OTTR & The Transplant Business

1. OTTR & The Transplant Business

2. Objectives • Introduction • Change management and institutional buy in • Go live • Beyond the basics • Future plans • Lessons learned

3. Miami Transplant Institute (MTI) • Joint venture between University of Miami Miller School of Medicine and Jackson Memorial Hospital • Surgeons and Medical doctors are University of Miami • Program resides within JMH • Sister Liver transplant program at Broward General

4. Scenario

6. The Early Stages • Transplant leadership commitment • 5 year process • Profitability analysis • Foundation Grant • Site visits • Strategic Plan • Enterprise Leadership Buy-in • 3 EMR (Cerner Jackson, Cerner Broward, Epic UM) • CIO, CMIO, CSIO & Lab Director • Data Sharing Agreement • Staff • Communication • Education

8. OTTR • Major goal for 2014 and beyond • All employees required to learn how to use and to adapt new work flows • Do not be afraid to ask questions and make suggestions • The system is only as good as we make it • Significant support for staff to learn OTTR • OTTR 101 – required • Lunch and learn sessions – employee suggestions welcome • Additional training on request – small or large groups • Tutorial and manuals

9. Go-Live • May 2nd, 2013 • 6 Organs,10 Modules – Adult and Pediatric • 25 Interfaces • 100 User Licenses • 450 fields of data conversion • 80 hours of staff training • 774 hours of customizations and configurations

11. History • MTI OTTR Go Live, May 2, 2013 • 6 Organs,10 Modules – Adult and Pediatric

12. The Next Stage • Commitment to change and success • You OTTR Know • Hardware and Network infrastructure upgrade • Mirror workflows in OTTR • Integration beyond interfaces • Dictionaries (Referring physician, Medications, Diagnosis, Dialysis, Pharmacies) • The paperless chart, scanning • Physician Daily Note • Web Portal • UNet Interface • Online referral • Business development

13. ??? • The stakeholders • MTI • Jackson Memorial Hospital • University of Miami • Broward General • 5 years and a strategic plan latter • There is consensus… • we need a new database, we have funding, how do we get to go-live?

14. The Next Stage • Commitment to change and success • You OTTR Know • Hardware and Network infrastructure upgrade • Mirror workflows in OTTR • Integration beyond interfaces • Dictionaries (Referring physician, Medications, Diagnosis, Dialysis, Pharmacies) • The paperless chart, scanning • Physician Daily Note • Web Portal • UNet Interface • Online referral • Business development

15. The Paperless Chart

16. Physician Daily Note

17. Physician Daily Note

18. Physician Daily Note

19. Case Manager Referring Physician Web Portal

20. Case Manager Referring Physician Web Portal

21. UNet Interface

22. UNet Interface

23. Online Referral

24. Online Referral

25. Business Development

26. Future Plans • Ongoing education and communication! • Eliminate duplicate data entry • OR Interface – Surginet • Allergies and Problem List Interface • Others • OTTR Mobile • Nursing and Physician Documentation • E-Prescribing • Vascular Composite Allograft • Quality dashboards

27. Lessons Learned • Become closely acquainted with CIO, CMIO, CSIO • Forget your old processes, embrace new ones • Revisit flow charts • Limit customizations until after go live, budget for them • Limit data conversion • Consider UNOS data import • Interfaces • Engage directors in early stages • Validation and signoff • Change control • Develop newsletter for post go-live communication • Physician engagement

28. Lessons Learned • Basic training upfront • Develop a training manual and grid for all employees • Set expectations continuously • Implementation phase, start early • Patient letters • Lists by job function • Dictionaries • Dialysis facilities • Employees • Diagnosis • Providers • Allergies • Problem Lists • Medications