Or CDR Registration EDIS Physicians Offices Radiology Results Hospital Pharmacy Lab Results

  10. Integration RHIO EMS HIS System Or CDR Registration EDIS Physicians Offices Radiology Results Hospital Pharmacy Lab Results

  11. Other Considerations • Customization • Time to deployment • “Easy win” – “small” project • Non-integrated, single vendor

  12. Answers vs. Solutions • No perfect answer • Pilot HIS Tracking Module • Consider “plug in” Physician Clinical Documentation Product with ADT and Inbound Labs

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