Agenda

1. Agenda • Clinical Data Repository • Key benefits • Brief introduction • CPOE • Key benefits of CPOE • Ordering process foundational design • Discharge process • PowerNote • Key benefits • Brief Introduction • Design and supporting process design activity • Data collection / design decision making tools and methods • Next steps

2. Clinical Data Repository

3. Key Benefits – Clinical Data Repository • Improved patient outcomes • Real-time access to cross-disciplinary patient results and information supports timely clinician decision-making and health planning, promoting optimum patient outcome • Optimized workflow efficiency and performance • Access to person/patient records from any location at any time and by multiple users decreases workflow bottlenecks

4. Clinical Data Repository • Framework • Electronic Medical Record framework includes patient lists, URL Links and access to the patient’s electronic chart

5. Clinical Data Repository • Message Center & Electronic Signature • Message Center provides immediate access to information such as new laboratory or radiology results, orders for cosign, documents for review and notifications.

6. Clinical Data Repository • Patient Chart • Table of contents allows navigation within the patient chart and provides access to patient demographic information, reference information, documentation and results viewing

7. Clinical Data Repository • Inpatient Summary MPage Ability to customize view of MPage

8. Clinical Data Repository • Inpatient Summary MPage Place orders from your favorites list directly from the MPage

9. Clinical Data Repository • Results Review • Flowsheet view provides real-time display of documented laboratory, radiology and patient care results

10. Computerized Provider Order Entry (CPOE)

11. Key Benefits – CPOE • Enhanced Patient Safety and Quality • Quality of care is improved through robust point-of-care decision support that provides clinical alerts for potential negative events, conflicts or reminders for wellness-oriented procedures, such as smoking cessation. • Improved standardization and regulatory compliance • Access at the point of ordering to various types of information, such as order sets incorporating evidence-based clinical protocols and best practice care management guidelines, policies, and patient education materials leads to improved compliance with standards. • Increased efficiency • Paper-based problems are eliminated, including illegibility, communication breakdowns, incomplete information and time delays. • Efficient order entry is made possible through client-defined order sets • Redundant or duplicate orders are reduced with a single facility-wide system. • Lengths of stay are reduced due to the elimination of errors.

12. – Computerized Provider Order CPOE • Ordering Process Foundational Design – General Ordering • PowerOrders - used to place orders on patients, as well to charge for bill only items in the office/clinic or inpatient setting.

13. CPOE • Ordering Process Foundational Design – Order Catalog • Alternate Synonyms • Physician input is required to approve alternate naming conventions that facilitate the search and selection of order items. • Example: A specific lab can be ordered by selecting Electrolyte Panel or Lytes

14. CPOE • Ordering Process Foundational Design – Order Sentences • Order Sentences • Order sentences allow one click selection of multiple details to facilitate order entry

15. CPOE • Ordering Process Foundational Design – Order Folders • Quick Order Folders - utilized to facilitate order search and selection • Defined at the position level • Users can define a “Home” folder • Clicking on a folder reveals the sub folder or orders that have been associated. • Users also have the ability to define their own Favorites folders for frequently selected items.

16. CPOE CPOE • Diagnosis Association - PowerOrders™ allows the provider the ability to associate a diagnosis to an order during the order entry process. • Previously documented diagnoses display in the Diagnosis Association window • Provider can add diagnoses if needed • Provider can convert existing problems to diagnoses

17. CPOE • Prescription Writer • Allows the provider to enter prescription orders via the same order entry mechanism as inpatient orders

18. CPOE • Order Sets • Collections of orders that allow the ability to plan and coordinate care in the acute care environment

19. CPOE • Order Sets • Orders grouped by clinical category and can be included or excluded by default.

20. CPOE • Order Set Favorites • Users have the ability to save an order set as a personal favorite with any changes they have made

21. CPOE • Medication Reconciliation • Admission, Transfer, and Discharge • Provides a clear before and after picture of a patient's medications.

22. CPOE • Discharge Process -- Hospital Wide Discharge • User friendly window used to allow clinicians easy access to different “action items” that need to be completed prior to departing the patient • Examples: Diagnosis, Patient education materials, Prescriptions, Nursing documentation and Medication reconciliation • Clinical and Patient Summaries that can be printed from the depart window

23. Discharge Process Generate electronic copy of Patient Summary on patient’s request

24. Discharge Readiness MPage • Better manage the discharge process and provide visibility to key discharge indicators • Goals: • Provide visibility to discharge readiness across a patient population • Quickly identify and resolve barriers to discharge • Improve clinician’s experience with a new user interface • Does not yet replace existing depart process – minimize need to use it

25. Discharge Readiness Dashboard

26. Discharge Summary

27. CPOE • Order Set Design and Supporting Process Design Activity • Design events related to the following content/processes: • Order Sets • Medication Reconciliation • Depart Process • Prescription Writing • Messaging • Institutional Standards – policy, procedures and bylaws effected by CPOE process

28. PowerNote

29. Key Benefits – PowerNote (Inpatient) • Increased consistency and documentation accuracy • Accuracy, completeness, and consistency in care documentation are promoted through the use of standard outlines, while the configuration feature supports institution or locale-specific standards. • Improved standardization • Patient care can be improved and care processes can be standardized as users are presented with options consistent with best clinical practices. • Decreased expenses • Expenses are reduced as the need for transcription and dictation management is reduced.

30. PowerNote (Inpatient) • Inpatient Physician Documentation • Automates the creation of a clinical note relating to care delivery in the patient care setting. PowerNote is Cerner’s tool for structured physician documentation

31. PowerNote • PowerNote (Physician Documentation) • Structured point-and-click documentation based on disease, condition, and process

32. PowerNote • All Care Designs include Patient Health Status/Summary Profile documentation and viewing as configured above for Medications (for history), Allergies, and Problems

33. PowerNote • All Care Designs include Auto Population • Populates commonly included elements into the Note

34. PowerNote

35. PowerNote • Ability to create macros, pre-completed/favorites notes • Ability to create Macros at the Paragraph, Sentence, or Term Level • Macro indicators and expand/collapse indicators to quickly maneuver through the note

36. Integrated Histories Components

37. Integrated Histories Components

38. Integrated Histories Components cont.

39. PowerNote • Ability to launch Modal Order Entry Window (orders/prescriptions), patient education/follow up, and discharge diagnosis

40. PowerNote • Depending on complaint, applicable pre-loaded digital drawings included • Additional drawings can be added on the fly

41. PowerNote • PowerNote Design and Supporting Process Design Activity • Design events related to the following content/processes: • Personalized design • Governance Structure - roles and responsibilities defined for the development and approval of PowerNotes • Messaging Process – designing messaging in relation to the documentation and communication processes • PowerNote Design Activity – reviewing 10 PowerNotes for content, macro development and template development. The remainder of PowerNotes will be reviewed by the Client with oversight • Institutional Standards - guidance for reviewing the policies, procedures and by-laws effected by physician documentation