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Implementing EHR in Health Care May 30, 2012

Implementing EHR in Health Care May 30, 2012. Tim Thompson Sr. Vice President & CIO. Title : Senior Vice President and CIO

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Implementing EHR in Health Care May 30, 2012

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  1. Implementing EHR in Health CareMay 30, 2012 Tim Thompson Sr. Vice President & CIO

  2. Title:Senior Vice President and CIO Bio: Tim Thompson currently serves as Senior Vice President and Chief Information Officer for BayCare Health System (BayCare) in Clearwater, Florida. His responsibilities include leadership of the technology planning and operations for the system-wide Information Services operation. Mr. Thompson has over 30 years of experience in health care administration and information technology. Prior to joining BayCare in 2010, he most recently served as Senior Vice President and Chief Information Officer for The Methodist Hospital System in Houston, Texas. Prior to working at Methodist, Tim was the CIO and Senior Vice President at both Adventist Health System in Orlando and Palmetto Health in Columbia, South Carolina. In addition he held senior management positions at The Cleveland Clinic, Dynamic Healthcare Technologies, Inc., and Proctor Healthcare Incorporated. Tim earned a bachelor’s degree in management from the University of Illinois. He is a member of the College of Healthcare Management Executives (CHIME) and Healthcare Information and Management System Society (HIMSS).

  3. Why are Hospitals Implementing Electronic Health Record (EHR) Systems?

  4. Federal EHR Strategy • President Bush’s goal in 2004 • “… an Electronic Health Record for every American by the year 2014. By computerizing health records, we can avoid dangerous medical mistakes, reduce costs, and improve care.” State of the Union address, Jan. 20, 2004 • President Barack Obama announces an audacious plan • “Computerize all health records within five years.” - during a speech at George Mason University on January 12, 2009 • February 17, 2009 – the American Reinvestment and Recovery Act (ARRA – Stimulus Bill) is signed into law • HITECH component of ARRA provides a $19B incentive program to stimulate the adoption and use of HIT, especially EHR’s • Dr. David Blumenthal appointed the new National Coordinator

  5. Meaningful Use Overview • WHAT is Meaningful Use? • Meaningful Use (MU) means providers must demonstrate they are using certifiedElectronic Health Record (EHR) technologyin ways that can be measured significantly in quality and in quantity • Achieving MU determines whether an organization will receive payments from the Federal government under the Medicare EHR Incentive Program, Medicaid EHR Incentive Program, or both

  6. Defining Meaningful Use (MU) • In a health information technology (HIT) context, there are three main components of Meaningful Use: • The use of a certified EHR in a meaningful manner, such as e-Prescribing • The use of certified EHR technology for electronic exchange of health information to improve quality and coordination of health care • The use of certified EHR technology to submit Clinical Quality and other measures • Achieving Meaningful Use determines whether an organization will receive payments from the federal government under either the Medicare EHR Incentive Program or the Medicaid EHR Incentive Program or both. 6

  7. Meaningful Use Overview, continued The REAL Bottom Line … • WHY is Meaningful Use (MU) so Important to Our Patients? • Improves the quality, safety, efficiency, and coordination of patient care • Provides patients and their families with timely access to data, knowledge, and tools to make informed decisions and to manage their health across the care continuum • Ensures privacy and security protections for confidential medical information • Enables patients to promptly access their own Personal Health Information (PHI)

  8. BayCare EHR Implementation Strategy

  9. BayCare BEACON • 7-Year $236M Clinical Transformation Project • The vehicle BayCare is using to drive toward practicing to a clinical standard • It is not only driving clinical practice change enabled by technology, but also driving evidenced-based standardization

  10. BayCare BEACON EMR Journey HomeHealth Future Phase III Cardiology Oncology Phase II Skilled Nursing ASC BehavioralHealth Phase I Closed-LoopMed Admin E-Prescribing Women’sHealth Internal HIE Pre-Phase I ED CPOE &Phys Doc Anesthesia Inpatient CPOE CarePlans Physician Doc ClinicalDoc Orders NursingDoc DeviceIntegration Real-timeDecision Support Evidence-based Practice Hospital-based SNF Therapies(RT, PT, OT, Speech, Rehab) eMAR CriticalCare eSig ResultsViewing Surgery HIM Pharmacy Lab Scheduling PhysicianPortal RAD PACs Dictation Demo-graphic ClinicalScanning ED TriageTracking Foundational Applications (Financial, Materials and Clinical) “High-Availability” Infrastructure and Skills 10

  11. BEACON Timeline 2008 2013 2009 2010 2011 2012 April SAH June NBH July MPH Aug MH Sep SFB Oct SJ Phase I Go-Live Phase II Design/Build MPNB Current State Phase II Rollout SJHN Future State Phase III Design/Build Proof of Concept Build & Validation Integration Testing Phase III Rollout Build & Validate Training Phase 1 - 19 Months Design and Build Phase 3 - 14 Months Design and Build Phase 2 - 24 Months Design and Build Upgrade 11

  12. Phase II Roll-Out Schedule 2009 2010 2011 2012 Oct Feb May Aug Aug * Oct Feb April June Clin. Doc. with ED CPOE, eMAR,Orders, Messaging Inbox to sign orders ED Physician Documentation* FirstNet at SJH, SJC, SJW BEACON InnovationPowerPlans & Problem Lists 12

  13. BEACON Phase III Activation Schedule SJHN PCM Jan 2012 MCH PCM Jul 2012 SFB PCM SJW PCM Mar 2012 May 2012 MPH PCM Sep 2012 SJH, SJC, SJW SJHN SFB MPH MCH, MDH MPNB SAH Jan 2012 Mar 2012 Oct 2012 Jun 2012 Aug 2012 Jan 2013 Apr 2013 2012 Q1 2012 Q2 Q3 Q4 Q1 2013 Q2 2013 Today Phase III includes: Inpatient Computerized Provider Order Entry (CPOE), PowerNote Documentation for Inpatient Physician’s with Dragon, Computerized Anesthesia Documentation, Interdisciplinary Plans of Care (IPOC), Quality Plans (Lighthouse), Stage I Meaningful Use Readiness, and PowerChart Maternity with FetaLink (PCM) PowerChart Maternity (PCM) Go-Lives 13

  14. BEACON Implementation Methodology • Clinical transformation is at the core of the entire project • It’s all about adoption • Early involvement by senior leadership in making key strategic design decisions is critical 14

  15. BEACON Methodology 15

  16. The Importance Of Decision Making HighLevelDecisions Clinical Systems Steering Committee (CSSC) MajorImpact What will be done? Who will do it? ~ 10% of decisions Clinical Standards Committee (CSC) Physician Advisory Council (PACo) ModerateImpact Mid Level Decisions How will it be done? ~ 25% of decisions Subject Matter Experts (SME) Less Impact Detailed Decisions Design the details ~ 65% of decisions 16

  17. Phase II BEACON Day 1 – Decisions Summary Executives Voting on Key Decisions 17

  18. Phase I BEACON Day 1- Decisions Summary 18

  19. Phase II BEACON Day 1- Decisions Summary 19

  20. Phase III BEACON Day 1- Decisions Summary 20

  21. Approach • Communications • BEACON Communications will deliver simple specific targeted messages early and often and through various mediums • Improve peer-to-peer communication using SuperUsers, SMEs and Physician Informaticists to deliver messages • Change Management / Adoption • Show organization that BEACON was designed, built, and validated by clinicians and physicians • Conduct standardization assessments at local level and change readiness surveys • Training • 75% of BEACON solution training will be web-based, available online or facilitated in a classroom setting • 25% of BEACON solution training will be “Day in the Life” classroom training, focusing on role based technology enabled process 21

  22. Workflow Localization – What is it? A disciplined and structured approach to standardizing the future state workflows and facilitating change management throughout the organization • Workflow Localization assists each facility in creating a strategy for implementing critical clinical and operational workflows • Workflow Localization assists in evaluating BEACON future state processes and driving necessary practice change to support BEACON best practices 22

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  24. Ways We Communicate Videos of team members Videos of team members • One-on-one Training through FBEs, Trainers, Change Management, Readiness Rounds, etc • http://www.baycare.org/BEACON Leadership e-mails Leadership e-mails E-Newsletters E-Newsletters Web sites (intranet and internet) Web sites (intranet and internet) Bulletin board flyers Bulletin board flyers Meetings Meetings Hospital Signage PowerPoint presentations Hospital Signage PowerPoint presentations Leadership voicemails Leadership voicemails 24

  25. Effective Process-Oriented Governance Structures 25

  26. Project Governance 26

  27. Questions and Discussion 27

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