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2008 VA HIMSS Annual Conference October 14, 2008 Informatics Corporation of America- Proprietary and Confidential Information

Bassett Healthcare Case Study: Using Leading Edge Technology to Drive an Evidence-Based Vision for Care

Questions to address… • Who are we? • What are our challenges? • How are we meeting these challenges? • Solution • Approach • What have we accomplished? • What have we learned? • Any additional questions…

ICA Heritage Vanderbilt Medical Center • Documented SuccessClinical tools and processes incorporating evidence-based and patient-centric practices • Proven Approach Physician focused and directed project; cornerstone of 15 year clinical evolution; 4 hospitals, 120 clinics • New Generation of Technology Support patient care across all treatment settings Current clients span 25 hospitals and over 50 treatment settings providing clinical interoperability solutions for a wide range of community-based solutions.

ONE PHYSICIAN’S IMPERATIVE: Bassett Healthcare

Bassett Healthcare 2008 • 4 hospitals • 23 Outpatient Health Centers • 14 School-Based Health Centers • 300+ Providers • 9 Counties • 5000+ Sq. Mile Area • 650K+ Patient Encounters • An integrated healthcare network covering a full spectrum of specialties and treatment settings

Evidence-based Bassett (ebB) Vision Easy access to complete patient information – anytime, anyplace Seamlessly incorporate findings and associated evidence at the point of care ebB Efficient and effective means for acting on information within clinical workflow Enhanced ability to find, measure and report on care patterns across treatment settings

Broad Spectrum of Care • Patients receive care across multiple treatment settings, across a broad geography. • Many clinicians provide care in multiple locations. • Core services – lab, radiology, HIM, etc. are shared across the network.

Multiple Systems & Modes Silos of core HIS, ancillary systems and paper throughout the enterprise

Ever feel that trying to integrate all of your systems for all facilities might be like trying to unite the languages and ethnicities of the BALKANS? The Balkans = = [Rexova, K., Frynta, D. & Zrzavy, J. “Cladistic analysis of languages: Indo-European classification based on lexicostatistical data.” Cladistics 19, 120–127 (2003)]

Impact on Clinicians…

What Causes More Threads? • Systems are often rigid, and not customizable enough • Motives are often more complex than physician ease of use – finance, compliance, etc. • Often times workflow must change to meet technology rather than technology serving the workflow

Solution Guiding Principles • Must be physician focused -> Make Quality Easy • System must be customizable in real time to allow iterative improvement • Must focus first on improving patient care • Minimizes time to value & fosters an environment of continuous improvement

Solution Found Collaboration/Partnership

The ICA Solution SuitePhysician Designed Software Solutions For Better Patient Care Informatics Corporation of America- Proprietary and Confidential Information

How does it work? Aggregated access to complete patient information Informatics Corporation of America- Proprietary and Confidential Information

How does it work? Secure, streamlined communication across the enterprise Informatics Corporation of America- Proprietary and Confidential Information

How does it work? Ability to easily capture clinical information either within the tool or integrated through source systems Informatics Corporation of America- Proprietary and Confidential Information

How does it work? Ability to track, measure and apply clinical metrics at the point of care Informatics Corporation of America- Proprietary and Confidential Information

What does the solution look like?

How did we implement? Make quality easy Logical phasing allowed us to achieve value quickly and continually build value over time. Phase IV: ebB across the enterprise Phase III: Easy to incorporate evidence Phase II: Easy to act on data Cultural Energy Perceived Value Phase I: Easy to access all data Threshold of Intolerable Pain Time

Our accomplishments to date • Complete patient information easily accessible across the enterprise • Rapid deployment: 6 week rollout across 200+ providers • Fast physician adoption: Most were able to productively use the system the 1st day with no clinic time lost

Our accomplishments to date • Improved physician satisfaction • Physicians are able to go home earlier • Traveling physicians are able to stay productive and responsive regardless of location • Improved patient satisfaction • Patient knowledge is maintained across treatment settings • 99+% of patient requests to clinics resolved within 24 hours

Our accomplishments to date • Better utilization of data across the enterprise • Consistent patient summaries across the enterprise • Aggregated patient data feeding into research efforts • Developing disease specific dashboards to leverage research and associated evidence at the point of care

And Most Recently (June 2nd, 2008)…

Oh, and guess what? Gulliver is free!

What have we learned? • Comprehensive information, easily accessible at the point of care is fundamental • Complete chart information • Communication and alerts • Key metrics • Identifying and addressing clinical inefficiencies across the enterprise is important to maintain momentum

What have we learned? • Initial phases should focus on establishing a strong solution and cultural foundation • Focus first on information • Get quick wins across as wide a user base as possible • Ensure that clinicians are involved in all aspects of the solution • Solution design • Establishing and propagating best practices across the enterprise

Informatics Corporation of America- Proprietary and Confidential Information

Informatics Corporation of America- Proprietary and Confidential Information