Welcome to Intermountain Healthcare Charles W. Sorenson, MD President and CEO

1. Welcome toIntermountain HealthcareCharles W. Sorenson, MDPresident and CEO

2. Intermountain Healthcare • Not-for-profit health system founded in 1975 • Governed by a voluntary board of trustees who represent the interests of the communities we serve • 23 hospitals in Utah, 1 in Idaho • Intermountain Medical Group • About 1000 Physicians • 145 Clinics • SelectHealth • Covers ~ 25% of commercially insured people in Utah • About 23,000 FTE’s

3. Intermountain Healthcare Board of Trustees, 1975 “Become a model healthcare system”

4. Our Mission • Excellence in the provision of healthcare services to communities in the Intermountain region.

5. Our VisionOur vision is to be a model healthcare system by continually learning and providing extraordinary care in all its dimensions: Clinical Excellence: We will deliver the best clinical care in a consistent, integrated way—always improving through innovation and evidence-based practice. Service Excellence: We will provide a compassionate healing experience that reflects the caring and noble nature of our work in every encounter with our patients, members, and guests. Physician Engagement: We honor the essential role of our physician colleagues and will create systems and processes that help them best serve their patients. Operational Effectiveness: We willbe wise and careful stewards of our resources to enable extraordinary care. We will maintainthe financial strength we need to meet our high standards of quality while providing the lowest sustainable cost to residents in our communities. Employee Engagement: We value our employees as our most important resource and will create a workplace that attracts and rewards caring and talented individuals. Community Stewardship: We are committed to serving the diverse needs of the young and old, rich and poor, and those living in urban and rural communities, with sensitivity to cultural differences. We work independently and with community partners to care for the underserved, and we provide generally available medical services to all residents in our service area, regardless of ability to pay.

6. Intermountain’s Core Business: Managing the Processes of Clinical Care • Appropriate care at the right time • Evidence-based whenever possible • Supported by efficient people and systems that allow us to provide care at the lowest appropriate cost to the community

7. Clinical Process Improvement Intermountain’s Clinical Programs • Women & Newborns • Cardiovascular • Primary Care • Oncology • Surgical Services • Pediatric Specialties • Intensive Medicine • Behavioral Health • Patient Safety

8. Clinical Process Improvement • Define key clinical processes • Accurately measure outcomes • Identify opportunities for improvement • Implement evidence-based best practices • Re-measure outcomes • Revise processes and goals

9. Engaging the Entire Team • At Intermountain, Clinical Goals lead the list of System Goals • The Board of Trustees holds leadership accountable for accomplishing these goals

10. “We have long known that some places, like Intermountain Healthcare in Utah… offer high-quality care at costs below average.” - President Obama “Intermountain is arguably the most productive single health system in the United States… and this is the result of a 40-year process.” - Newt Gingrich Pictures courtesy of: Zimbio.com and gingrichproductions.com

11. A Learning Organization: “When we accurately measure our performance, we find that we’re not as good as we think we are.”

12. Legacy of Electronic Clinical Information Systems • Pioneers in medical informatics • Largest data warehouse in the industry • Invaluable resource in improving clinical quality and reducing costs

13. A systems approach to healthcare not only improves quality, it reduces cost.

14. Percent Inductions < 39 Weeks

15. By Weeks Gestation at Time of Induction 2.0% 1.5% 1.0% 0.5% 0.0% Percent on Ventilator 39th Week 37th Week 38th Week Risk of Newborns on Ventilators

16. Percent Inductions < 39 Weeks Superior outcomes and $1 million saved in 2009

17. Newborn ICU Blood Transfusion Guidelines • Blood transfusions – life-saving therapy for babies in NICU • Benefits and risks to blood transfusions • NICU team reviewed national guidelines and research; established evidence-based guidelines for NICU transfusions • Ordering and tracking system

18. Newborn ICU Blood Transfusion Guidelines

19. Newborn ICU Blood Transfusion Guidelines 2009 Results • 984 fewer blood transfusions than in 2007-2008 • 200 NICU babies that would have gotten a transfusion did not • Decreased charges of $778,500 (blood components only) • No change in neonatal morbidity or mortality

20. Extending Best Practices to Operations • Supply Chain • Patient Registration and Application for Financial Assistance (FAIR) • Patient Flow through Hospital Units • Revenue Cycle • Staffing

21. Intermountain’s Vision of an Enterprise-wide Clinical Information System An intelligent EMR, not simply an electronic filing cabinet, but a repository of clinical knowledge and best practice pathways that are presented to the clinician in the course of documenting clinical workflow.  We believe that front line clinicians can only benefit from current clinical knowledge through a real-time electronic assistant that works with them as they provide care.

22. The Future of Clinical Information Systemsat Intermountain • 2005: Began work to take our systems to the next level: • Modern architecture (Service Oriented Architecture) • New programming languages and tools (Java, .NET, data bus, etc.) • New data structure for advanced decision support (Clinical Element Model) • New ideas to significantly decrease dependence on vendors and software developers and place innovation in the hands of the clinicians • Allow for knowledge sharing – a major key to real healthcare transformation • Partnership with GE has allowed for innovation and the vetting of ideas between other major organizations and countries around the world

23. The Future of Clinical Information Systemsat Intermountain "To raise new questions, new possibilities, to regard old problems from a new angle, requires creative imagination and marks real advance in science.“ — Albert Einstein